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Updated: Mar 21, 2026

Induction and Assessment of Exertional Skeletal Muscle Damage in Humans
Published on: December 11, 2016
Return to Play After Exertional Rhabdomyolysis
Kevin Schleich1, Tyler Slayman1, Douglas West1
1The University of Iowa, Iowa City.
Objective:
To outline a 4-phase progressive program that safely and successfully enabled athletes to return to sport without recurrence of exertional rhabdomyolysis symptoms.
Background:
In January 2011, a large cluster of National Collegiate Athletic Association Division I football athletes were evaluated and treated for exertional rhabdomyolysis. After the athletes were treated, the athletic trainers and sports medicine providers were challenged to develop a safe return-to-play program because of the lack of specific reports in the medical literature to direct such activities.
Treatment:
A progressive 4-phase program based on existing recommendations, including guidelines for continued clinical and laboratory monitoring.
Conclusions:
Although the actual process of reintegrating players will differ based on each athlete's unique circumstances, this program provides a safe and effective foundation that can be modified based on the response to activity and sport.
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