Extreme Exercise And Rhabdomyolysis (Rhabdo)

09/14/2023

Physical activity fuels the body, and a body in motion stays in motion. Health enthusiasts have sworn by rigorous, highly disciplined exercise regimens for years with excellent success. However, with the increasing influence of advertisements and social media promoting the health (and social) benefits of a "ripped" physique, the physical limits of what the body can endure have been pushed to growing extremes.

Intense workouts may lead to 'Rhabdo'.

The technical name for Rhabdo, 'rhabdomyolysis,' results from extreme muscular degeneration and can be severe enough to be life-threatening. Rhabdo is not associated with a moderate amount of muscle breakdown with moderate exercise, which is expected to promote the repairing and restrengthening of muscles. The complications of Rhabdo may surface when muscle fibers are entirely torn apart, and the body is stressed beyond its limits.

Typically, beginners to new exercises who need to pace themselves correctly are most susceptible to expiring Rhabdo. This can include high-intensity sports, gym sessions, or hiking up steep inclines.

Rhabdo is directly associated with urinary changes.

Within one to three days after intense physical activity, an unusually dark-colored urine similar to tea may appear. However, this symptom of Rhabo is commonly mistaken for another condition associated with muscle overexertion known as hematuria (blood in urine).

What distinguishes Rhabo from hematuria, however, is the presence of myoglobin, a harmful protein in the urine responsible for the discoloration. Myoglobin begins to travel through the bloodstream during the degeneration of overstrained muscles. Afterward, irreversible kidney damage can occur as these toxic proteins overwhelm the kidneys. Acute renal failure is the complication with the most severe effects; 15 percent of all Rhabo-diagnosed patients will also experience acute renal failure.

What other symptoms are indicators of Rhabdo?

Rhabdo may be present if the following symptoms are present:

  • Distinct muscle stiffness, but only in specific areas
  • Swelling in localized exerted muscles
  • Overwhelming muscle pain not typical with workout intensity/duration
  • Lingering sensations similar to cramps
  • Weakened muscles in a particular group

What are the treatment options for Rhabdo?

Supportive therapy options are part of Rhabo treatment, which can include the following:

  • Muscle strengthening physical therapy with a rest period following beforehand.
  • Intravenous fluid intake through a vein to rehydrate and replenish electrolytes to filter harmful toxins out of the body. This may require an extended hospital stay for a few days to complete treatment.
  • In the case of extensive kidney damage, dialysis may be required. Dialysis works by recycling a portion of your blood out of the body, filtering out toxins, and then replenishing the filtered blood back into the body.

Can the risk of Rhabo be minimized?

The likelihood of developing Rhabdo brought on by intensive exercise can be reduced by:

  • Paying attention to your body and easing yourself into new forms of physical activities. If fatigue and soreness interfere during exercise, consider taking a rest day or decreasing your usual intensity and duration.
  • Don't consume habit-forming substances such as drugs or alcohol.
  • Drink the recommended daily water intake and be mindful of heat exhaustion. Seek shady areas or well-ventilated/air-conditioned buildings if you're exerting yourself in hot weather.
  • Discuss medications you're taking with your health care provider, which may be a risk factor for developing Rhabdo.