More on rhabdomyolysis
We've been talking to experts, and let's distill it all into a few bullet points.
-- It's not common.
-- It's not rare, either.
-- It is unusual for well-conditioned athletes to fall victim to it.
-- It's usually associated with trauma, side effects from medications and existing diseases.
-- Though he's likely recovered from last week's bout, Haynesworth isn't any more likely than his teammates to become stricken with rhabdomyolysis again.
"It's probably more common than we think, but we don't test for it," said Dr. Bryan Becker, president of the National Kidney Foundation. "There's a lot of causes, a lot of things associated with it. Obviously, excess exercise in the heat is one and that was documented many years ago in the military.
"There are all kinds of infections and drugs that can be associated with it. For an athlete, in summer time weather who goes out and does a lot of things, some individuals for whatever reason may have a change in their muscle metabolism and it sets into motion the muscle destruction. Those individuals just need a lot of rehydration. This tends to resolve on its own, as long as you don't go back immediately to the same activity, if you give it a day or two."
Haynesworth first cut short a practice last Tuesday and Coach Mike Shanahan said it was due to an illness. When Haynesworth missed practice Wednesday, Shanahan said it might have been related to the heat. On Thursday, Shanahan said Haynesworth was bothered by headaches, a characterization that prompted Haynesworth's colorful post-game comments on Saturday night. Haynesworth revealed at that time he'd also experienced dizziness and vomiting.
While many sports fans might be learning of rhabdomyolysis for the first time, Becker suggested it might be under-diagnosed in athletes. Because of the physical contact and hot practices in some sports, athletes can be susceptible to the condition. But because sports teams' doctors often specialize in orthopedics and not internal medicine, the diagnosis can be a difficult one.
"This is probably a more common condition among players in the NFL than people would recognize," Becker said, "but it's just not tested for. ...Athletes are susceptible if they have repeated trauma in the context of their athletic pursuit, but unless they have other symptoms, we probably don't necessarily look for it as much."
Citing a 2005 study, Dr. Lynne P. Yao, chairman-elect of the National Kidney Foundation's board of directors, said there are as many as 26,000 cases of rhabdomyolysis a year, and that it has historically linked with new military recruits reporting to boot camp.
"Training camp, I would imagine would be similar to Army recruits going out and exercising for the first time in the summer," Yao said. "That's a very analogous situation."
While rhabdomyolysis can be fatal in some instances, both Becker and Yao agree that early treatment can usually resolve the problems quickly. The best treatment, they say, is aggressive hydration, which cleanses the kidneys.
"When muscle is damaged, a protein pigment called myoglobin is released into the bloodstream and filtered out of the body by the kidneys," Yao explained. "Myoglobin breaks down into potentially harmful compounds.
"Exertion and hot conditions exacerbate the problem, but in most mild cases people recover in a week or two," Yao said. "It is treated with aggressive hydration to dilute the urine and flush the myoglobin from the kidneys."
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