As of 1994, corporal punishment in schools is prohibited in 27 American states including New York State. Two boys, aged 11and 12 years, developed rhabdomyolysis from excessive exercise used as corporal punishment they received in a New York City public school. Both boys were ordered to perform 150 push-ups by their gymnastics teacher as a punishment for running around the gymnasium. Both developed tender and swollen deltoid and pectoralis major muscles and both required hospitalization for five days for parenteral hydration and urinary alkalinization to prevent acute renal failure. Serum levels of creatine kinase (CK), aminotransferases (AST, ALT), lactate dehydrogenase (LDH), and urine myoglobin (Ur Myoglobin) are shown below:Table After educational intervention, school officials responded with a new policy that no student perform more than six push-ups at any one time. As demonstrated here, corporal punishment in schools still endangers the health of children even in those states where it is illegal. Pediatricians can contribute to the abolishment of corporal punishment by: (1) educating him/herself that it is still legal in many American states, (2) promoting public awareness, (3) educating school officials and parents regarding alternatives, such as positive reinforcement for good behavior, (4) detecting and reporting cases of such punishment in schools and encouraging parents to utilize their rights to request that their children not be punished, and (5) educating school personnel and parents about the potential adverse effects of excessive exercise.

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