Creatine a Culprit in Oregon Compartment Syndrome Cases?

August 23, 2010 -- An Oregon hospital is running tests to determine if a muscle-enhancing supplement may have caused 13 members of the McMinnville High School football team to be hospitalized with severe muscle problems.

Williamette Valley Medical Center spokeswoman Rosemary Davis said the players are being tested for creatine, which has been linked to compartment syndrome, a condition caused by extreme pressure on the blood vessels within a muscle compartment causing swelling and considerable pain. If not treated, the syndrome can cause permanent damage.

Three of the players had surgery for compartment syndrome, and tests showed those players had creatine kinase levels of more than 40,000 in their blood. A normal level is between 200 and 2,000. If not treated, the syndrome can cause permanent damage.

Experts are divided about whether the use of creatine -- or something else -- is the root cause of the unusual cluster of compartment syndrome cases.

"I still think it is creatine. This is why its use is banned by many trainers. At the same time it is heavily promoted, also by some trainers as well as by nutrition stores," Dr. Thomas L. Schwenck of the University of Michigan told ABC News. "I doubt any follow-up blood testing is going to help. Testing for creatine can't distinguish between endogenous and exogenous sources, nor test for the supplement directly."

Dr. Donald Christie, Maine-based sports medicine specialist, disagrees.

"Injecting the bugaboo of creatine into the story is just creating artificial hype," Christie said. He added that there are just as many athletes who developed compartment syndrome without using creatine as there are those with the syndrome who have used it.

So far, Williamette Valley Medical Center says that six of the players have been discharged. Three are going home today, and the rest will be released tomorrow.

Unusual Cluster of Cases

Medical experts say the fact that compartment syndrome occurred in three players on the same team is highly unusual.

"Usually, you have it happen in 1 in 5,000 kids or even less often. To have several like this is really weird," said Dr. Misty Suri, team physician for the New Orleans Saints.

"This is a very unusual condition, and it is extremely rare to see a rash of cases like this," said Dr. Robert Sallis, co-director of the sports medicine fellowship at Kaiser Permanente.

Compartment syndrome can be caused by a variety of factors in addition to the use of creatine, and doctors can only speculate about what caused the condition to affect the McMinnville football team.

Several attribute the cases to overzealous coaching.

"I have to believe this rash of cases was related to a very inappropriate training routine," said Sallis. "The athletes must have been doing very excessive exercise involving the affected extremities."

"This is a textbook case of overexertion in insufficiently conditioned athletes," said Dr. Stephen G. Rice, director of Jersey Shore Sports Medicine Center in Neptune, N.J.

The Oregon hospital told ABC News that the players were training all summer, but started an immersion camp last Monday. Players began reporting symptoms on Tuesday.

At a press conference on Friday, McMinnville Schools superintendent Maryalice Russell said she didn't believe the problems had anything to do with the players' training. Parents of the hospitalized players told ABC affiliate KATU-TV that they also didn't think their sons' problems were related to the training.

The school says that practice will resume today, the start of the regular season.