Exertional rhabdomyolysis

[2] This condition and its signs and symptoms are not well known amongst the sport and fitness community and because of this it is believed that the incidence is greater but highly underreported.

[10] In addition to the proteins released, large quantities of ions such as intracellular potassium, sodium, and chloride find their way into the circulatory system.

Intracellular potassium ion has deleterious effects on the heart's ability to generate action potentials leading to cardiac arrhythmias.

[citation needed] When the protein reaches the kidneys it causes a strain on the anatomical structures reducing its effectiveness as a filter for the body.

[11] In addition, the increased intracellular calcium has greater time to bind due to the blockage allowing for renal calculi to form.

This initiates the body's natural reaction to increasing perfusion to the area allowing for an influx of specialized cells to repair the injury.

When results are positive the urine normally obtains a dark, brown color followed by serum CK level evaluation to determine the severity of muscle damage.

Elevated levels of serum CK greater than 5,000 U/L that are not caused by myocardial infarction, brain injury or disease, generally indicate serious muscle damage confirming the diagnosis of ER.

[citation needed] Although sufficient evidence is currently lacking, supplementation with a combination of sodium bicarbonate and mannitol is commonly utilized to prevent kidney failure in rhabdomyolysis patients.

[22] Before initiating any form of physical activity, the individual must demonstrate a normal level of functioning with all previous symptoms absent.

However, special considerations prior to participating in the rehabilitation program include the individual's 1) extent of muscle injury, if any 2) level of fitness before the incident and 3) weight training experience.

[19] These special considerations collectively are a form of assessing the individual's capacity to perform physical activity, which is ultimately used to specify the ExRx design.

In some cases ER can lead to acute kidney failure and bring medical costs up due to the need for hemodialysis for recovery/treatment.