Rhabdo: A Drawback of Intense Exercise

Rhabdomyolysis

is a condition in which muscle fibers breakdown or get damaged due to direct or indirect muscle injury. This breakdown of muscles causes the release of a protein called myoglobin into the blood. This can be serious because if you have high levels of myoglobin it can cause 8cc318kidney problems or even kidney failure because the kidneys cannot filter it out. Hence kidney tubes will be plugged, and all your waste products will get concentrated in the kidneys and cannot be removed. Here’s what you need to know about rhabdomyolysis:

Type of muscles affected by Rhabdo:

The human body has three different types of muscles: smooth muscles, skeletal muscles and heart muscles. Smooth muscles are those found in organs such as stomach or intestines. Skeletal muscles are the muscles attached to bones and are responsible for moving your body such as arm or thigh muscles. These skeletal muscles are the ones that can get affected by rhabdomyolysis. So, don’t worry, eating intensely will not give you Rhabdo!  … Might give you indigestion or bloating so you also want to be careful with that.

How do you get Rhabdo:

Most commonly from extreme physical activity or an intense workout session such as running a marathon or doing Murph – a high intensity Crossfit workout (Crossfitters would know!). If you push too much beyond what your body can handle, which let’s face it, it’s not smart but it happens especially when you’re training for a competition or even during a competition. This can put high stress on muscles and can damage or disrupt muscle fibers resulting in Rhabdo.

Other causes include:

• Extreme muscle strain especially in untrained athletes
• Low levels of electrolytes in the blood (magnesium, potassium, phosphate)
• A crush injury: from an accident or fall or something heavy falls on you
• Third degree burns, heat stroke, electric shock or lightning strike
• Prolonged coma
• Severe muscles contractions during seizures
• Medications such as anti-psychotics, statins (used to treat high cholesterol)
• Severe hypothyroidism (low thyroid level)
• Muscular diseases such as muscular dystrophy
• Drugs such as cocaine, LSD

The symptoms of Rhabdo:

The damage to the muscles causes inflammation and you will start to feel tenderness, swelling and weakness in those muscles, soreness, muscle aches and pain and infrequent passing of urine. Another common symptom is dark urine color (red or cola) which is a result of myoglobin (the muscle protein) being released into the blood and kidneys trying to pass it out from your body through the urine.

Other symptoms you should pay attention to which are more related to complications of rhabdo in severe cases include:

• Symptoms of kidney problems such as swelling of hands and feet
• Shortness of breath if fluid builds up in the lungs
• Fatigue and weakness
• Symptoms of high potassium in blood such as nausea, lightheadedness, palpitations
• Unexplained bleeding or excessive bleeding with delayed clotting

Diagnosing Rhabdo:

Most of you will google your symptoms and arrive to this conclusion of Rhabdo anyway. But to get properly diagnosed with rhabdo, blood and urine tests must be done to confirm that you’ve been struck with the Rhabdo. Elevated levels of creatine kinase, myoglobin, potassium and creatinine will confirm the diagnosis.

Rhabdo complicating life even more:

The biggest and most serious complication of rhabdo is kidney failure. In severe cases, when you really crushed your training and crushed your muscles with it, there will be dangerously high levels of myoglobin concentrated in the kidneys which the kidney can no longer filter out and get rid of, hence they will block those tubes and the kidneys will stop functioning normally. Other complications include:

• Irregular heartbeat or cardiac arrest due to high level of potassium in the blood
• Liver problems
• Compartment syndrome due to massive swelling increasing pressure in a confined space which can compress nerves and blood vessels and lead to tissue damage and reduced blood flow (for example in lower legs, arms or abdominal muscles)

Making peace with Rhabdo

Treatment of rhabdo depends on the cause and how bad it is. If your rhabdo is exertional, meaning caused by intense workouts, then it can simply be managed by rest, rehydration, replacing electrolytes in mild cases. Getting enough fluid into your body should be your main goal and then of course terminating your exercise for some time until have fully recovered. In severe cases, you may need to visit the hospital to promptly hydrate your body through IV fluids, correcting electrolyte levels to protect your heart and kidneys, monitor kidney function and remove provoking factors if any, such as medications or underlying muscle problem.

Good news for you, most causes of rhabdo are reversible. Unless rhabdo is caused by a medical condition such as diabetes, thyroid or muscular genetic disorder, you should consult with a doctor to provide you with the appropriate treatment.

“Don’t let Rhabdo crash your exercise party”

Nermine F.