The safety of athletes is always a priority. At January’s NSCA Coaches Conference, there was a session on Exertional Rhabdomyolysis which I thought was very informative. I wanted to share some of the points, made by physician Jeffery Anderson of UCONN, to ensure that athletes and coaches understand the different types of muscle pain and recognize the signs, symptoms, and risks of “Rhabdo” if it occurs.
What is Exertional Rhabdomyolysis?
Exertional Rhabdomyolysis is the breakdown of a muscle cell due to the repetitive stress of exercise. The breakdown of a cell results in the release of the cell’s contents into the bloodstream. When this happens in large enough quantity, or in major muscle groups, like the quadriceps, the result can become life threatening. This breakdown is not the same as the “micro-tears” of protein filaments inside muscle cells after normal strength training, thought to stimulate strength gains. Click Here to learn the difference between micro-tears and muscle tears.
Symptoms of Rhabdomyolysis include extreme joint and muscle pain and swelling, beyond that of DOMS, the soreness occurring 48-72 hours after unaccustomed exercise. Also, cola colored urine is an indicator of intracellular myoglobin being excreted from the body.
The major health risks of rhabdomyolysis include kidney failure, from the clogging effect that myoglobin has on the renal tubules, and cardiac arrhythmia due to hyperkalemia (an excess of potassium in the blood). The risks rhabdomyolysis are exacerbated by dehydration, due to the decreased blood flow to the kidneys.
Lets Make A Case Of “Rhabdo”
Dr. Anderson presented this section (below), and I thought it was a great way of showing what training variables and risk factors are of importance to avoid rhabdomyolysis:
Start with:
o A reconditioned athlete, or
o An athlete coming off of a break, or
o A conditioned athlete performing a new exercise
Add in a high volume of:
o Running (or marching in the Military)
o Resistance Training (especially eccentric exercise)
Add in the following risk factors:
o Heat
o Dehydration
o Recent illness (flu, mono, etc.)
o Metabolic disease (diabetes or thyroid disease)
o Genetic muscle energy storage disease
o Autoimmune or inflammatory disease
o Alcohol or Drugs (statins or amphetamines)
o Sickle Cell Trait (not to be confused with sickle cell anemia)
Mix these items together and you have a high risk for creating exertional rhabdomyolysis.
An Example
In 2011, a significant case of exertional rhabdomyolysis occurred with the University of Iowa Football Team. Thirteen players were hospitalized to be treated for the disorder after a workout including 100 squats (10 sets of 10 repetitions) at 50% 1RM, followed by a series of sled pushes. The squats were reportedly performed within a period of 17 minutes. The NSCA has since suggested that this workload was above and beyond the safe volume recommendations set forth by organization for athletes. For more examples of exertional rhabdomyolysis, Click Here.
Keep Your Athletes Safe
Be aware of the signs and symptoms of exertional rhabdomyolysis to prevent injury, hospitalization, or even death! Pay attention to volume and periodization in training programs with your athletes.
Exertional Rhabdomyolysis is 100% Preventable
Eric McMahon, MEd, RSCC
Minor League Strength and Conditioning Coach
Texas Rangers
Showing posts with label DOMS. Show all posts
Showing posts with label DOMS. Show all posts
Wednesday, February 29, 2012
Monday, March 7, 2011
Avoiding Muscle Soreness: Micro Tears vs Muscle Tears
For professional baseball players, the majority of training occurs in-season while balancing the physical workload of games, practice, and team travel. Spring Training begins early in the year (February-March) and is followed by a 140-162 game regular season lasting through September or later (The 2010 World Series ended on November 1st). It is also not uncommon for players to participate in Winter Leagues in the Dominican Republic, Venezuela, or Arizona during the off-season months. So, given the limited time for physical preparation during the off-season and the high baseball workload throughout the year, how should coaches go about avoiding muscle soreness in players from in-season strength and conditioning work? A simple answer is that coaches must use caution towards high-volume types of training while promoting a variety of fatigue-reducing recovery strategies (i.e. SMFR, contrast bathing, massage, nutrition, and rest). Possessing a better understanding of muscle soreness is helpful in providing guidance to players who do not wish to perform resistance training in fear of becoming sore.
The muscle soreness occurring 24-72 hours following unaccustomed training is referred to by exercise professionals as DOMS (Delayed Onset Muscle Soreness). Symptoms of DOMS may include compromised running mechanics, decreased functional range of motion or stiffness, and reductions in strength and power. Of importance to coaches, baseball performance may be negatively affected by excessive muscle pain, leading to compromised movement patterns in throwing, running, and hitting. A risk of muscle injury in tissues surrounding the prime movers (major muscle groups) is of increased concern from altered baseball mechanics.
It is important to realize that the negative effects of DOMS are temporary, and that the damage to the muscle from training (i.e. overstretching) occurs within the muscle cells (at the level of the myofibril) and not in the muscle tissue as a whole. From a medical perspective, a muscle tearing injury (occurring in an entire muscle) would result in a less pliable, scarring over of the affected tissue (i.e. scar tissue). This is NOT the same tearing of muscle tissue which results in DOMS. The term “micro-tears” is often used to describe the displacement, or tearing, of the myofibril proteins (actin, myosin, troponin, and tropomyosin) which serve as cogs to contract our muscles. Micro-tears are believed to promote muscle growth and gains in strength, leading to the notion that DOMS may be a natural part of the early strength building process.
The most effective method of preventing DOMS is to avoid unaccustomed training through a consistent routine. The complete replacement of myofilament proteins naturally occurs every 7-15 days within muscle cells, allowing for relatively quick recovery and adaptation from exercise induced stress. A consistent training approach which considers the overall workload of professional baseball players (i.e. games, practices, travel, nutrition, and sleep) will allow for the players to gradually improve muscular fitness to achieve a higher training level. A workload of 1-2 strength or power sessions per week in-season is a good starting point to avoid overtraining. Workouts can be divided into lower and upper body days as needed.
Key Points For In-Season Training:
DOMS is most common with strenuous initial training sessions after prolonged inactivity – Perform a consistent routine and do not add new exercise movements in-season.
DOMS is caused by the eccentric, or lowering, portion of exercise movements –
Avoid performing “negatives” or exercises with strenuous deceleration components.
DOMS symptoms temporarily lessen after a warm-up which promotes blood flow –
Recommend that players perform a general cardiovascular warm-up before all activity.
DOMS can negatively impact players physical and psychological performance –
Be cautious in overloading players too soon to avoid poor performance on the field.
Eric McMahon, MEd, CSCS
Minor League Strength and Conditioning Coach
Texas Rangers
The muscle soreness occurring 24-72 hours following unaccustomed training is referred to by exercise professionals as DOMS (Delayed Onset Muscle Soreness). Symptoms of DOMS may include compromised running mechanics, decreased functional range of motion or stiffness, and reductions in strength and power. Of importance to coaches, baseball performance may be negatively affected by excessive muscle pain, leading to compromised movement patterns in throwing, running, and hitting. A risk of muscle injury in tissues surrounding the prime movers (major muscle groups) is of increased concern from altered baseball mechanics.
It is important to realize that the negative effects of DOMS are temporary, and that the damage to the muscle from training (i.e. overstretching) occurs within the muscle cells (at the level of the myofibril) and not in the muscle tissue as a whole. From a medical perspective, a muscle tearing injury (occurring in an entire muscle) would result in a less pliable, scarring over of the affected tissue (i.e. scar tissue). This is NOT the same tearing of muscle tissue which results in DOMS. The term “micro-tears” is often used to describe the displacement, or tearing, of the myofibril proteins (actin, myosin, troponin, and tropomyosin) which serve as cogs to contract our muscles. Micro-tears are believed to promote muscle growth and gains in strength, leading to the notion that DOMS may be a natural part of the early strength building process.
The most effective method of preventing DOMS is to avoid unaccustomed training through a consistent routine. The complete replacement of myofilament proteins naturally occurs every 7-15 days within muscle cells, allowing for relatively quick recovery and adaptation from exercise induced stress. A consistent training approach which considers the overall workload of professional baseball players (i.e. games, practices, travel, nutrition, and sleep) will allow for the players to gradually improve muscular fitness to achieve a higher training level. A workload of 1-2 strength or power sessions per week in-season is a good starting point to avoid overtraining. Workouts can be divided into lower and upper body days as needed.
Key Points For In-Season Training:
DOMS is most common with strenuous initial training sessions after prolonged inactivity – Perform a consistent routine and do not add new exercise movements in-season.
DOMS is caused by the eccentric, or lowering, portion of exercise movements –
Avoid performing “negatives” or exercises with strenuous deceleration components.
DOMS symptoms temporarily lessen after a warm-up which promotes blood flow –
Recommend that players perform a general cardiovascular warm-up before all activity.
DOMS can negatively impact players physical and psychological performance –
Be cautious in overloading players too soon to avoid poor performance on the field.
Eric McMahon, MEd, CSCS
Minor League Strength and Conditioning Coach
Texas Rangers
Tuesday, December 21, 2010
Are You Hurt or Just Sore?
When we first begin a training program, we see a lot of improvement early. Things then level off and the rate of improvement slows down. The initial sky-rocket of improvement results from the brain learning how to coordinate the movements and recruit the muscles and energy needed to perform the new activities. This typically happens over the initial 1-2 weeks. The next 3-5 weeks are the slower, more physical adaptations that the body produces as a result of the specific activity (i.e. increased cardiac output, increased oxygen transport and use by the cells, or increased muscle fiber size, etc).
Whether you are a seasoned athlete or a beginner, whenever a new training activity is started, a common body reaction is known as “Delayed Onset Muscle Soreness” (DOMS). This is soreness that occurs 24-48 hours after activity and generally resolves within 3-7 days. Many studies have been performed to try and determine a cure for DOMS. Unfortunately, it is a natural response and a typical indication of when you’ve performed something new. The symptoms of DOMS can be decreased by performing a proper warm-up. When the muscles are “warm”, they are more pliable and responsive to activity. The best remedy for this normal muscle reaction, however, is to repeat the exercise activity. This “Repeated Bout Effect” is part of the adaptation process. Too often, we experience soreness and then wait a prolonged period before attempting to resume activity. By that time, the body considers the activity to be “new” again which results in more soreness. We then put off activity again or quit all together.
In order to see results from any training program, you have to challenge the body to a degree of stress that is greater than what it is normally accustomed. Too little, and you will see minimal or no improvement at all. Too much, may result in overtraining or potential injury. But, ultimately how much challenge your body can take, depends on your current fitness status. If you are just beginning a training program or you have had a long break, then you should start slower and with lower intensities to give your body time to adapt to the new stresses. If you are more fit, your body can handle greater challenges.
A couple of questions that I am asked frequently are “How can I tell whether what I am feeling is ‘normal soreness’ or the result of an injury?” and “How can I maintain my fitness when I am injured?”.
First, some typical symptoms that would signify an injury are:
- Swelling
- Numbness, tingling, or loss of joint motion
- Warmth to the touch
- Discoloration or bruising
- A twinge during a workout that becomes worse later
- Limping
- Pain that lasts more that 2-3 days
- Pain that increases over time
- Pain that interferes with normal activities
Second, an injury doesn’t have to sideline you for good. By following a few simple recommendations, it is possible to continue exercising, maintain your fitness level, and heal properly at the same time:
1. Listen to your doctor! - Your physician can provide you with appropriate exercises that can be done to promote healing and fitness. Most importantly, he/she can provide you with advice to avoid further problems.
2. Modify your workouts so that they don’t include the injured area. – For an upper body injury, focus on lower body training. For lower body injuries, focus on the upper body or maybe perform exercises while sitting. High impact activities (i.e. running) can be modified to low or no impact activities (i.e. stationary bike, swimming, etc).
3. If the injury continues to hurt, continue to modify your activities until you find something that doesn’t hurt. – Increased pain or swelling are signs of continued stress and occasionally, activity may need to be discontinued altogether in order to allow some healing first.
David Yeager, ATC, CSCS
Co-Founder
BaseballStrengthCoaching.com
Whether you are a seasoned athlete or a beginner, whenever a new training activity is started, a common body reaction is known as “Delayed Onset Muscle Soreness” (DOMS). This is soreness that occurs 24-48 hours after activity and generally resolves within 3-7 days. Many studies have been performed to try and determine a cure for DOMS. Unfortunately, it is a natural response and a typical indication of when you’ve performed something new. The symptoms of DOMS can be decreased by performing a proper warm-up. When the muscles are “warm”, they are more pliable and responsive to activity. The best remedy for this normal muscle reaction, however, is to repeat the exercise activity. This “Repeated Bout Effect” is part of the adaptation process. Too often, we experience soreness and then wait a prolonged period before attempting to resume activity. By that time, the body considers the activity to be “new” again which results in more soreness. We then put off activity again or quit all together.
In order to see results from any training program, you have to challenge the body to a degree of stress that is greater than what it is normally accustomed. Too little, and you will see minimal or no improvement at all. Too much, may result in overtraining or potential injury. But, ultimately how much challenge your body can take, depends on your current fitness status. If you are just beginning a training program or you have had a long break, then you should start slower and with lower intensities to give your body time to adapt to the new stresses. If you are more fit, your body can handle greater challenges.
A couple of questions that I am asked frequently are “How can I tell whether what I am feeling is ‘normal soreness’ or the result of an injury?” and “How can I maintain my fitness when I am injured?”.
First, some typical symptoms that would signify an injury are:
- Swelling
- Numbness, tingling, or loss of joint motion
- Warmth to the touch
- Discoloration or bruising
- A twinge during a workout that becomes worse later
- Limping
- Pain that lasts more that 2-3 days
- Pain that increases over time
- Pain that interferes with normal activities
Second, an injury doesn’t have to sideline you for good. By following a few simple recommendations, it is possible to continue exercising, maintain your fitness level, and heal properly at the same time:
1. Listen to your doctor! - Your physician can provide you with appropriate exercises that can be done to promote healing and fitness. Most importantly, he/she can provide you with advice to avoid further problems.
2. Modify your workouts so that they don’t include the injured area. – For an upper body injury, focus on lower body training. For lower body injuries, focus on the upper body or maybe perform exercises while sitting. High impact activities (i.e. running) can be modified to low or no impact activities (i.e. stationary bike, swimming, etc).
3. If the injury continues to hurt, continue to modify your activities until you find something that doesn’t hurt. – Increased pain or swelling are signs of continued stress and occasionally, activity may need to be discontinued altogether in order to allow some healing first.
David Yeager, ATC, CSCS
Co-Founder
BaseballStrengthCoaching.com
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