In the days after a 45-minute workout led by a Tufts graduate turned Navy SEAL, members of the men’s lacrosse team became ill and nine were hospitalized with a serious muscle condition. On Wednesday, nine days after the voluntary workout, the last three players were released, and the university’s independent investigation began in earnest.
The players were treated after developing rhabdomyolysis, also known as rhabdo, a serious and rare muscle condition. It is unclear what the workout entailed. The person who led it is an active duty Navy SEAL, a Naval Special Warfare spokeswoman said. The SEAL was not there as part of a Navy-sanctioned event, and it was unclear if the sailor would face any disciplinary action, the spokeswoman said.
The workout on Sept. 16 was voluntary and supervised, according to Patrick Collins, a Tufts spokesman, and about 50 players participated. Tufts declined to say who supervised the workout.
Men’s lacrosse practices are postponed until the university’s medical staff decides they can resume, Mr. Collins said in an email on Wednesday. But some individual athletes have been cleared to continue training.
On Wednesday, Tufts announced that it had appointed two independent investigators to look into what had happened and how to prevent it from recurring. The university did not provide a timeline for the investigation but said that it would give the investigators “all the time and information” they need.
The Division III team, coached by Casey D’Annolfo, has won several N.C.A.A. national championships, including in May, when it defeated Rochester Institute of Technology.
Rhabdo is a serious, sometimes life-threatening, condition.
Rhabdo is a condition that can require critical care, according to Dr. Lisa Kodadek, a physician and surgeon at Yale New Haven Hospital who wrote a paper on the subject. It happens when a person injures their skeletal muscles, causing the muscles to die and release their contents into the bloodstream, according to Dr. Kodadek.
The contents of the muscles’ cells can cause “pretty significant health problems,” Dr. Kodadek said. Those include kidney failure, problems with heart rhythm and blood clotting. In serious cases, it can require treatment in an intensive care unit.
Many activities can cause rhabdo, Dr. Kodadek said, like a car accident or an older person’s fall.
But it’s more likely diagnosed after a lengthy high-intensity workout, Dr. Kodadek said. She added that she found it surprising that several athletes were seriously affected by the 45-minute workout.
“I suppose if it was incredibly extreme and it taxed their muscles in a way that they weren’t able to compensate, then it certainly could have resulted,” she said.
Rhabdo is not common. About 26,000 people in the United States develop it every year, according to the Cleveland Clinic. Usually, those with rhabdo can recover within three to five days, but in more serious cases, it can take longer, Dr. Kodadek said.
College athletes don’t often experience rhabdo, but there have been some cases, said A.J. Duffy III, president of the National Athletic Trainers’ Association.
In 2011, 13 University of Iowa football players were hospitalized with rhabdo when the team jumped back into workouts after taking some time off following a bowl game. In recent years, there have been reports of a women’s soccer team in Texas suffering from rhabdo, which left one player hospitalized.
The N.C.A.A. has training guidelines in place for college athletes to prevent rhabdo, Mr. Duffy said. The guidelines mention “transition periods” that occur after a break in training or introducing new members to a team. During transition periods, the N.C.A.A. recommends, athletic trainers and coaches should ensure that intensity and volume of activity is gradually increased over time.
“I think that athletes, they’re very competitive,” Mr. Duffy said, adding that many want to do what it takes to give them a physical edge on their opponents.
Training gradually, he said, “will help you in the long run and minimize the potential risk of events like this occurring.”
Navy SEAL training is among the most difficult in the military.
The Navy SEAL who led the workout had recently graduated from the Basic Underwater Demolition/SEAL training program, also known as BUD/S, according to Tufts. BUD/S is a monthslong selection course that sailors must complete to become SEALs.
The program puts trainees through months of physical and mental challenges, many which involve groups of trainees carrying heavy logs along loose sand beaches and spending hours in frigid water.
Brad McLeod, a fitness trainer and former Navy SEAL who went through BUD/S twice in 1984, said the program was “incredibly hard and intensive.” It is unclear if tactics from BUD/S were used in the 45-minute training at Tufts.
Mr. McLeod leads camps and CrossFit training inspired by his Navy SEAL programs. When he organizes workouts, he said, he always has water on hand — sometimes even a tub filled with ice water — in case his clients become overheated. During one training camp he helps run, Mr. McLeod said, they put athletes through physical screening tests to measure each participant’s fitness level.
“Lacrosse and Navy SEAL training are two different things in terms of conditioning,” Mr. McLeod said, adding that he felt that in most cases rhabdo was avoidable.
Men’s lacrosse is a contact sport that risks concussions while also requiring lots of cardio exertion. Many players on the field are running for a majority of a match while dodging hits.
“They’re bunch of guys on the lacrosse team, they’re trying to man up and do the workout, nobody wants to walk off or whatever,” he said. “It can be a bad recipe.”
A number of people have died or been injured during the BUD/S training program, which has prompted investigations into its safety risks in recent years. Graduation rates from the program decreased from about 40 percent in the 1980s to 10 percent in 2021.
Since 2020, rhabdo brought on by overexertion has increased across the military, according to a study published in April by the Armed Forces Health Surveillance Division Defense Health Agency. In 2023, there were 529 cases of rhabdo among active duty military members, and about 41 percent of those diagnosed ended up in the hospital. The study found new recruits going through training were more likely to experience the condition.
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