Update: Exertional rhabdomyolysis, active component, U.S. Armed Forces, 2010-2014

Among active component U.S. service members in 2014, there were 403 incident episodes of rhabdomyolysis likely due to physical exertion or heat stress ("exertional rhabdomyolysis"). Th e annual incidence rates of exertional rhabdomyolysis increased nearly 50% during 2010–2014. In 2014, the highest incidence rates occurred in service members who were male; younger than 20 years of age; black, non-Hispanic; members of the Marine Corps and Army; recruit trainees; and in combat-specific occupations. Incidence rates were higher among service members with homes of record from the Northeast compared to other U.S. regions. Most cases of exertional rhabdomyolysis were diagnosed at installations that support basic combat/recruit training or major ground combat units of the Army or Marine Corps. Medical care providers should consider exertional rhabdomyolysis in the differential diagnosis when service members (particularly recruits) present with muscular pain and swelling,limited range of motion, or the excretion of dark urine (e.g., myoglobinuria)aft er strenuous physical activity, particularly in hot, humid weather.