North Texas Daily

After eight student athletes on the Texas Woman’s University volleyball team were hospitalized with a muscular-breakdown condition called rhabdomyolysis, the university hired Buckner, a sports and education law firm, to conduct an independent and external investigation into the program.

Monica Mendez-Grant, TWU vice president of student life, said in a news release, “Buckner’s investigation will build upon the University’s ongoing internal investigation to determine what led to this happening, and what we can to do to ensure it doesn’t happen again.”

The first volleyball player began treatment for rhabdomyolysis on Aug. 20. By the next day, seven more were hospitalized. One week later, the final athlete receiving treatment was released from the hospital.

“Although the investigation remains underway, Texas Woman’s University’s initial belief is that overexertion coupled with dehydration during practices last week caused these student-athletes to experience rhabdomyolysis,” Mendez-Grant said.

TWU officials said 18 student-athletes participated in two-a-day practices Aug. 15-19. The pre-season program consisted of fitness-tests, weight training, conditioning and pool stretches in the morning followed by team practice in the afternoon.

The university expects Buckner to report its findings within 90 days.

Getting some work done in the weight room this morning with Coach Crossland ?? pic.twitter.com/f7FjAOc6Nd

— TWU Volleyball (@TWUVolleyball) August 16, 2016

Brian McFarlin, professor of exercise science at UNT said the condition, rhabdomyolysis, or “rhabdo,” occurs when intense exertion tears muscle apart faster than it can heal, discharging intramuscular fibers into the bloodstream and putting an excessive workload on the kidneys. He said a small amount of muscle damage is healthy but a large amount can have serious consequences.

“Rhabdomyolysis can cause death,” McFarlin said. “They’re lucky to get out of it with the few problems that they had.”

Dustin Hill, director of sports medicine at UNT, said in his 20 years working in sports medicine, he’s seen fewer than 10 cases of rhabdomyolysis. He noted once the offseason for any team concludes, it’s important to acclimate athletes from the “basement level” and build up to the season.

He and his staff work to prevent rhabdomyolysis in athletes through hydration, urinalysis and screening for pre-existing medical conditions like sickle cell anemia. At UNT, Hill uses a color coded sign placed above the urinals in locker rooms. He said it’s impossible to constantly monitor every player, but the signs remind athletes to be aware of their hydration by checking the color of their urine.

“It’s just an easy little tool, but if [the stream] comes out brown, dark brown or dark red, you’re already getting into rhabdo,“ Hill said. “If it’s gotten to that point, it’s an immediate deal that you’re sending people to get seen.”

With the Texas heat, Hill said, if he “played it by the book,” the football team would never practice. But because that is not likely to happen, he and the sports medicine staff are extra vigilant to ensure players stay healthy, keeping a nurse in-house with IVs ready in case of an emergency.

“You have to know your athlete and know certain things that might be the red flag,” Hill said. “A lot of this can be like a muscle pain or a cramping feeling in your lower extremities, but you can get that from getting tired and getting cramps.”

In a report posted to the TWU website, officials said the volleyball team altered this year’s pre-season fitness tests.

Instead of doing all the tests in one day, the screenings were spaced out over a period of three days. Another change required the team to perform a specific number of repetitions within a limited time instead of attempting as many reps as possible within the time frame. Officials said the reason for the change was to give players a different goal to reach and for every player to have the same test.

OUR ENTIRE TEAM PASSED THEIR RUNNING TEST TODAY!! ??? #300s pic.twitter.com/EmTITYoFLT

— TWU Volleyball (@TWUVolleyball) August 16, 2016

McFarlin said high volume training focused on developing a specific technique is consistent with rhabdomyolysis and, unlike Denton County Public Health officials, didn’t see the news of eight players having rhabdomyolysis as unusual or surprising.

“There really should be a compromise between how much you do for skill development versus what you do for physiological adaptation,” McFarlin said. “A lot of coaches, right, wrong or otherwise, are just not trained to do that.”

Because sore muscles are the body’s way of telling an athlete to stop, rhabdomyolysis occurs when athletes ignore those warning signs. Therefore, it can be challenging for athletes to choose between pushing themselves to the limits and heeding biological cautions.

Although he can only speculate on the situation, McFarlin offered his thoughts on what he thinks likely transpired at TWU.

“I know athletes,” McFarlin said. “I’ve worked with them in the past as an athletic trainer, and when they don’t feel good they aren’t usually quiet about it. They’re usually pretty vocal about it. My guess is they were probably complaining about being sore and the coach responded to those complaints.”

On Aug. 26, TWU head volleyball coach Shelly Barberee resigned, ending her 13-year career at the university. Despite the timing, she said her decision to step down “is in no way related to student-athletes’ hospitalization.”

In her written statement posted on the university website, Barbaree said she took a leave of absence on Aug. 12, three days before the first practice.

“I took a leave of absence from my position as head volleyball coach at Texas Woman’s University to focus on and address a personal matter,” she said. “Since that date, I have not attended or been a part of any of the TWU volleyball team workouts.”

After Barberee’s resignation, TWU athletic director Chalese Connors named assistant Jessica Beener interim head coach. The name of the coach in charge of the preseason workouts has not been released.

Beener named interim head coach for @TWUVolleyball https://t.co/s1fNAJp3td

— TWU Athletics (@twupioneers) August 28, 2016

Barbaree said she’s leaving the program in a good place.

“I am extremely proud of my 13 years as head volleyball coach at TWU,” Barbaree said. “I am leaving the TWU volleyball team in a strong position coming off of a 2015 NCAA tournament appearance and believe the team will have continued success.”

In a release, Mendez-Grant said Dr. Michael Auvenshine, a sports medicine specialist, will work with TWU athletic training staff to determine each individual’s risk for recurrence and determine restrictions before athletes are approved to practice or play.

Over the weekend, the TWU Pioneers kicked off the 2016 season as scheduled, hosting the Hilton Garden Inn classic at Kitty McGee Arena in Denton. The Pioneers closed out the tournament with a  2-2 mark.

Next Friday, TWU will take their improving health to Lakeview, Florida, with hopes of improving their record, facing Florida Southern University in their first road game of the season.

“All student athletes are out of the hospital and continue to improve daily,” Mendez-Grant said. “I would like to thank the university community for their support and well wishes for the student-athletes this week.”

Featured Image: Patrick Green | TWU