Dehydration, Cramping, and Exertional Rhabdomyolysis: A Case Report with Suggestions for Recovery

in Journal of Sport Rehabilitation
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Objective:

We present a case of severe dehydration, muscle cramping, and rhabdomyolysis in a high school football player followed by a suggested program for gradual return to play.

Background:

A 16-year-old male football player (body mass = 69.1 kg, height = 175.3 cm) reported to the ATC after the morning session on the second day of two-a-days complaining of severe muscle cramping.

Differential Diagnosis:

The initial assessment included severe dehydration and exercise-induced muscle cramps. The differential diagnosis was severe dehydration, exertional rhabdomyolysis, or myositis. CK testing revealed elevated levels indicating mild rhabdomyolysis.

Treatment:

The emergency department administered 8 L of intravenous (IV) fluid within the 48-hr hospitalization period, followed by gradual return to activity.

Uniqueness:

To our knowledge, no reports of exertional rhabdomyolysis in an adolescent football player exist. In this case, a high school quarterback with a previous history of heat-related cramping succumbed to severe dehydration and exertional rhabdomyolysis during noncontact preseason practice. We provide suggestions for return to activity following exertional rhabdomyolysis.

Michelle Cleary, Daniel Ruiz, and Lindsey Eberman are with Florida International University, College of Nursing and Health Sciences, Miami, FL. Israel Mitchell is with Belen Jesuit Preparatory School, and Helen Binkley is with Middle Tennessee State University. E-mail: clearym@fiu.edu.