Adverse events associated with eccentric exercise protocols: six case studies

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Abstract
SAYERS, S. P., P. M. CLARKSON, P. A. ROUZIER, and G. KAMEN. Adverse events associated with eccentric exercise protocols: six case studies. Med. Sci. Sports Exerc., Vol. 31, No. 12, pp. 1697–1702, 1999. Rhabdomyolysis is a condition characterized by muscle damage and degeneration of muscle cells after strenuous, overexertion exercise. Although the incidence of severe rhabdomyolysis is rare, this condition can be dangerous and even fatal. Eccentric exercise protocols are currently being used to induce and study mild forms of muscle damage. However, serious adverse events can occur in these laboratory investigations. The purpose of this report was to expose some of the adverse events resulting from performance of eccentric exercise protocols to study muscle damage in humans. The following case studies involved an eccentric exercise protocol where two sets of 25 maximal eccentric actions of the elbow flexors were performed, separated by a 5-min rest period. Case reports are presented that reveal prolonged losses in the ability of the muscle to generate force lasting 43–47 d, extreme swelling of the exercised arm lasting several weeks, and greatly elevated serum creatine kinase levels. Although adverse events resulting from eccentric exercise are rare, our laboratory has observed a 3% incidence rate during the past year. Investigators should be knowledgeable of the sequelae of events that are associated with muscle damage after high-force eccentric exercise and take appropriate precautions.