Cynthia was a gym addict, attending Pilates, yoga and aerobic classes nearly every day of the week. She’d occasionally work with the gym machines or lift a weight or two, and thought she had a fairly high fitness level. So, she was obviously excited when her bestie asked her to try out a HIIT (High Intensity Interval Training) class.
At first everything seemed fine and Cynthia was able to keep up easily with all the exercises and movements just like the trainer instructed. Cynthia did suicide sprints, jumping jacks, burpees, squats, high knees and plyo push ups. Yes, the feeling was great, she was getting the adrenaline rush she wanted….. or so she thought.
By 15 minutes into the hour-long session, Cynthia realised she was probably into something over her head. She decided to tone down the intensity and slow down her movements through the rest of the class. Her legs felt weak and shaky, but she dismissed it as muscle ache due to the new movements and high intensity.
Two very achy days later, Cynthia noticed her urine had turned a darker color. Warning bells set off, and she headed to the nearest emergency room. After hearing her symptoms and that she recently participated in a high intensity workout, the doctor insisted Cynthia be immediately admitted where tests confirmed she had Rhabdomyolysis, or Rhabdo in short.
Luckily Cynthia was treated and able to recover quickly, but she did say the pain was the worst she’d ever experienced.
What is Rhabdo?
Rhabdo is a dangerous and rare syndrome which happens when muscles get damaged and break down. The breaking down process causes the release of a protein call myoglobin into the bloodstream. Excessive myoglobin in the bloodstream can lead to kidney damage.
It is important to recognize Rhabdomyolysis symptoms, as initial symptoms can be subtle. Be on the lookout for:
- Muscle soreness
- Infrequent urination / low urination output / dark coloured urine
- Fever / feeling sick / vomiting / nausea
Causes of Rhabdo:
Rhabdomyolysis is caused by muscle injury. It can be brought about in several ways, some of which are:
- trauma, exertion or even heat.
- Genetic and metabolic disorders
- Medications or toxins
How is Rhabdo diagnosed?
First of all, if your doctor suspects Rhabdo, he will examine the muscles which ache, to check for tenderness, after which urine and blood tests will be performed to confirm a diagnosis of Rhabdo.
Tests will include determining levels of:
- Creatine kinase, an enzyme found in muscles, the brain and the heart.
- Creatine in blood and urine, caused by muscle breakdown which is normally removed by the kidneys.
- Myoglobin caused by muscle breakdown, which will be present in blood and urine.
- Potassium, an important mineral that may leak out from injured muscles or bones.
A clear indication of muscle damage will be seen if elevated levels of the above products are found.
Treatment of Rhabdo:
Rhabdo can be successfully treated without long-term kidney damage, if diagnosed early.
Your doctor will start by hooking you up to IV fluids immediately. The fluids should contain bicarbonate which will help flush out myoglobin from your kidneys.
High potassium levels and low calcium levels can be treated with different IV fluids as well.
If you have been diagnosed with early stage Rhabdo, your doctor may prescribe bicarbonate and diuretics to keep your kidneys functioning.
If Rhabdo has progressed to a stage where kidney damage has started, you may need to go on dialysis.
Prevention of Rhabdomyolysis:
Stay hydrated all the time! Drinking plenty of fluid before and after strenuous exercise dilutes your urine and helps the kidneys flush out myoglobin that your muscles released during a hard workout.
It is important to also stay well hydrated during exercises. Don’t put off taking that sip of water until you feel extremely thirsty – the damage may be already starting on the onset of feeling sore.
Slow down or take a break to cool down when you start feeling overheated, as overheating can bring on Rhabdo.
Wait a few days after an intense bout of exercise, as symptoms may take time to appear or worsen.
And if you do wish to participate in intense exercise, you have to train your body up to a higher level of fitness over time first, so you can adapt easily to a bootcamp or HIIT class. Don’t be a hero and exercise yourself to death! Doing 500 squats with no prior practise is a sure-fire way to end up with Rhabdo.
Now that you have a picture of Rhabdomyolysis and the severity of its effects on your kidneys, do not delay seeing your doctor straightaway when you start noticing Rhabdo symptoms after a heavy workout.
2nd June 21:30