Aim for commitment, intensity and focus from your clients, but be sure not to over-exert them.

So you’ve worked hard to attract and retain awesome clients. You are diligent in planning thoughtful lessons for them. Your sessions have an admirable intensity and you present your clients with interesting and challenging exercises. Your clients reward you back with punctuality, focus and consistent effort.

So what’s next? Well, it might be time to reflect how ‘hard you hit’ and reflect on how you will continue to deliver effective, well-programmed lessons without pushing participants over the proverbial ledge.

We, as professional trainers, need to understand the risks of over-exertion. Neglect this and the consequences can be catastrophic.

It’s worth reminding ourselves of the risks of exertional rhabdomyolysis?

Exertional Rhabdomyolysis

What is it?

The textbook states that exertional rhabdomyolysis occurs in response to strenuous physical activity where exercise places stress on the muscle causing damage to the muscle fibres, the more strenuous or prolonged the activity is the more damage that can occur.

This muscle breakdown can also be caused by normal exercise under extreme circumstances.

Rhabdomyolysis can be so severe as to be life threatening due to several factors, including renal failure, hyperkalaemia, and disseminated intravascular coagulation [1].

Who’s at risk?

Although, as instructors, we strongly encourage tough, competitive and challenging bootcamps/ fitness programs, we should always be aware of the effects of over-exertion.

In particular, clients just starting out are often at increased risk as they push themselves [2].

In order to minimise this risk, ensure your programming is gradual in its progression, provides scaled options for clients and monitors each client individually.

Springer and Clarkson [1] also highlight there is a higher incidence of rhabdomyolysis in men is due to the fact that more men may feel themselves to be in situations of being ‘pushed‘ to over-exert themselves.

2 young sports women, standing with their backs to the camera on an athletics track. They need to be aware of exertional rhabdomyolysis

Take Away Points

In reviewing the excellent work from Springer and Clarkson [1], the following key recommendations can be taken away:

1)  Exercises that are biased toward eccentric contractions, where the muscles are lengthening while trying to contract, are particularly effective in damaging muscle fibres because of the increased strain they place on muscle tissue.

2)  In two case studies, the primary factor that led to rhabdomyolysis was over-exertion encouraged by the fitness trainer. (Interestingly. in one case study the 22 year old healthy female had no underlying risk factors, leading to the conclusion that over-exertion encouraged by the trainer was the primary factor).

Preventative Measures

Sutton [2] highlights that the key preventative measures are proper hydration and adequate rest and recovery periods. Furthermore, it is recommended that diet plans are reviewed to ensure adequate amounts of carbohydrates, fats, proteins and water are consumed prior to training sessions.

[1] Springer, B., and Clarkson, P. “Two Cases of Exertional Rhabdomyolysis Precipitated by Personal Trainers”, Medicine and Science in Sport and Exercise, 2003, Vol 35, Issue 9

[2] Sutton, B., “Exertional Rhabdomyolysis-Risk Factors and Preventative Measures”, National Academy of Sports Medicine

If you would like more information on staying hydrated whilst exercising, see here.