13 Iowa Football Players with Rhabdomyolysis: A Case of Coaching Incompetence

Thirteen University of Iowa football players were recently hospitalized for rhabdomyolysis caused by extreme physical exertion. Symptoms of the ailment include dark-colored urine, fatigue, muscle weakness, and muscle tenderness. Although the athletes have since been released from the hospital, information has not been released as to whether any permanent injury has resulted.

Rhabdomyolysis is a serious medical problem. It occurs when myoglobin leaks out of muscle cells due alcoholism, crush injuries, heatstroke, extreme physical exertion and other causes. Just as hemoglobin in red blood cells carries oxygen to the muscles and other body tissue to provide energy through oxidation of carbohydrates and fats, myoglobin carries oxygen within the muscle cells to the mitochondria, which are the oxidative energy-production units within the cells. Myoglobin is a large molecule and, when it leaks into the blood stream, it travels to the kidneys for removal. However, the myoglobin molecules are too large for the kidneys to readily clear, and can easily block the kidney’s filtration system. In addition, myoglobin breaks down into potentially harmful compounds. Permanent kidney damage or even kidney failure may result, which may require lifelong dialysis or a kidney transplant. See the National Institutes of Health for further information on rhabdomyolysis.

Extreme muscle soreness brings with it with a significant risk for rhabdomyolysis. Virtually all muscle soreness is attributable to the eccentric phase of exercise, which occurs when the muscle is lengthened while resisting. This occurs in the lowering phase of every weightlifting or calisthenic repetition, and also in the initial ground-contact phase of running, particularly downhill running. It also occurs during the deceleration phase of sports activities, as in braking for directional change and bringing a moving limb to a halt.

There is no excuse for any strength and conditioning coach to induce rhabdomyolysis. The press has reported that the workouts of the Iowa football players were extremely severe and may have been used as a punishment. One athlete said, “I had to squat 240 pounds 100 times and it was timed. I can’t walk and I fell down the stairs.” Another one said, “Hands Down the hardest workout I’ve ever had in my life!”. In addition, the severe workout occurred just after the athletes returned from winter break, during which most of them had not engaged in heavy resistance exercise. That made them particularly vulnerable to extreme muscle soreness and rhabdomyolysis.

Such an approach is totally unnecessary. Firstly, exercise should never be used as a punishment. Secondly, any knowledgeable and competent coach has to be aware that any exercise regimen that induces extreme muscle soreness presents a significant risk for rhabdomyolysis. Muscle soreness is not a prerequisite for muscle strengthening! The most effective way to increase strength is to start with light resistance and gradually increase the weight lifted over a period of time as the muscles strengthen. High repetitions are totally unnecessary for strength and power athletes like football players. Muscle fatigue following a workout is expected and desirable within limits, but muscle soreness is unnecessary and can actually slow down progress in strength development.

An extensive article and interview of coaches, doctors, and a parent of one of the players is available on the Internet.

FDA Warns That Statin Drugs Can Cause Muscle Damage

Statins, the most widely prescribed medications in the world, have been widely recognized to cause muscle pain and weakness in a small percentage of users. Now, the U.S. Food and Drug Administration has issued a warning that Zocor, a popular version of simvastatin, can cause muscle damage, particularly when used in its highest approved dosage (80 mg). What makes this even more dangerous is that muscle damage results in the release into the blood stream of large proteins that are not easily flushed through the kidneys. This can result in kidney failure and death. Admittedly, fatal problems due to statins are highly unlikely. Nevertheless, the problem is very serious for susceptible individuals. The 80 mg dose should be avoided, if possible, and patients must be encouraged to lower their total and LDL cholesterol by more natural means (e.g. weight control, exercise, reduced consumption of saturated fat and cholesterol). It is unfortunate that so many people see statins as the easy way out. Who wants to control one's eating and activity level when a pill will do? Mens-fitness-and-health.com believes that MOST people can keep their total and LDL cholesterol levels within recommended ranges if they follow a healthy lifestyle. Drugs should only be used as a last resort. See our natural methods for reducing total and LDL cholesterol levels.