title: Adverse events associated with eccentric exercise protocols: six case studies.
abstract: OBJECTIVE
  Rhabdomyolysis is a condition characterized by muscle damage and degeneration of muscle cells after strenuous, overexertion exercise. Although the incidence of severe rhabdomyolysis is rare, this condition can be dangerous and even fatal. Eccentric exercise protocols are currently being used to induce and study mild forms of muscle damage. However, serious adverse events can occur in these laboratory investigations. The purpose of this report was to expose some of the adverse events resulting from performance of eccentric exercise protocols to study muscle damage in humans.
  
  
  METHODS
  The following case studies involved an eccentric exercise protocol where two sets of 25 maximal eccentric actions of the elbow flexors were performed, separated by a 5-min rest period.
  
  
  RESULTS
  Case reports are presented that reveal prolonged losses in the ability of the muscle to generate force lasting 43-47 d, extreme swelling of the exercised arm lasting several weeks, and greatly elevated serum creatine kinase levels.
  
  
  CONCLUSIONS
  Although adverse events resulting from eccentric exercise are rare, our laboratory has observed a 3% incidence rate during the past year. Investigators should be knowledgeable of the sequelae of events that are associated with muscle damage after high-force eccentric exercise and take appropriate precautions.
authors.affiliation: Department of Exercise Science and the University Health Services, University of Massachusetts, Amherst 01003, USA. ssayers@excsci.umass.edu
authors.forename: S P
authors.initials: SP
authors.lastname: Sayers
authors.forename: P M
authors.initials: PM
authors.lastname: Clarkson
authors.forename: P A
authors.initials: PA
authors.lastname: Rouzier
authors.forename: G
authors.initials: G
authors.lastname: Kamen
mesh_terms: D001132:Arm; D003402:Creatine Kinase / Q000097:blood; D015444:Exercise; D006801:Humans; D008297:Male; D008875:Middle Aged; D009212:Myoglobinuria / Q000209:etiology; D012206:Rhabdomyolysis / Q000209:etiology*
chemical_list: D003402:Creatine Kinase