From the Guidelines
For a football athlete recovering from rhabdomyolysis with elevated CK levels, preparing for NFL pro day, I strongly recommend prioritizing hydration and electrolyte balance to minimize further kidney strain and support muscle recovery. To achieve this, the athlete should drink at least 6 mL of fluid per kg of body mass every 2–3 h, as suggested by the consensus recommendations on training and competing in the heat 1. This approach is crucial for minimizing physiological strain and preserving optimal performance. Key aspects of the recovery plan include:
- Hydration: drinking plenty of fluids with meals to rehydrate after exercise-heat stress, aiming to offset 100–150 % of body mass losses 1
- Electrolyte supplementation: including sodium, potassium, and magnesium to replace losses, with sodium supplementation potentially required during exercise 1
- Nutrition: focusing on a balanced diet that includes carbohydrates, protein (1.6-2.0g/kg body weight daily), and anti-inflammatory foods like fatty fish, berries, and turmeric
- Monitoring: daily assessment of hydration status through urine color (aiming for pale yellow) and morning body mass, as well as watching for warning signs such as dark urine, severe muscle pain, or weakness
- Gradual return to training: progressing from light activities to increased intensity over 2-3 weeks to avoid exacerbating the condition
- Avoiding NSAIDs like ibuprofen, which can stress the kidneys, and considering creatine monohydrate supplementation (5g daily) after full recovery with physician clearance. By following this comprehensive approach, the athlete can support muscle recovery, minimize the risk of further complications, and optimize performance in time for the NFL pro day, while prioritizing morbidity, mortality, and quality of life outcomes.
From the Research
Supplements and Home Care for Rhabdomyolysis
- There is no specific evidence to recommend supplements for a patient with rhabdomyolysis and elevated creatine kinase (CK) levels 2, 3, 4, 5, 6.
- However, it is essential to note that patients with rhabdomyolysis require aggressive fluid resuscitation to prevent acute kidney injury (AKI) 2, 3, 4.
- Home care for a patient with rhabdomyolysis may include:
- Adequate hydration to help flush out myoglobin from the kidneys 3, 4
- Rest and avoidance of strenuous activities to prevent further muscle damage
- Monitoring of urine output and color to detect any signs of myoglobinuria
- Regular follow-up with a healthcare provider to monitor CK levels and renal function
Considerations for a Football Athlete Preparing for NFL Pro Day
- The patient's athletic activities should be modified to avoid exacerbating the condition 3, 4.
- A gradual return to exercise and training may be recommended to prevent further muscle damage and promote recovery.
- It is crucial to prioritize the patient's health and safety over athletic performance, and to seek medical clearance before resuming intense physical activity 2, 3, 4, 5, 6.