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Exertional Rhabdomyolysis

 

Rhabdomyolysis, or “rhabdo,” is a medical condition where muscle tissue breaks down and the by-products of this process may lead to kidney failure and other complications. 

Rhabdo is commonly mistaken for heat illness or dehydration, so early recognition is critical. 

Exertional rhabdo can result from excessive exercise, physical training, or work. Wildland firefighters are engaged in strenuous activities and prolonged exertion often under harsh environmental conditions and difficult terrain–and so are at increased risk for exertional rhabdomyolysis. 

It is not possible to diagnose rhabdomyolysis in the field because specialized blood tests and a clinical evaluation by a professional are necessary. 

Contributing Factors:  

  • Sudden intense increase in physical exertion after periods away from activity such as occurs with poor conditioning and/or lower fitness levels.
  • Overexertion such as during high-intensity or long-duration activities without adequate recovery time.
  • Heat stress or working in extreme heat.
  • Excessive caffeine intake.
  • Dehydration.
  • Over the counter medications (decongestants, antihistamines, NSAIDs).
  • Prescription medications (antidepressants, statins).
  • Supplements such as creatine.

Treatment: Stop your current activity. Seek immediate care at the nearest hospital.

Rhabdomyolysis–Watch Out Situations:

Image
Plastic cup with very dark urine.
  • Extremely sore for more than 3 days.
  • Soreness extends beyond muscles that were exercised→ i.e., the full body.
  • Soreness that feels out of proportion to the exercise done.
  • Stiffness and decreased range of motion.
  • Nausea, vomiting, headache, confusion.
  • Swelling in the arms and legs.
  • Dark, cola colored urine; gradually getting darker.
  • Extreme fatigue and/or weakness.

Key Recommendations:

  • Listen to your body!
  • Maintain your physical training program, nutrition, hydration, and rest.
  • Introduce new exercises slowly.
  • Keep open lines of communication about fitness, rhabdo, and other injuries/ailments.

Discussion Questions:

  • Given we have a very physical job, what would excessive pain, fatigue, and cramps look like to you?
  • What is your crew’s medical plan for rhabdomyolysis?
  • What are specific steps you and your crew can take to prevent and respond to this condition?

References:

Category
Firefighter Health & First Aid

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Questions? Please contact:
Fuels Management Committee 

The S-219, Firing Operations (Blended) course is now available on the Wildland Fire Learning Portal. Developed through the Incident Performance and Training Modernization (IPTM) effort, this training supports individuals working towards Firing Boss, Single Resource (FIRB) incident qualifications.

This blended course combines online and instructor-led training to provide students with the knowledge and skills required to perform the duties of the FIRB, as described in the NWCG Incident Position Standards for Firing Boss, Single Resource, PMS 350-105.

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1, scheduled for January 2026.

References:

S-219, Firing Operations (Blended)

NWCG Firing Boss, Single Resource Position Page

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Date: Sep 5, 2025
Questions? Please contact:
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Date: Aug 26, 2025
Questions? Please contact:
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Since its launch in 2023, IPTM has made major strides in updating how we manage incident positions:

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The Story Map guides you through the IPTM process, highlights key accomplishments, and outlines what’s ahead. Whether you are a trainer or a trainee, this tool offers valuable insight into the modernization effort shaping the future of wildland fire training and qualifications.

This effort would not be possible without the contributions of NWCG staff, NWCG committees, and hundreds of subject matter experts across the wildland fire community.

References:

IPTM Story Map

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NEW! S-290, Intermediate Wildland Fire Behavior (Blended) Available Now

Date: Aug 15, 2025
Questions? Please contact:
Fire Behavior Subcommittee

NWCG is excited to announce that the S-290, Intermediate Wildland Fire Behavior (Blended) training is now available on the Wildland Fire Learning Portal. S-290 (Blended) training combines online training and instructor-led training components that support individuals working towards any Single Resource Boss or Fire Effects Monitor incident qualifications.

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S-290, Intermediate Wildland Fire Behavior (Blended)

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