03 February 2026
: Case report 
Atypical Presentation of Exertional Rhabdomyolysis in Older Adults: Two Case Reports and Literature Review
Unusual clinical course
Qing-song Wang ABCDEFG 1, Qiao Feng ABCDEF 2, Yan Zhao BCD 1, Qing Zhang ABE 1, Bin-feng He
ABCDEFG 1*, Zai-Chun You ABCDEFG 1
DOI: 10.12659/AJCR.949841
Am J Case Rep 2026; 27:e949841
Table 1 Reported cases of exertional rhabdomyolysis, 2015 to 2024.
| Author, Year [Ref] | Demographics (age/sex) | Exertional activity | Myalgia location or other symptoms | Creatine kinase maximum (U/L) |
|---|---|---|---|---|
| Busanello Mata Alves et al, 2024 []6 | 45/M | CrossFit | Arm | 126 891 |
| Hashi Mohamed et al, 2023 []7 | 32/M | Gym workout | Generalized body | 39 483 |
| Dai et al, 2022 []8 | 24/M | Long-distance running and rock climbing | Generalized body | 5800 |
| Kumar et al, 2022 []9 | 26/M | Gym workout | Lower leg | 87 750 |
| Butkus et al, 2022 []10 | 21/M | Daily exercise and gym workout | Generalized body | 590 000 |
| Benedict et al, 2021 []11 | 33/F | Exercise to lose weight | Generalized body | 119 800 |
| Yow et al, 2021 []12 | 29/M, 31/M, 30/F, 28/M, 33/F | Spinning | Lower leg | >100 000, 42 983, 24 789, 62 280, 50 278 |
| Adhikari et al, 2021 []13 | 22/M | CrossFit | Generalized body | 132 540 |
| Peng et al, 2019 []14 | 21/M | Gym workout | Lower leg | 140 500 |
| Pereira et al, 2019 []15 | 21/M | Military training | Lower leg | 2116 |
| Murugappan et al, 2019 []16 | 26/M | Exercise to lose weight | Generalized body | 223 100 |
| Tibana et al, 2018 []17 | 35/F | Extreme conditioning competition | Generalized body | 77 590 |
| Khamsi et al, 2018 []18 | 16/F | Cycling | Unilateral labial edema | 3120 |
| Mitchell et al, 2018 []19 | 18/F, 18/F, 24/F | High-volume bodyweight squats, push-ups, strength/interval training | Lower leg, arm, generalized body | 134 090, 47 120, 9482 |
| Longo and Shanes, 2018 []20 | 28/F | Spinning | Lower leg | 74 978 |
| Brogan et al, 2017 []21 | 33/F, 20/M, 33/F | Spinning | Lower leg | 60 000, 14 493, >80 000 |
| Clark and Manini, 2017 []22 | 20/M | Blood flow–restricted exercise | Lower leg | 36 000 |
| Atias-Varon et al, 2017 []23 | 19/M, 18/M, 18/M | Crawling exercise | Lower leg, back, headache and general weakness | 176 599, 150 000, 45 000 |
| Yang et al, 2016 []24 | 17/F | Cheerleading camp | Arm | 47 500 |
| Bhakthavatsalam et al, 2016 []25 | 26/F | Super Yoga Brain | Lower leg and back | 13 800 |
| Hoon Lee et al, 2015 []26 | 66/M | Squatting sessions | Myoclonus | 1906 |
| F – Female; M – Male. | ||||