While the NFL sucked most of the air from the room over the last two weeks with talk of concussions and Tom Brady’s thumb, there have been other medically related issues in the sports world that should not have escaped notice.

One story that broke reminded me of my column of Jan. 23, 2017. The lead paragraphs read in part, “In the hours after news broke last week about University of Oregon football players being hospitalized following a conditioning session, my email inbox started filling.

“The reaction from readers was disbelief that an epidemic of rhabdomyolysis could occur at a vaunted Division I program such as Oregon’s. Rhabdomyolysis is (according to Merriam-Webster) the destruction or degeneration of muscle tissue, as from traumatic injury, excessive exertion, or stroke, accompanied by the release of breakdown products into the bloodstream and sometimes leading to acute kidney failure.

“Well, believe it.

“The circumstances under which it occurred make it that much more believable: sub-performing team, new coach, new semester.

“As believable as this latest episode is, though, it was entirely preventable and therefore inexcusable.”

All I need to do is change “Oregon” to “Nebraska.”

A year ago, new Oregon football strength coach Irele Oderinde was suspended for one month without pay in the wake of the incident that affected three Oregon players. Oderinde has since left the Ducks, accompanying head coach Willie Taggart to Florida State after just a year in Eugene for both men.

At Nebraska, new football strength and conditioning coach Zach Duval — who accompanied new head football coach Scott Frost from Central Florida — will not be disciplined despite two Cornhuskers being hospitalized with rhabdomyolysis after an intense workout late last month.

Nebraska athletic director Bill Moos told the Lincoln Journal Star that his decision was based on Duval’s “planning, performance testing and decision to moderate the opening weeks of the winter program before it began.”

Apparently the opening weeks of the program were not moderated enough.

Just days after the Nebraska incident, on Feb. 1, the NCAA’s chief medical officer, Brian Hainline, MD, issued the following guidelines on how to avoid rhabdomyolysis:

  • 1. Transition periods are particularly vulnerable times for athletes and demand careful attention to progression in volume, intensity, mode and duration of activity. Examples of transition periods:
    • a. Athletes new to the program.
    • b. Athletes returning after an injury or illness.
    • c. Any delayed participation relative to the team schedule.
    • d. Resumption of training after an academic break (e.g., winter, spring, summer).
  • 2. All strength and conditioning workouts should be exercise-based, scientifically sound and physiologically representative of the sport and its performance requirements.
  • 3. Conditioning programs should begin with a work-to-rest ratio of 1-to-4.
  • 4. The first four days of transition periods should be separate-day workouts, and all workouts:
    • a. Should be documented in writing.
    • b. Should be intentional.
    • c. Should increase progressively in the volume, intensity, mode and duration of physical activity.
  • 5. All strength and conditioning workouts:
    • a. Should be documented in writing.
    • b. Should reflect the progression, technique, and intentional increase in the volume, intensity, mode and duration of the physical activity.
    • c. Should be available for review by athletics department staff.

While rhabdomyolysis is a muscle-related overuse condition, overuse tendon injuries have been epidemic in the NBA. More on that next week.

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John Doherty is a licensed athletic trainer and physical therapist. This column reflects solely his opinion. Reach him at jdoherty@comhs.org. Follow him on Twitter @JDohertyATCPT.

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