Exertional rhabdomyolysis in a collegiate american football player after preventive cold-water immersion: a case report
Kahanov L, Eberman LE, Wasik M, Alvey T
Journal of athletic training · 9 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Case report (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2012-03-01 · J Athl Train · vol. 47 · issue 2 · pp. 228–232
- Publisher
- National Athletic Trainers' Association
- Cited
- 20 citations · more than 80% of similar papers · 1.1× the field average
- References
- 49 works
- Access
- Open access (repository copy)
- Research areas
- Muscle and Compartmental Disorders · Exercise and Physiological Responses · Cardiovascular Effects of Exercise
- Keywords
- Medicine, Rhabdomyolysis, Heat illness, Creatine kinase, Football, Fluid replacement, Physical therapy, Anesthesia, Internal medicine
- MeSH
- humans, muscle cramp, rhabdomyolysis, creatine kinase, immersion, universities, football, male, cold temperature, physical exertion, young adult, athletes
4 authors
From US
- Leamor Kahanov · correspondingIndiana State University
- Lindsey E. EbermanIndiana State University
- Mitchell WasikIndiana State University
- Thurman AlveyUnion Hospital
Abstract
Objective
To describe a case of exertional rhabdomyolysis in a collegiate American football player after preventive coldwater immersion.
Background
A healthy man (19 years old) participated in full-contact football practice followed by conditioning (2.5 hours). After practice, he entered a coach-mandated postpractice cold-water immersion and had no signs of heat illness before developing leg cramps, for which he presented to the athletic training staff. After 10 minutes of repeated stretching, massage, and replacement of electrolyte-filled fluids, he was transported to the emergency room. Laboratory tests indicated a creatine kinase (CK) level of 2545 IU/L (normal range, 45-260 IU/L), CK-myoglobin fraction of 8.5 ng/mL (normal < 6.7 ng/mL), and CK-myoglobin relative index of 30% (normal range, 25%-30%). Myoglobin was measured at 499 ng/mL (normal = 80 ng/mL). The attending physician treated the athlete with intravenous fluids.
Differential diagnosis
Exercise-associated muscle cramps, dehydration, exertional rhabdomyolysis.
Treatment
The patient was treated with rest and rehydration. One week after the incident, he began biking and swimming. Eighteen days later, the patient continued to demonstrate elevated CK levels (527 IU/L) but described no other symptoms and was allowed to return to football practice as tolerated. Two months after the incident, his CK level remained high (1900 IU/L).
Uniqueness
The athlete demonstrated no signs of heat illness upon entering the cold-water immersion but experienced severe leg cramping after immersion, resulting in a diagnosis of exertional rhabdomyolysis. Previously described cases have not linked cold-water immersion with the pathogenesis of rhabdomyolysis.
Conclusions
In this football player, CK levels appeared to be a poor indicator of rhabdomyolysis. Our patient demonstrated no other signs of the illness weeks after the incident, yet his elevated CK levels persisted. Cold-water immersion immediately after exercise should be monitored by the athletic training staff and may not be appropriate to prevent muscle damage, given the lack of supporting evidence.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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