Rhabdomyolysis is like going to the dark side of intense fitness. No matter your fitness level, believe it or not, you can overtrain and get yourself into a situation where you face a case of rhabdo head on. While you’re breaking a sweat in your ‘happy place’ rhabdo is a serious condition, that left untreated, can be life-threatening. Let’s learn more about what it is, what the signs and symptoms are, how to prevent it, and what to do if you suspect you have it
What is Rhabdomyolysis
Rhabdomyolysis (aka rhabdo) is caused by the rapid and excessive muscle breakdown process during high intensity exercise. While yes, muscle tissue does break down during exercise so that you can build and rebuild new muscle to get stronger, too much muscle breakdown is not good. This can happen when you train too fast, too hard, or too much. When too much is demanded from the muscles, muscle cells actually burst, leaking myoglobin (a protein), sarcoplasmic proteins (creatine kinase, lactate dehydrogenase, aldolase, alanine, and aspartate aminotransferase, and electrolytes into the bloodstream. [R]
When muscle mass is breaking down rapidly and you’re pushing into the extreme fatigue realm, still trying to exercise, blood is pumping and the filtering system, like the kidneys, can’t keep up with the excretion. This is when myoglobin and other byproducts are just circulating in the blood stream. These byproducts are very damaging to the kidney(s) and often cause kidney damage since they cannot be flushed out. This is also when your body can use up all your electrolytes and water, causing dehydration, cramps, and extreme fatigue or sickness.
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While not all rhabdo symptoms are obvious, there are some pretty plain ones that show up the day of or within a few days thereafter your exercise. If you suspect you have rhabdo symptoms, we recommend consulting a doctor, visiting urgent care, and hydrating sufficiently to provide your body with the hydration it needs to support the kidneys to do their job.
When myoglobin is released, it will show up as a red or dark colored urine either the day of or within a couple days of your overdone exercise bout. These harmful proteins can cause permanent damage to the kidneys, and of the most serious rhabdo symptoms, acute renal failure can happen (which occurs in about 15% of people diagnosed with rhabdo). [R]
Other Rhabdomyolysis Symptoms [R]:
- Delayed Onset Muscle Soreness (DOMS)
- Dark colored urine
- Significant muscle weakness out of proportion
- Swelling or cramps
- Numbness or tingling
- Nausea, dizziness, confusion
- Extreme fatigue
- Dehydration/Electrolyte imbalance
Rhabdo can also cause something called compartment syndrome, which is a really painful condition. The pressure within injured muscles begins to build to a level that actually causes significant swelling, reducing or blocking the ability for blood to flow freely into the muscle. Sometimes, in more severe cases, surgery may be required to get the swelling to come down and to prevent the muscle tissue from dying due to the lack of oxygen rich blood not being delivered properly. [R]
- Acute Compartment Syndrome: this is a medical emergency which is very painful, does not resolve on its own, requires medical attention and/or surgery (i.e. fracture, badly bruised muscle, steroid use, accidents, too tight of bandages)
- Chronic Compartment Syndrome: not a medical emergency, often caused by exercise, reversible/heals with rest
Prolonged muscle injury can also happen, in less severe cases, that can last weeks or months, until the muscle is repaired. If you do experience this rhabdomyolysis symptom, we recommend not pushing the muscle, getting adequate rest, hydrating, and letting the muscle tissue heal to avoid permanent or severe injury.
While rhabdo is relatively uncommon, those who show symptoms and end up getting treatment comes to around 26,000 people in the United States annually. Individuals who are more susceptible to the uncontrolled and rapid muscle mass breakdown include those who have high levels of muscle. [R] However, exercise-related rhabdo can occur in both experienced and non experienced individuals, most often seen in high-intensity training, functional fitness, spinning and ultra running, for example. [R] Rhabdo can happen from alcohol abuse, severe electrolyte/dehydration, and medication use, especially when coupled with exercise.
Other Rhabdomyolysis Causes Include:
- Electrolyte Imbalances
- Drug Use
- Illicit Drug Use
- High Intensity Training
- Alcohol Abuse
- Trauma (blunt force)
- Heat Stroke
- Muscle Ischemia
How To Prevent Getting Rhabdo
First and foremost, listening to your body and understanding to not push it into the extremes is going to be the way to go. There’s nothing wrong with taking it easy, especially if you’re brand new to an exercise or sport. It is also important to take into account what you’ve eaten, what you’ve drank, how hot it is where you’re working out, and if you’re able to handle the stimulus at hand.
We recommend also avoiding things like alcohol, drugs, NSAIDs, and caffeine prior to your intense workout, as these thigns can dehydrate the body, put a lot of unnecessary pressure on the kidneys, setting you up for rhabdo symptoms. If you run into intense fatigue, cramps, pain, or any other very negative effect of your workout, we recommend calling your doctor or visiting an urgent care. As stated previously, diagnoses of rhabdo are relatively rare, but that doesn’t mean that the undiagnosed symptoms don’t exist and often go untreated.
We also recommend supplementing with an electrolyte powder, like INTRA from Swolverine, made with essential amino acids and superfoods to keep your body hydrated and fueled for your exercise.
Getting rhabdo isn’t something you want to do. We recommend being smart, listening to your body, hydrating properly, and progressing appropriately as your body can handle the workout stimulus. Too much too fast can set you up for failure with your health, and trust us when we say, putting that much pressure on your kidneys from the byproducts released by muscle mass breakdown is not worth the risk. Getting close to exhaustion? Take a break or be done with it. If you’re working with a trainer, don’t let them pushing you overrule your body and your mind if they are telling you that you’re pushing into the extreme. A good trainer or coach will know your limitations and be able to provide you with modifications/tailer the exercise to your level of fitness.
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