What Caused Prep Football Team's Injury Epidemic?

At least 24 football players from McMinnville (Ore.) High School have been treated for what some medical experts are calling an extreme version of a muscle syndrome caused by intense exercise. About half of the student-athletes were admitted to a local hospital, and at least three needed surgery; one player required operations on both arms to reduce painful pressure.

The New York Times reports that the syndrome, known as rhabdomyolysis, often occurs when athletes who have not been training have a sudden increase in the intensity of their workouts - such as a return to practice after a summer break. Rupert P. Galvez, a sports medicine doctor in Denver who wrote a 2008 article about the syndrome, documented a case of rhabdomyolysis that year involving seven NCAA Division I swimmers who were put through an intense upper-body workout. And in 2005, according to The Times, a British medical journal reported on 119 high school students in Taiwan who developed the syndrome after their physical-education teacher required them to complete 120 push-ups in five minutes.

Associated Press reports indicate that all or some of the players had elevated levels of the enzyme creatine kinase, or CK, which is released by muscles when they're injured, according to Craig Winkler of the Willamette Valley Medical Center in McMinnville, about 35 miles southwest of Portland. High CK levels can result from vigorous exercise or the use of certain medications or food supplements, and they can lead to kidney failure if not properly treated.

All that said, there has been no official word on the cause of the players' injuries, and medical authorities were awaiting the results of blood tests to determine whether any of the players ingested a supplement that could help explain what happened. The AP indicated that some of the players told doctors they had taken protein shakes but were not sure what was in them.

Before their symptoms began last week, McMinnville's players were at an immersion camp organized by first-year coach Jeff Kearin, and the team worked out on Aug. 15 in the high school's wrestling room, where temperatures reached 115 degrees and, according to players and parents, water breaks were limited.

McMinnville School District superintendent Maryalice Russell told local reporters that she doesn't think Kearin's workout was excessive, but the Oregon School Activities Association's Medical Aspects Sports Committee is investigating the situation. The OSAA leaves oversight of high school athletics from Memorial Day to late August up to local districts - a policy that could very well change in light of what happened in McMinnville. "I think it's high time for somebody to have some jurisdiction during that time of year, because it's out of control," Michael Koester, the physician who chairs both the OSAA sports medicine committee and the National Federation of State High School Associations' Medical Advisory Committee, told OregonLive.com. "One of the issues we're going to be looking at is making recommendations to school districts about offseason conditioning programs."

Meanwhile, The Oregonian Editorial Board on Tuesday urged football coaches everywhere to "be careful with those kids": "No teenage football player knows his limits. All those McMinnville kids cycling through repetition after repetition of push-ups and 'chair dips' in that sweltering workout room last week were going to keep going until a coach or other adult told them they could stop. They had a brand new head coach, Jeff Kearin, to impress. As Brent Cordie, a 17-year-old fullback said, 'I was trying to prove to the coaches I can push myself to the max.' "