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 hydration. Show all posts
Showing posts with label hydration. Show all posts
Wednesday, February 29, 2012
Sunday, July 24, 2011
It Is Brutal Hot Outside Right Now!
Just a Friendly Reminder. . .
It is brutal hot outside right now.
CNN reports that the “heat index values” – how it feels outside – have been running over 125 degrees Fahrenheit in the worst areas. The heat index scale is designed to describe how intense heat feels, which includes factors such as humidity.
In working multiple camps this summer – the athletes have not been prepared for this heat. Most of you have already heard all of this, but now would be a nice time for a friendly reminder. As the athletic trainer for these camps, I am not nearly as active as the athletes. However, each day I have easily taken down a gallon of water and a few cups of some sports drink.
Here are some examples of stories that I have heard over the camps:
- Have you drank enough today? “I drank a lot of water. Two or three cups.”
- When’s the last time you have used the bathroom? “”First thing this morning.”
- Have you eaten anything? “I had a couple bananas.”
These are never good signs when it is six o’clock in the evening and people start cramping up during activity.
These are just a few symptoms for dehydration:
- Headache
- Fatigue
- Nausea
- Dizziness
- Decreases bathroom breaks
- Decreased sweating
If your body is telling you it is thirsty, you are already a little behind when it comes to hydration. Another great way to check your hydration levels is to check the color of your urine. Yes, it sounds pretty nasty, but it is an excellent way to take a quick measure of your hydration levels.
If your urine is pale like lemonade, that’s a sign of proper hydration. If it’s dark like apple sauce, you need more fluids. With proper hydration and a sound diet, most of the time, you will be in good shape.
Use a water bottle that you brought to be your guide through the process. For example – I carry around a half gallon container (yes I get made fun of) throughout the day. It serves as my reference for that days H20 intake. Plus, I would not always bank on water being in the dugout for every game in the summer.
This is information that you should have heard before this point in time. However, each year around this time, the athletes tend to struggle and need a little refresher.
Enjoy what is left of your summer and stay cool.
Chris Ham, MSA, ATC, CES
Athletic Trainer
Vanderbilt University Baseball
It is brutal hot outside right now.
CNN reports that the “heat index values” – how it feels outside – have been running over 125 degrees Fahrenheit in the worst areas. The heat index scale is designed to describe how intense heat feels, which includes factors such as humidity.
In working multiple camps this summer – the athletes have not been prepared for this heat. Most of you have already heard all of this, but now would be a nice time for a friendly reminder. As the athletic trainer for these camps, I am not nearly as active as the athletes. However, each day I have easily taken down a gallon of water and a few cups of some sports drink.
Here are some examples of stories that I have heard over the camps:
- Have you drank enough today? “I drank a lot of water. Two or three cups.”
- When’s the last time you have used the bathroom? “”First thing this morning.”
- Have you eaten anything? “I had a couple bananas.”
These are never good signs when it is six o’clock in the evening and people start cramping up during activity.
These are just a few symptoms for dehydration:
- Headache
- Fatigue
- Nausea
- Dizziness
- Decreases bathroom breaks
- Decreased sweating
If your body is telling you it is thirsty, you are already a little behind when it comes to hydration. Another great way to check your hydration levels is to check the color of your urine. Yes, it sounds pretty nasty, but it is an excellent way to take a quick measure of your hydration levels.
If your urine is pale like lemonade, that’s a sign of proper hydration. If it’s dark like apple sauce, you need more fluids. With proper hydration and a sound diet, most of the time, you will be in good shape.
Use a water bottle that you brought to be your guide through the process. For example – I carry around a half gallon container (yes I get made fun of) throughout the day. It serves as my reference for that days H20 intake. Plus, I would not always bank on water being in the dugout for every game in the summer.
This is information that you should have heard before this point in time. However, each year around this time, the athletes tend to struggle and need a little refresher.
Enjoy what is left of your summer and stay cool.
Chris Ham, MSA, ATC, CES
Athletic Trainer
Vanderbilt University Baseball
Sunday, May 8, 2011
Are you coo-coo for coconut water?
Coconut water is all the rage right now and everyone, including Hollywood stars and some athletes, are going coo-coo over it. What’s the big draw? After tasting the Zico brand last week while on a road trip in California, I can honestly say it may not be the taste or the mouth feel. I truly am a coconut lover, but the slippery liquid with the off-coconut flavor isn’t something I could enjoy drinking—for pleasure, thirst or during exercise for hydration.
The health and nutrition claims certainly draw you in. The Zico brand label states Zico pure premium coconut water is, “A miracle of hydration and replenishment with 5 essential electrolytes (sodium, magnesium, calcium, phosphorus) and more potassium than a banana (Ok, true: 569mg vs. 560mg---but, really?) Zico assures rapid hydration and replenishment and has zero fat and cholesterol.” Not sure where the fat and cholesterol content factors in to its importance as a drink, other than to tell us that it does not contain any coconut oil.
Coconut water is the liquid inside young coconuts and for the first time, about 10 years ago, it was given the patent to bottle it in a way that preserves its nutrients—although they do vary among the fruit. That said, the calcium, phosphorus, magnesium are in very small amounts (30 mg calcium vs. 300 mg in 8oz of skim milk) and the potassium contained is about the same as in an equivalent amount of skim milk, as well. The high potassium content can lead to diarrhea and other GI issues, so not a great choice for athletes in intensive or endurance sports especially.
Zico is one coconut water that is enriched with sodium so it’s sodium content is about the same as an equivalent amount of skim milk or even Gatorade. From a rehydration standpoint, that is the biggest plus about the the Zico Coconut Water for use during or after exercise. Many of the other coconut waters on the market have too little sodium for them to be an effective rehydrator. Its sugar content is about the same as Gatorade so it’s low in sugar and in the right concentration for use during exercise.
There are no scientific published studies to back up the claims that it is a good sports drink. So don’t believe all you see or hear from Hollywood movie stars about a new drink or food..….it could be someone just going coo-coo for no reason at all.
Kim Larson, RD
Sports Nutrition Consultant
BaseballStrengthCoaching.com
The health and nutrition claims certainly draw you in. The Zico brand label states Zico pure premium coconut water is, “A miracle of hydration and replenishment with 5 essential electrolytes (sodium, magnesium, calcium, phosphorus) and more potassium than a banana (Ok, true: 569mg vs. 560mg---but, really?) Zico assures rapid hydration and replenishment and has zero fat and cholesterol.” Not sure where the fat and cholesterol content factors in to its importance as a drink, other than to tell us that it does not contain any coconut oil.
Coconut water is the liquid inside young coconuts and for the first time, about 10 years ago, it was given the patent to bottle it in a way that preserves its nutrients—although they do vary among the fruit. That said, the calcium, phosphorus, magnesium are in very small amounts (30 mg calcium vs. 300 mg in 8oz of skim milk) and the potassium contained is about the same as in an equivalent amount of skim milk, as well. The high potassium content can lead to diarrhea and other GI issues, so not a great choice for athletes in intensive or endurance sports especially.
Zico is one coconut water that is enriched with sodium so it’s sodium content is about the same as an equivalent amount of skim milk or even Gatorade. From a rehydration standpoint, that is the biggest plus about the the Zico Coconut Water for use during or after exercise. Many of the other coconut waters on the market have too little sodium for them to be an effective rehydrator. Its sugar content is about the same as Gatorade so it’s low in sugar and in the right concentration for use during exercise.
There are no scientific published studies to back up the claims that it is a good sports drink. So don’t believe all you see or hear from Hollywood movie stars about a new drink or food..….it could be someone just going coo-coo for no reason at all.
Kim Larson, RD
Sports Nutrition Consultant
BaseballStrengthCoaching.com
Monday, December 13, 2010
Understanding Sports Drinks
Sports drinks are intended and were developed for use during sports, as the
name implies. Many people are confused about the role these drinks should
play in their lives as a beverage choice. Sports drinks should be used only
if an individual is participating in strenuous activity or sport that is
constant and lasts over an hour. For an activity lasting less than hour or
one that is not intense (walking the dog), water will meet hydration needs
just fine and the carbohydrate and electrolytes (sodium, potassium) provided
in the sports drink are not necessary. Sports drinks should not be consumed
unless you need them during exercise or immediately after exercise for
hydration. They are not a good beverage choice outside of that because
then they are just adding extra calories, in the form of sugar, that are not
being used. These extra sugar calories have no valuable nutrition and can
easily be stored as fat, if not burned. With obesity rates in children (as
well as adults) skyrocketing, the appropriate use of these drinks is
essential. If not used properly and judiciously they can promote excessive
calorie consumption, leading to high Body Mass Index numbers, overweight and
obesity.
Sports drinks are a great tool during long, high intensity workouts because
they provide a small amount of carbohydrates to fuel muscles along with
sodium and potassium for fast, effective hydration. The carbohydrates help
replenish the carbohydrate stores in the muscle (called glycogen) that are
being used to fuel the work of exercise. For the serious exerciser, these
carbohydrates help to delay the fatigue that happens when the muscles run
out of fuel, enhancing performance through longer and more effective
training. They also help keep blood glucose levels stable (optimal fuel
for the brain) which enhances mental focus, so that the athlete or fitness
buff are able to concentrate and perform at the highest level possible.
Sports drinks actually hydrate better than regular water even post exercise.
Individuals who sweat a lot or who are "salty" sweaters will benefit from
using a sports drink during and after exercise to replace the sodium and
potassium that are lost in sweat. They also stimulate thirst, as opposed to
water which does not, that encourages more fluid consumption to aid in
rehydration.
Because this is a multi-billion dollar industry today, it's important to
look past the marketing and choose the best sports drink, being armed with
good information. Look for one that is around 50 calories per 8 oz., which
supplies about 6-8 per cent carbohydrate.
Although sports drinks are effective during exercise and for hydration after
exercise, they are not adequate for recovery. Foods or fluids that are high
in carbohydrate, accompanied by a small amount of protein are a better
choice to jumpstart the muscle recovery process, after high intensity
exercise. Wholesome, nutrient rich choices will supply the vitamins,
minerals, phytonutrients and antioxidants active children and adults need
for good health. Some examples include: a peanut butter/jelly sandwich, low
fat fruit yogurt and fresh fruit, low fat chocolate milk, fresh fruit
smoothie and a handful of nuts, granola bar & stick of string cheese.
Kim Larson, RD, CD
Total Health
Contributor, BaseballStrengthCoaching.com
name implies. Many people are confused about the role these drinks should
play in their lives as a beverage choice. Sports drinks should be used only
if an individual is participating in strenuous activity or sport that is
constant and lasts over an hour. For an activity lasting less than hour or
one that is not intense (walking the dog), water will meet hydration needs
just fine and the carbohydrate and electrolytes (sodium, potassium) provided
in the sports drink are not necessary. Sports drinks should not be consumed
unless you need them during exercise or immediately after exercise for
hydration. They are not a good beverage choice outside of that because
then they are just adding extra calories, in the form of sugar, that are not
being used. These extra sugar calories have no valuable nutrition and can
easily be stored as fat, if not burned. With obesity rates in children (as
well as adults) skyrocketing, the appropriate use of these drinks is
essential. If not used properly and judiciously they can promote excessive
calorie consumption, leading to high Body Mass Index numbers, overweight and
obesity.
Sports drinks are a great tool during long, high intensity workouts because
they provide a small amount of carbohydrates to fuel muscles along with
sodium and potassium for fast, effective hydration. The carbohydrates help
replenish the carbohydrate stores in the muscle (called glycogen) that are
being used to fuel the work of exercise. For the serious exerciser, these
carbohydrates help to delay the fatigue that happens when the muscles run
out of fuel, enhancing performance through longer and more effective
training. They also help keep blood glucose levels stable (optimal fuel
for the brain) which enhances mental focus, so that the athlete or fitness
buff are able to concentrate and perform at the highest level possible.
Sports drinks actually hydrate better than regular water even post exercise.
Individuals who sweat a lot or who are "salty" sweaters will benefit from
using a sports drink during and after exercise to replace the sodium and
potassium that are lost in sweat. They also stimulate thirst, as opposed to
water which does not, that encourages more fluid consumption to aid in
rehydration.
Because this is a multi-billion dollar industry today, it's important to
look past the marketing and choose the best sports drink, being armed with
good information. Look for one that is around 50 calories per 8 oz., which
supplies about 6-8 per cent carbohydrate.
Although sports drinks are effective during exercise and for hydration after
exercise, they are not adequate for recovery. Foods or fluids that are high
in carbohydrate, accompanied by a small amount of protein are a better
choice to jumpstart the muscle recovery process, after high intensity
exercise. Wholesome, nutrient rich choices will supply the vitamins,
minerals, phytonutrients and antioxidants active children and adults need
for good health. Some examples include: a peanut butter/jelly sandwich, low
fat fruit yogurt and fresh fruit, low fat chocolate milk, fresh fruit
smoothie and a handful of nuts, granola bar & stick of string cheese.
Kim Larson, RD, CD
Total Health
Contributor, BaseballStrengthCoaching.com
Thursday, August 19, 2010
The Importance of Hydration
With August temperatures soaring into the high 80’s and 90’s around most of the country, staying well hydrated is a full time job for athletes and fitness enthusiasts alike. Fluid consumption is especially important if you play sports outside in these hot, humid and sultry dog days of summer.
Being at fall ball tryouts last weekend when the temps hit 98 degrees made me realize how critical daily hydration, as well as rehydration, is to baseball players. Watching preadolescent players wilt as tryouts progressed, brought up a dangerous scenario that parents, coaches and trainers should all be aware of when working with young athletes. Lowered sweating capacity, poorly developed thirst mechanism and a limited ability to transfer heat from their muscles to their skin make this age group particularly vulnerable to dehydration and heat exhaustion. Core temperature rises in children at a faster rate than adults because they produce more metabolic heat than adults and it can cause serious heat-related illnesses. Adolescents also are still developing their body temperature control and are susceptible to these same issues. Special attention should be paid to drink adequate fluids before and during active play, as well as rehydrating properly afterwards, to reduce the risks of dehydration.
Dehydration has many negative, and possibly dangerous, effects on health and performance. Dehydration—even as little as 1-2 percent weight loss from sweating--is enough to diminish energy, accelerate fatigue and impair performance. A 2 percent weight loss is only 3 pounds for a 150 pound athlete. Sweat losses vary between individuals and with different exercise intensity, however, this amount of weight/sweat loss is not uncommon in hot, humid climates with several hours of practice and/or games. Some signs of dehydration include nausea, headache, fatigue, muscle cramps, lightheadedness and lack of urination and sweating.
Players will benefit from weighing before and after practices and games to determine their sweat losses so that rehydration is adequate to replace fluid losses. For every pound lost, replace with 24 oz (3 cups) of fluids, like sports drinks, 100% fruit juices or chocolate milk. Because your body also needs to replace the electrolytes sodium and potassium that you lose along with sweat, these fluid choices that contain electrolytes help to do that. Both fluid and electrolytes need to be taken in to restore a positive water balance in the body after exercising over one hour or in extreme heat, humidity or high altitude. Sports drinks are the preferred drink, over water, during exercise because they provide energy in the form of carbohydrates and electrolytes that provide rapid fluid absorption.
How much should you drink? To make sure you are fully hydrated follow these hydration recommendations:
Pre-practice/Pre-game
• At least 2 hours before drink 16-24 oz of fluids (all fluids count!)
• Follow with an additional 8-12 oz. of fluids 1 hour before (water or sports drinks)
During practice/games
• Drink 6-8oz. of fluids every 15 minutes (Best choice: sports drinks)
• Adolescents need to drink more: 8-12 oz every 15 minutes
• Consume at least 24 oz in one hour
Post game
• Drink 24 oz. of fluid
• Calculate fluids needed to replace those lost in sweat (1 pound =24 oz. of fluid) and continue drinking to meet those needs.
How do you know if you are drinking enough? The easiest, quickest way to know is to check the color of your urine. It should be the color of light lemonade, not apple juice. Monitor daily and adjust your drinking schedule accordingly to get the most out of your training and practices!
Winning Hydration Strategies
Every day drink at least half your body weight in ounces (For example:
A 160 pound athlete should drink 80 fluid ounces per day)
Drink before you are thirsty & keep drinking when you no longer feel thirsty!
Drink early and drink often throughout the day
Plan your fluids and carry a water bottle with you wherever you go
Do regular urine checks
Eat foods high in water, like fruit (at least 2 cups a day) & soups
Drink sports drinks that taste good to you to help you drink more during exercise
Avoid beverages like energy drinks, pop and fruit juice during exercise (they are too high in sugar and will delay gastric emptying & hydration)
Coaches: Develop Hydration Protocols for your teams and implement periodic drink stops every 15 minutes for adequate hydration that supports good performance!
By Kim Larson, RD, CD
Regular Contributor
BaseballStrengthCoaching.com
Being at fall ball tryouts last weekend when the temps hit 98 degrees made me realize how critical daily hydration, as well as rehydration, is to baseball players. Watching preadolescent players wilt as tryouts progressed, brought up a dangerous scenario that parents, coaches and trainers should all be aware of when working with young athletes. Lowered sweating capacity, poorly developed thirst mechanism and a limited ability to transfer heat from their muscles to their skin make this age group particularly vulnerable to dehydration and heat exhaustion. Core temperature rises in children at a faster rate than adults because they produce more metabolic heat than adults and it can cause serious heat-related illnesses. Adolescents also are still developing their body temperature control and are susceptible to these same issues. Special attention should be paid to drink adequate fluids before and during active play, as well as rehydrating properly afterwards, to reduce the risks of dehydration.
Dehydration has many negative, and possibly dangerous, effects on health and performance. Dehydration—even as little as 1-2 percent weight loss from sweating--is enough to diminish energy, accelerate fatigue and impair performance. A 2 percent weight loss is only 3 pounds for a 150 pound athlete. Sweat losses vary between individuals and with different exercise intensity, however, this amount of weight/sweat loss is not uncommon in hot, humid climates with several hours of practice and/or games. Some signs of dehydration include nausea, headache, fatigue, muscle cramps, lightheadedness and lack of urination and sweating.
Players will benefit from weighing before and after practices and games to determine their sweat losses so that rehydration is adequate to replace fluid losses. For every pound lost, replace with 24 oz (3 cups) of fluids, like sports drinks, 100% fruit juices or chocolate milk. Because your body also needs to replace the electrolytes sodium and potassium that you lose along with sweat, these fluid choices that contain electrolytes help to do that. Both fluid and electrolytes need to be taken in to restore a positive water balance in the body after exercising over one hour or in extreme heat, humidity or high altitude. Sports drinks are the preferred drink, over water, during exercise because they provide energy in the form of carbohydrates and electrolytes that provide rapid fluid absorption.
How much should you drink? To make sure you are fully hydrated follow these hydration recommendations:
Pre-practice/Pre-game
• At least 2 hours before drink 16-24 oz of fluids (all fluids count!)
• Follow with an additional 8-12 oz. of fluids 1 hour before (water or sports drinks)
During practice/games
• Drink 6-8oz. of fluids every 15 minutes (Best choice: sports drinks)
• Adolescents need to drink more: 8-12 oz every 15 minutes
• Consume at least 24 oz in one hour
Post game
• Drink 24 oz. of fluid
• Calculate fluids needed to replace those lost in sweat (1 pound =24 oz. of fluid) and continue drinking to meet those needs.
How do you know if you are drinking enough? The easiest, quickest way to know is to check the color of your urine. It should be the color of light lemonade, not apple juice. Monitor daily and adjust your drinking schedule accordingly to get the most out of your training and practices!
Winning Hydration Strategies
Every day drink at least half your body weight in ounces (For example:
A 160 pound athlete should drink 80 fluid ounces per day)
Drink before you are thirsty & keep drinking when you no longer feel thirsty!
Drink early and drink often throughout the day
Plan your fluids and carry a water bottle with you wherever you go
Do regular urine checks
Eat foods high in water, like fruit (at least 2 cups a day) & soups
Drink sports drinks that taste good to you to help you drink more during exercise
Avoid beverages like energy drinks, pop and fruit juice during exercise (they are too high in sugar and will delay gastric emptying & hydration)
Coaches: Develop Hydration Protocols for your teams and implement periodic drink stops every 15 minutes for adequate hydration that supports good performance!
By Kim Larson, RD, CD
Regular Contributor
BaseballStrengthCoaching.com
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