A Case of Rhabdomyolysis Caused by Blood Flow-Restricted Resistance Training

Krieger, Joshua; Sims, Donald; Wolterstorff, Cameron

doi:10.55460/1yxc-izh1

Cited by 11 publications

(7 citation statements)

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“…We disagree with the conclusions in both the review of Loenneke et al 4 and the editorial by Thompson et al 5 For example, Loenneke et al 4 did not include the case study of Iversen and Røstad 6 in their review for unknown reasons. There are now no fewer than 4 case studies on rhabdomyolysis after BFRRE, 6–9 all reporting peak creatine kinase (CK) values in excess of 10 000 U/L, a level accepted to be diagnostic of rhabdomyolysis. 10 Furthermore, we have in 2 studies 11,12 reported marked elevations of CK after acute and short-term BFRRE at 20% to 30% of 1RM.…”

mentioning

confidence: 99%

Risk of Muscle Damage With Blood Flow–Restricted Exercise Should Not Be Overlooked

Wernbom

Paulsen

Bjørnsen

et al. 2021

Clinical Journal of Sport Medicine

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mentioning

confidence: 99%

Risk of Muscle Damage With Blood Flow–Restricted Exercise Should Not Be Overlooked

Wernbom

Paulsen

Bjørnsen

et al. 2021

Clinical Journal of Sport Medicine

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“…10,23 A case report by Iverson et al of a patient knee articular cartilage resection and microfracture and a case report by Krieger et al of a patient with an ankle sprain, reported that the patient developed rhabdomyolysis after just a singular treatment. 24,25 In both cases, the authors concluded that this was a freak occurrence and both subjects made a full recovery and were able to continue BFRT training. 24,25 Additionally, the subject of the case report by Iversen et al had a history of deep vein thrombosis after knee surgery.…”

Section: Findings and Clinical Implicationsmentioning

confidence: 91%

“…24,25 In both cases, the authors concluded that this was a freak occurrence and both subjects made a full recovery and were able to continue BFRT training. 24,25 Additionally, the subject of the case report by Iversen et al had a history of deep vein thrombosis after knee surgery. 10,24 Once this subject had been treated and recovered from rhabdomyolysis, they were able to return to the study and complete BFRT without any further complications.…”

Section: Findings and Clinical Implicationsmentioning

confidence: 91%

“…In the case by Krieger et al, the subject did not have any known preexisting conditions, but it should be noted that the exercise load is not specified. 25 Preexisting conditions should not be seen as an absolute contraindication for BFRT use and individuals with preexisting conditions are still able to experience the benefits of BFRT. To limit adverse events, future research should explore in depth safety precautions and guidelines, specifically for at-risk populations with specific factors or indicators, while continuing to explore mechanisms to improve clinician and patient adherence to the guidelines already outlined.…”

Section: Findings and Clinical Implicationsmentioning

confidence: 99%

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Safety of Blood Flow Restriction Training for Musculoskeletal Disorders: An Evidence-to-Practice Review

2022

Clin Prac Athl Train

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Blood flow restriction training (BFRT) is low-level resistance training while partially occluding proximal blood flow. It is well documented that this style of training leads to increased muscle size as well as strength. It is theorized that these size and strength gains are due in part to the decreased oxygen environment. This results in increased muscular stress without the need for increased external load making this style of resistance training ideal for individuals who have restrictions due to musculoskeletal disorders. The guiding systematic review examined the safety of BFRT when used as a therapeutic intervention for patients with a variety of musculoskeletal disorders. Currently, there are no definitive set of parameters for clinicians to follow to ensure safe and effective use of BFRT. The purpose of the guiding review was to evaluate the safety and possible adverse events that may occur from different BFRT parameters in the rehabilitation or musculoskeletal disorders. There are many different types of devices used when implementing BFRT, but safety parameters suggest using a device that can measure the exact pressure so that occlusion can be personalized for each patient. Using a predetermined pressure for all patients could result in full occlusion, depriving the muscle of all oxygen and creating too much muscular stress. Conversely, not enough occlusion could result in a lack of muscular stress occurring to lead to muscular adaptations, ultimately rendering the treatment pointless. Additionally, timing of the exercises, which is work-torest ratios, as well as the frequency of training, is an important component for safe and effective use. Finally, the movement selection, load, and volume contribute to the parameters for safe and effective use of BFRT. Adverse reactions found in the guiding systematic review ranged from discomfort or dull pain to rhabdomyolysis. Following recommended safety guidelines decreased the risk of adverse reactions.

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“…Many RCTs have also found benefits of BFRT in elderly populations at risk for sarcopenia and other medical and musculoskeletal disorders [178][179][180][181][182][183][184][185][186][187]. Preliminary evidence from non-RCT study designs have indicated potential efficacy of LL-BFRT for ankle sprains [188,189], ankle fractures [190], shoulder injuries [191], reactive arthritis [192], thoracic outlet syndrome [193], inclusion body myositis [194], knee arthroplasty [195], tibial fractures [196], meniscus repair [197], patellar instability [198] and spinal cord injury [199]. The application of BFRT to general chronic medical conditions is also continuing to expand, with recent studies indicating potential efficacy for chronic conditions such as type-2 diabetes [200,201], chronic kidney disease and renal decline [202,203], hypertension [204], cardiovascular disease [205,206], cancer [207,208], and coma patients [209,210].…”

Section: Bfrt Musculoskeletal Rehabilitation Outcomesmentioning

confidence: 99%

Blood Flow Restriction Training for Tendinopathy Rehabilitation: A Potential Alternative to Traditional Heavy-Load Resistance Training

Burton¹

2022

Rheumato

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Tendinopathy is a chronic tendon disease which can cause significant pain and functional limitations for individuals, and which collectively places a tremendous burden on society. Resistance training has long been considered the treatment of choice in the rehabilitation of chronic tendinopathies, with both eccentric and heavy slow resistance training demonstrating positive clinical effects. The application of progressive tendon loads during rehabilitation is essential to not compromise tendon healing, with the precise dosage parameters of resistance training and external loading a critical consideration. Blood-flow restriction training (BFRT) has become an increasingly popular method of resistance training in recent years and has been shown to be an effective method for enhancing muscle strength and hypertrophy in healthy populations and in musculoskeletal rehabilitation. Traditional resistance training for tendinopathy requires the application of heavy training loads, whereas BFRT utilises significantly lower loads and training intensities, which may be more appropriate for certain clinical populations. Despite evidence confirming the positive muscular adaptations derived from BFRT and the clinical benefits found for other musculoskeletal conditions, BFRT has received a dearth of attention in tendon rehabilitation. Therefore, the purpose of this narrative review was threefold: firstly, to give an overview and analysis of the mechanisms and outcomes of BFRT in both healthy populations and in musculoskeletal rehabilitation. Secondly, to give an overview of the evidence to date on the effects of BFRT on healthy tendon properties and clinical outcomes when applied to tendon pathology. Finally, a discussion on the clinical utility of BFRT and its potential applications within tendinopathy rehabilitation, including as a compliment to traditional heavy-load training, is presented.

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A Case of Rhabdomyolysis Caused by Blood Flow-Restricted Resistance Training

Cited by 11 publications

References 0 publications

Risk of Muscle Damage With Blood Flow–Restricted Exercise Should Not Be Overlooked

Risk of Muscle Damage With Blood Flow–Restricted Exercise Should Not Be Overlooked

Safety of Blood Flow Restriction Training for Musculoskeletal Disorders: An Evidence-to-Practice Review

Blood Flow Restriction Training for Tendinopathy Rehabilitation: A Potential Alternative to Traditional Heavy-Load Resistance Training

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