Rhabdomyolysis is the breakdown of muscle fibers resulting in leakage into the bloodstream. It occurs when myoglobin, a protein found in muscle tissue, is released into the bloodstream, causing kidney damage. A wave of rhabdomyolysis among high school athletes, particularly football players, has elicited concern. Some people believe that creatine, a sports supplement, may have contributed to these cases. However, heatstroke and sickle cell trait are also factors.
Heat
Heatstroke is one of the most common risk factors contributing to the development of rhabdomyolysis, says PubMed Health. High school football players commonly practice in elevated temperatures and may lack proper hydration. High school football coaches are now taking precautionary measures to reduce the risk of heatstroke among players. Practicing indoors when outdoor temperatures are too high and taking frequent breaks to rehydrate can help reduce heat-induced rhabdomyolysis.
Creatine
Creatine is a protein building block produced by your liver. It is stored in your muscles and plays an important role in muscle energy. It is a common sports supplement taken by athletes to enhance performance. Creatine supplementation increases the risk of rhabdomyolysis, especially at doses that exceed 5 grams per day. There are no reports of rhabdomyolysis associated with recommended doses. The typical maintenance dose for creatine is 2 grams per day, according to the University of Maryland Medical Center.
Sickle Cell Trait
Sickle cell trait refers to a genetic condition of having one gene for normal hemoglobin and one for sickle hemoglobin, which is an iron-storing protein found in your red blood cells. It is a life-long condition, but does not turn into sickle cell disease. However, overexertion can cause serious complications in athletes with the sickle cell trait. The January 2010 issue of the journal "Medicine and Science in Sports and Exercise," documents the case of a 19-year-old football player with sickle cell trait who died after developing rhabdomyolysis during practice. Precautions must be taken to avoid complications in athletes with sickle cell trait.
Considerations
Rhabdomyolysis symptoms include muscle weakness, abnormal urine color and fatigue. Creatine should only be taken under the direction of a physician to reduce associated risks. Researchers at the Office of the Medical Examiner in Texas recommend screening athletes for the sickle cell trait as a precaution to prevent rhabdomyolysis. Consult your sports doctor if you think you may be at risk for developing rhabdomyolysis.
References
- PubMed Health: Rhabdomyolysis
- University of Maryland Medical Center: Creatine
- Medicine and Science in Sports and Exercise: Sickle Cell Trait and Fatal Rhabdomyolysis in Football Training: a Case Study
- Oregon Public Heath Division: Clust of Compartment Syndrome and Rhabdomolysis Among McMinnville High School Football Team
