Lack of Caution Could Cause Muscle Breakdown and Acute Kidney Failure

Rhabdomyolysis – or “rhabdo” as commonly referred to among health care professionals – is a condition first observed in London during the Blitz of World War II.

Bombs fell day and night, destroying buildings and trapping Londoners in the rubble. People trapped in the rubble sustained severe crush injuries; treating physicians observed that survivors who recovered from shock often succumbed to complications associated with kidney failure. Thus, physicians described the condition as “crush syndrome.”

Today, the medical community has a clearer understanding of rhabdo, wherein muscle tissue breaks down from one of many possible causes, such as:

  • Overexertion (such as from negligent personal training)
  • Traumatic injury
  • Infection
  • Heart attack
  • Stroke
  • Drug and alcohol abuse
  • Side effects from the use of prescription medications

As the muscle tissue breaks down, it is released into the bloodstream and the kidneys are unable to process it. As a result, the injured person suffers from risk of acute kidney failure.

Overexertion: Exercise-Induced Rhabdo

Of the rhabdomyolysis causes, one of the most common is overexertion brought on by exercise. Research shows that exercise-induced rhabdo is fairly common among military recruits and athletes, who often engage in strenuous exercise to the point of overexertion. In fact, in 2007, there were 159 rhabdo cases in the military – 34 of which involved hospital admissions.

Classic symptoms of exercise-induced rhabdo include weakness, muscle pain and brown urine accompanied by a history of heavy physical exertion. It’s unclear whether some people are more susceptible than others. It’s also unclear whether there exists a threshold of exertion triggering muscle tissue breakdown.

One study indicates that acute kidney failure occurs in 17 percent to 40 percent of patients with rhabdo; however, another study suggests that acute kidney failure occurs, rarely if at all, in exercise-induced rhabdo. Nonetheless, the same study encourages hospital admission to prevent the condition from getting worse.

The Legal Implications: Duties of Athletic Trainers

It is important for trainers to properly assess their trainee’s physical condition prior to working out, especially if the trainee is to engage in high-intensity exercise, or the trainee runs the risk of sustaining serious injury.

A lawsuit brought by former sailor Makimba Mimms against a gym in Virginia alleged that a high-intensity training session in 2005 caused exercise-induced rhabdo. According to the complaint, “The defendants, in concert with one another, entreated, promoted, encouraged and coached Mr. Mimms to perform and endure the extreme exertion prescribed by the CrossFit regimen.” (CrossFit is the brand name of a particular high-intensity workout program.)

Mimms’s attorney also stated that the defendants failed to exercise diligence in having him go through the workout when he was unprepared for it, and that as a result he has “incurred and will in the future incur medical and related expenses, [and] has sustained permanent disability.”

To be fair, sole responsibility cannot fall on the trainer; the athlete or trainee must be aware of his or her own limitations, and must not continue to exercise if something is obviously wrong. But if a trainer fails to assess the trainee’s physical condition and encourages high-intensity physical activity in spite of warning signs or red flags, there’s the question whether the trainer was negligent if the trainee suffers from exercise-induced rhabdo.

Prognosis of Exercise-Induced Rhabdo Injuries

If treated promptly and correctly, exercise-induced rhabdo is not likely to lead to acute kidney failure, but kidney failure is still possible if proper treatment is not given or treatment is delayed.

In addition to muscle pain, anyone suffering from rhabdo has the possibility of a long-term disability. The best course of action is to be prudent and reasonable: if a trainer or gym pushes too far, too fast, it’s best to know one’s limitations. If you have been injured by the negligence of an athletic trainer, consult with a personal injury attorney in your area for an evaluation of your case.

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