Return to activity
What is the process of returning to activity?
According to , There are no specific guidelines regarding return to play decisions. However, there are definitely things you can do to make this whole process a lot safer. First off, if a patient has relatively normal CK levels, there is no myoglobinuria present, and the patient is otherwise symptom free, you can ease back into light activity. If another week passes and there are no further concerns, you can get back into your normal pre-rhabdo exercise routine. You just have to make sure you are almost overhydrating and not pushing your limits as you do not want to develop Rhabdo again.
According to to , “In January 2011, a large cluster of National Collegiate Athletic Association Division I football athletes were evaluated and treated for exertional rhabdomyolysis.” Because there were no specific return to play guidelines, the athletic trainers and sports medicine providers had to come up with their own process. Because they were dealing with Division I athletes, the trainers developed an extremely safe 4 week return to play plan. The plan was split into 4 different phases. Phase 1 lasted 2 weeks and the athletes returned to their normal lives without any physical activity. The athletes were also being monitored for good hydration and at least 8 hours of uninterrupted sleep. Phases 2-4 each lasted 5 days. At the beginning of phase 2, the athletes started moving in chest deep water and slowly progressed to waist deep and finally by the fourth day, a 10 minute stationary biking session at 70% maximum heart rate was introduced. Throughout phases 3 and 4, the intensity level of these exercises gradually increased and by the last day the athletes were doing interval sprints. It is important to note that the athletes were training every other day throughout phases 3 and 4. This is just one return to play process and is again extremely on the safe side.
According to , there is another safe return to play option. This process consists of 3 phases. Phase 1 consists of 72 hours of complete rest and constant oral hydration. Patients should also get at least 8 hours of continuous sleep each night and avoid hot environments. At 72 hours, if the patient’s CK levels are less than 5 times the upper end of the normal values with clear urine, the patient is cleared to move on to phase 2. If not, the patient should repeat this process until the requirements are hit. In phase 2, patients are able to resume light activity. Use your own discretion but try to err on the side of caution. If no symptoms occur, the patient may move on to phase 3. From phase 3 and on, you can gradually return to your normal activity. Again use your own discretion.
Overall, there is some recurring advice throughout all three articles. Recap of these important ideas: 1. Begin with no activity and very gradually ease back into activity. 2. Constantly monitor your CK levels and your symptoms and seek help if there is anything out of the ordinary. 3. Sleep and hydration are extremely important to speed up your recovery.