From the Research
A player should be excluded from football practice for at least 2-4 weeks after a bout of rhabdomyolysis, with return only after complete resolution of symptoms and normalization of creatine kinase (CK) levels, as supported by the most recent and highest quality study 1. The return to play should be gradual, beginning with light activities and slowly progressing to full participation under medical supervision. Before returning, the athlete needs medical clearance from a physician who should verify normal kidney function, electrolyte balance, and CK levels, as highlighted in the study 2. Hydration status must be optimal, with the athlete drinking sufficient fluids before, during, and after activity. Rhabdomyolysis involves muscle breakdown that releases myoglobin into the bloodstream, potentially causing kidney damage, as discussed in the case report 3. The recovery period allows damaged muscle tissue to heal and reduces the risk of recurrence. Athletes with a history of rhabdomyolysis have a higher risk of recurrence, so they should be monitored more closely and may need a more conservative return-to-play timeline, as noted in the systematic review 1. Environmental factors like heat and humidity should be considered when planning the return to practice, as mentioned in the study 4. Some key points to consider when managing exertional rhabdomyolysis include:
- Prompt recognition and appropriate management to prevent serious consequences, as emphasized in the clinical review 2
- Stratifying the athlete into high- or low-risk categories to determine if further workup is warranted, as discussed in the study 2
- Treatment modalities should include rest and hydration, as supported by the study 1
- Return to play and future workup should be determined by the risk stratification of the athlete, as noted in the study 2