Is rhabdo the cost of doing business in the military and the fitness industry? Or should doctors, coaches, and leaders change their training and medical risk management? Is it ethical or necessary to cause rhabdo in a percent of all military recruits? Does it matter that most rhabdo cases will not require dialysis or result in a fatal arrhythmia?

As a physician and former semi-elite amateur athlete, I know how to structure training to accomplish fitness goals and minimize the risk of rhabdo, acute kidney injury, and potentially fatal arrhythmias.

So, I was concerned when a military leader in 2023 responded to my team’s medical advice by blaming the hospitalized recruits. “They are showing up out of shape…we have always trained like this, and it’s never been a problem before.”

Was the commander right? Can you prevent rhabdo when recruits show up out of shape? Are rhabdo and its medical risks the price of doing business? Or do young military men and women deserve something more?