Exertional Rhabdomyolysis

[1972Shocker]

I have never heard of exertional rhabdomyolysis but apparently 6 Butler County softball players were hospitalized with the condition following a tough workout at on the El Dorado Lake Dam.

The main danger from rhabdomyolysis is that when too much muscle tissue breaks down, it can clog up the kidneys and cause renal failure. Nothing to take lightly.

As hard as many college athletes work out I am a little surpised it isn't more common. In any case, it's probably something all coaches, training staff should be aware of I would think. Not sure how you know when you have pushed the envelope too far or what conditions are most likely to trigger this condition.

Read more here: http://www.kansas.com/sports/college...#storylink=cpy

[MoValley John]

I've heard of it. Anyone coaching, even at the juco level should know of it, I'm not buying the coaches ignorance. He overworked them, period. It bit him in the ass and could have killed some of his girls. Sorry to be a sick about it, but that coach knew better.

[Shocker1976]

I've heard of it. Anyone coaching, even at the juco level should know of it, I'm not buying the coaches ignorance. He overworked them, period. It bit him in the ass and could have killed some of his girls. Sorry to be a sick about it, but that coach knew better.

Yes coaches should know but I am not certain they are aware of the possible impact of poorly conditioned athletes engaging in strenuous exercise. When I was a kid in Kansas all of my high school coaches (especially football) engaged in "disciplinary" actions that could have lead to ER.

Three key risk factors (especially in early season training with poorly conditioned athletes) to watch for - hot and humid conditions, dehydration and inadequate recovery time.

[MoValley John]

Yes coaches should know but I am not certain they are aware of the possible impact of poorly conditioned athletes engaging in strenuous exercise. When I was a kid in Kansas all of my high school coaches (especially football) engaged in "disciplinary" actions that could have lead to ER.

Three key risk factors (especially in early season training with poorly conditioned athletes) to watch for - hot and humid conditions, dehydration and inadequate recovery time.

I grew up in the same era. Wrestlers literally killed themselves to make weight, football players suffered concussions and were right back in because "they just got their bell rung a bit." I remember running stairs and two a days in hundred degree heat. Today, it's different. That coach should have known better. The stuff has been drilled in his head, he chose to ignore the risks of his "training regimen." Even youth coaches are given mandatory courses on concussion awareness. They must learn warning signs for dehydration and heat injury. I can't even coach youth baseball without a certificate showing I completed the courses. Today, high school, juco and college coaches are all well versed in concussion, overexertion and heat related injuries. Those that don't take it seriously shouldn't be coaching.

Exertional rhyabdomyolysis is a combination of over work of the muscles and dehydration. It can happen, but when two, three, four or six people suffer from it from the same team workout, it's the coaches fault, period. Things like compartment syndrome and exertional rhyabdomyolysis are more common in running, weightlifting and other individual activities, those athletes sometimes ignore warning signs and may not hydrate properly. In team sports, a player might slip through the cracks, but when several do, and when several get sick, they didn't slip through the cracks, it was the coach.

Why would a softball coach think it was a good idea to run a bunch of girls up and down the face of a dam? Stupid.

[shocka khan]

Yes coaches should know but I am not certain they are aware of the possible impact of poorly conditioned athletes engaging in strenuous exercise. When I was a kid in Kansas all of my high school coaches (especially football) engaged in "disciplinary" actions that could have lead to ER.

Three key risk factors (especially in early season training with poorly conditioned athletes) to watch for - hot and humid conditions, dehydration and inadequate recovery time.

Reminds me of the story (I was never able to verify, but can attest to his poor temper) of our head football/assistant wrestling coach who reportedly dangled a student out of a 3rd floor window.

And I would believe it why? Because he hoisted me up by my collar and pinned me against a wall during wrestling practice while threatening me. I think he was really pissed off, but I don't think he would have lasted long in this era. It's not acceptable for teachers to go all ballistic these days.

[shocka khan]

Why would a softball coach think it was a good idea to run a bunch of girls up and down the face of a dam? Stupid.

Sounds like a DAM good question to me. And speaking about slipping through cracks, how about slipping through cracks and twisting an ankle or worse yet, slipping on a rock and splitting their heads open.

Coach wasn't too concerned about the safety of his players when he designed the drill either, which means he is probably pretty DAM stupid.

[SHOXAAC]

I've heard of it. Anyone coaching, even at the juco level should know of it, I'm not buying the coaches ignorance. He overworked them, period. It bit him in the ass and could have killed some of his girls. Sorry to be a sick about it, but that coach knew better.

"Could have killed some of his girls" is extreme. Kidney failure is nothing to sneeze at, but ER would have to exist for an extended period of time for that to happen. ER is not a clearly understood occurrence among college athletics according to the literature available. It is slowly happening more however, so education among high school and college athletics will increase. Two major factors were stacked against the Butler softball program. One, the strenuous workout came after the period of the off-season, where the players are beginning their conditioning process for the upcoming season. Two, there was an obvious lack of proper hydration. I would be careful to vilify the coach. My questions would include is this type of workout new, or has it been a part of his normal conditioning program. Him saying he has never heard of ER before is consistent with many coaches. The microscope is on him now to see his management of conditioning in the future.

[SHOXAAC]

Sounds like a DAM good question to me. And speaking about slipping through cracks, how about slipping through cracks and twisting an ankle or worse yet, slipping on a rock and splitting their heads open.

Coach wasn't too concerned about the safety of his players when he designed the drill either, which means he is probably pretty DAM stupid.

I don't know this coach from spit. I do know that athlete training and conditioning has changed drastically. Cross-training strategies are used by about every athletic program on about every level. According to the Eagle article the coach had the players walk the incline first, then jog up and walk it backwards four times. It's a different way to train and condition athletes. He also was quoted as saying "in hindsight, we've all learned a lesson." Glass houses are very unstable.

[RoyalShock]

All colleges athletic programs are going to have to move in a direction where all off-the-field/court workouts are managed by the strength and conditioning coach. Put the players in the hands of an expert. And if they don't have one, that's why they need one.

[shoxlax]

I've got to step in here.

Doug Chance is a good friend of mine, so I'm biased, but to say this workout was some Jody Adams II scheme is ridiculous. Thousands of athletes have trained on that hill including several Shockers. It is a very similar workout to what WSU uses with Cessna Stadium. Softball season starts in the fall so conditioning peak time is now.

Doug's reputation as a coach, developer of talent, and life mentor to these girls precedes him. He is a role model on and off the field. The workouts are approved by the strength and conditioning coach and AD at BuCo and he would never do anything irrational or unauthorized. BuCo softball has very little budget so Doug has to be coach, recruiter, spiritual leader, mom and dad to these kids. I would not want my daughter playing for anyone else if she was a softball player. The comments on this board from some of you are so out of touch with reality that it's almost laughable. Go see what Kerry Rosenboom or his assistant does to get the kids conditioned and get back with me. Kerry is the best in the business too.
Why these girls all got this from what is a routine workout for all remains a mystery but don't blame the coach.

[Art Bunch]

echoing the statements of Shoxlax. Not the fault of the coach, he took the appropriate action once the problem became known. Anyone who has been involved with young athletes at any level has experienced issues with kids that do not take care of themselves prior to a practice or a workout in hot and humid conditions. The problem has only gotten worse as lifestyles have changed and kids have gone from playing outdoors most of the time to hanging out in front a screen playing video games. And girls are no different.

You guys could use an education on this softball program. Coach Chance took a weak, downtrodden program and made it into one of the nation's best juco softball teams. His program has been dominant for several years now and one big reason is conditioning. His players pitch, play d and hit a warehouse full of home runs. The speed and power they play with comes from athletes that are highly conditioned. Chance is passionate about the game, about playing it right and about setting these young ladies up to succeed.

Having any player get rhabdo is a bad thing, but if the workout was unethical or abusive, we would have seen 20+ players affected. So dial it back a few notches MVJ and Shocka Khan. We have enough "mob rule" in this country right now without you guys getting something stirred up on Shockernet.

[MoValley John]

I've got to step in here.

Doug Chance is a good friend of mine, so I'm biased, but to say this workout was some Jody Adams II scheme is ridiculous. Thousands of athletes have trained on that hill including several Shockers. It is a very similar workout to what WSU uses with Cessna Stadium. Softball season starts in the fall so conditioning peak time is now.

Doug's reputation as a coach, developer of talent, and life mentor to these girls precedes him. He is a role model on and off the field. The workouts are approved by the strength and conditioning coach and AD at BuCo and he would never do anything irrational or unauthorized. BuCo softball has very little budget so Doug has to be coach, recruiter, spiritual leader, conditioning czar, mom and dad to these kids. I would not want my daughter playing for anyone else if she was a softball player. The comments on this board from some of you are so out of touch with reality that it's almost laughable. Go see what Kerry Rosenboom or his assistant does to get the kids conditioned and get back with me. Kerry is the best in the business too.
Why these girls all got this from what is a routine workout for all remains a mystery but don't blame the coach.

That's all fine and good, but he failed in one serious yet simple manner. Hydration. Good guy or not, you push fluids. If that many girls went down from that workout, he didn't push fluids. That is his job and he's lucky none of them are in renal failure. As my kid's football coach says, during two a days, if you dont have to piss half way through practice, you aren't drinking enough. He's a high school coach and yes, they make sure the kids are drinking and peeing.

[Art Bunch]

That's all fine and good, but he failed in one serious yet simple manner. Hydration. Good guy or not, you push fluids. If that many girls went down from that workout, he didn't push fluids. That is his job and he's lucky none of them are in renal failure. As my kid's football coach says, during two a days, if you dont have to piss half way through practice, you aren't drinking enough. He's a high school coach and yes, they make sure the kids are drinking and peeing.

So you have knowledge that he didn't push fluids during the workout? Apparently you didn't hear me when I said to dial down the accusations because you don't know what you are talking about. And here you have just proven my point.

The issue with hydration is not DURING the workout, it's BEFORE the workout. Have you noticed how your kid's football coach is telling his players to drink water all day long? That's because if someone starts working out and gets a headache or has other issues related to lack of hydration, it's TOO LATE. A coach can push water all he wants but it doesn't make that much of a difference. The responsibility is on the athlete to keep themselves hydrated long before the workout begins.

[1972Shocker]

I've been doing a little research on exercise-induced rhabdomyolysis (ER) as I was totally unfamiliar with this condition. These sessions at the El Dorado dam were held at 6 a.m. so heat and humidity should not have been too much of a problem at that time of the day. However, lack of adequate hydration, before, during and after the exercise could have been a factor. I could see where there would be very little hydration going on pre-exercise and taking Coach Chance at his word that he was not aware of ER he may very well have not provided adequate hydration during or encouraged hydration after the workout.

Also, I read a couple of articles that reported negatives (eccentric exercises) seem to be especially associated with ER. Negatives are exercises that work the muscle while it is lengthening. I'm thinking that the walking backwards down the incline might be a good example of a negative or eccentric exercise as the calf muscles would definitely be lengthening while descending the incline backwards plus it is working the muscle in a way that those muscles aren't particularly accustomed to.

While MVJ may be correct in his assertion that Coaches should be aware of ER I am not at all sure that is actually the case although I have no way of really knowing that one way or the other.

[Quick Pitch]

Here are the facts that I gleaned from all the news stories:
They ran the dam at 6:00 AM. So heat was not an issue.
There was an athletic trainer there with water at the top of the dam and the bottom.
The team went through a 9 week summer strength and conditioning program so they were in shape.
They only went up the dam 4 times yet most of the teams there do 10 - 12 times up the dam so 4 times was not excessive.
Most cases go undetected and the athlete recovers without treatment, but after one case they had several more tested as a precaution. So if they had not
checked the first kid, the others would have simply passed it off as muscle soreness and recovered without medical attention.

It's easy to accuse someone of negligence and malice if you don't have all of the facts, but to do so is negligent and malicious.