title: Dehydration, cramping, and exertional rhabdomyolysis: a case report with suggestions for recovery.
abstract: 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.
authors.affiliation: Florida International University, College of Nursing and Health Sciences, Miami, FL, USA. clearym@fiu.edu
authors.forename: Michelle
authors.initials: M
authors.lastname: Cleary
authors.forename: Daniel
authors.initials: D
authors.lastname: Ruiz
authors.forename: Lindsey
authors.initials: L
authors.lastname: Eberman
authors.forename: Israel
authors.initials: I
authors.lastname: Mitchell
authors.forename: Helen
authors.initials: H
authors.lastname: Binkley
mesh_terms: 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