Rhabdomyolysis (rhabdo) among Tufts lacrosse players made national news this week following the hospitalization of multiple participants of a 45-minute workout led by an activeduty Navy SEAL. The New York Times described this as unexpected and rhabdo as a rare condition in these circumstances. This is incorrect.

Rhabdo is neither rare nor unexpected in the context of this type of workout. As popular fitness trends have shifted from running, crunches, and pushups to CrossFit and high-intensity interval training (HIIT), we’ve seen a corresponding rise in cases of rhabdo.

In my experience as a physician treating military populations, this scenario plays out all too often. An inexperienced fitness leader, without a solid understanding of exercise physiology or the associated medical risks, conducts a “break off” session typically lasting from 15 minutes to one hour. These sessions usually involve high-intensity training, and seemingly fit individuals end up in the hospital with rhabdo.

This outcome should not come as a surprise. It is a predictable consequence of poorly designed training and inadequate medical risk management. Just as you wouldn’t run a machine at full capacity without proper testing, you shouldn’t push human bodies to their limits without adequate preparation. When you severely tax untrained muscle groups—whether in specialized athletes or individuals out of shape—you are going to encounter rhabdo.

A more thoughtful approach to training incorporates progressive overload, where individuals are pushed near their limits but given adequate time for rest and recovery. After several weeks of progressively challenging training cycles with appropriate rest, the risk of rhabdo drops significantly.

This incident was neither a freak accident nor intentional harm. It was the foreseeable result of poor training design and a lack of attention to well-established medical risks.