The classic triad of rhabdomyolysis is dark urine, muscle weakness or fatigue, and muscle pain. Although exercise can be the primary factor, other key contributing elements such as dehydration, genetic conditions (e.g. sickle cell), metabolic disorders, nutritional supplements, drug use, and heat stress can exacerbate muscle damage. Without appropriate medical evaluation and care, rhabdomyolysis can cause permanent damage to the kidneys and may even be life-threatening in severe cases. Here are some tips to help your young athlete remain active and healthy:
- Maintain adequate hydration – preferably with plain water. Sports and energy drinks may often contain caffeine and excessive amounts of sugar which can cause dehydration. On average, children that are 6-10 years old should have about 1L of fluid a day, children 10-14 years old should have 1.5L/day and teens over 14 years should have at least 2L of fluid a day. It is important to increase fluids with increased activity due to the additional fluid losses that occur.
- Eliminate protein supplements. A recent study by the American Academy of Pediatrics found that about a third of teens participating in sports use supplements containing protein, creatine, or whey. Many times this is because of the belief that they are not getting enough protein in their daily diet or that they need to increase their intake in order to build muscle mass. However, the average teenager gets 1.5-2x the daily recommended amount of protein in their daily diet, so protein supplements are not needed and may actually cause harm. Excessive amounts of protein increase the risk of dehydration, kidney stone formation, and high blood pressure. In addition, supplements are not regulated by the FDA so the quality and exact contents are not monitored. If your teen insists on use of an energy or protein supplement, be sure to discuss the product with their physician.
- Maintain consistency. Avoid sudden strenuous workouts – particularly those that target one muscle group to the point of exhaustion - as these may increase the risk of muscle injury. Instead, maintain consistency in workouts and increase intensity gradually with appropriate rest in between.
- Try to exercise in a well-ventilated area. If the workout is in a hot room or outdoors during the summertime, make sure to increase fluid intake to prevent dehydration.