Excessive increase of creatine kinase after one hour of horse riding.

The research investigates the occurrence of rhabdomyolysis, a condition caused by skeletal muscle breakdown, in a woman after she participated in one hour of horse riding. The study discusses the possible causes and indicators of this condition in relation to intense physical activities.

Background and Purpose of the Research

• The study was motivated by the need to understand rhabdomyolysis, especially in the context of physical activities. The authors highlight that rhabdomyolysis has many triggers including drugs, infections, excessive muscle activity, trauma, and electrolyte disorders.
• This research aimed to investigate a rare case where rhabdomyolysis occurred because of a short, intense physical activity namely, horse riding, that was not typically associated with the condition.

Patient’s Condition and Presentation

• The subject of this study was a 53-year-old woman who reported to the emergency ward with symptoms of sudden thoracic pain, sweating, dizziness, and leg cramps.
• She had no other relevant disorders in her medical history and was in stable cardiac and respiratory condition. Notably, she felt pain in both legs.

Lab tests and Findings

• The lab tests were performed and the most striking discovery was an abnormally elevated creatine kinase (CK) of 8273 U/L, far beyond the upper normal range of 145 U/L.
• The CK-isoenzyme CK-MB, another significant muscle damage indicator, was also noted to be high at 177.3 U/L against the upper normal range of 24 U/L.
• However, the relative percentage of CK-MB was 2%, which was within the normal range of ≤6%, and Troponin T was negative, suggesting that the woman was experiencing rhabdomyolysis.

Patient’s Activity Leading to Condition

• Upon further conversations with the woman, she mentioned that she had participated in an hour of intensive horse riding using a special technique without stirrups the previous day.
• Sequential measurements of CK and CK-MB in the following days showed a constant decrease, and the patient didn’t experience any further issues. This led the research to conclude that the intense hour of horse riding was likely the cause of rhabdomyolysis in this case.

Conclusion

• The researchers concluded that the rhabdomyolysis occurrence in this woman was most probably caused by the excessive strain placed on the adductor muscles during the one-hour horse riding session.