von Deneen, Karen M, Alemayehu, Dereje Gobena, Khosla, Ajit · Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine · 2024 · DOI
This case report describes a 46-year-old female athlete with ME/CFS and fibromyalgia who experienced a serious muscle injury called rhabdomyolysis after just one session of electrical muscle stimulation (EMS) training. Her muscles broke down severely enough to cause compartment syndrome—a dangerous swelling in the muscle tissue—requiring intensive hospital care with fluids and medications. The report warns that people with ME/CFS and similar chronic conditions should be very cautious with EMS training because their bodies may react more severely to this type of exercise.
For ME/CFS patients, this report highlights an important safety concern: certain exercise modalities marketed for fitness and recovery may trigger disproportionate and dangerous physiological responses in people with ME/CFS. Understanding which interventions carry heightened risk of severe complications helps patients and clinicians make informed decisions about exercise prescription and avoid harm. For researchers, this case underscores the need to study how ME/CFS-related muscle and metabolic dysfunction may alter vulnerability to acute muscle injury from external stimuli.
This single case report does not establish the prevalence or incidence of rhabdomyolysis in ME/CFS populations undergoing EMS, nor does it prove that all people with ME/CFS will experience similar reactions. The case does not identify which specific ME/CFS-related mechanism (mitochondrial dysfunction, metabolic abnormality, neuromuscular disorder) predisposes to this complication. Causation is inferred from temporal association, not demonstrated through controlled comparison.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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