Dehydration, cramping, and exertional rhabdomyolysis: a case report with suggestions for recovery.
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.


METHODS
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.


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


RESULTS
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 pre-season practice. We provide suggestions for return to activity following exertional rhabdomyolysis.
Cleary
Michelle
M
Florida International University, College of Nursing and Health Sciences, Miami, FL, USA. clearym@fiu.edu
Ruiz
Daniel
D
Eberman
Lindsey
L
Mitchell
Israel
I
Binkley
Helen
H
D000064:Acclimatization; D000293:Adolescent; D003681:Dehydration / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D003937:Diagnosis, Differential; D005538:Football; D017408:Guidelines as Topic; D018882:Heat Stress Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009120:Muscle Cramp / Q000503:physiopathology; D005082:Physical Exertion / Q000502:physiology*; D012206:Rhabdomyolysis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D012720:Severity of Illness Index