It's the destruction of skeletal muscle resulting in leakage into the urine of the muscle protein myoglobin. Myoglobin, a protein component of muscle cells, leaks into the bloodstream. An enzyme Creatine kinase, is a protein that assists chemical reactions in the body, and muscle cells. Each of these proteins can be measured in blood to monitor their levels, and degree of muscle injury from rhabdo. Myoglobin can also be measured in urine samples.
Common Causes of Rhabdo: I’ve highlighted some in yellow, as they especially pertain to athletes.
- Extreme Physical Activity
- Muscle trauma
- Electrolyte imbalance
- Infections (viral or bacterial)
- Not enough blood going to an extremity
- Severe hypothyroidism (low thyroid)
- Prescription medications: mainly statins for high cholesterol.,
- Severe burns
- Low body temperature for a long time
- Alcohol intoxication
- Crush injury
- Illegal drugs
- Trauma victims: People who fall, are unconscious, and unable to get up for a long time, such as, earthquake victims.
Know the Symptoms of Rhabdo:
Note: Rhabdomyolysis may not cause any symptoms at all.
- Muscle aches and pain
- Muscle weakness (especially common with severe muscle damage). - Dark urine
From the above, you can see Rhabdo resembles much of Delayed Onset Muscle Soreness (DOMS) The only way you can tell is to be mindful of other symptoms, and symptoms that are not getting better, or worse.
What Do I Do if I Have Several Symptoms?
- See your doctor immediately!
What Can I expect From My Doctor?
- Most likely tests will be performed, depending on your physician:
- Complete Blood Count (CBC)
- Metabolic Panel
- and/or Muscle Enzymes
What If I Choose Not to See My Physician Because I Only Have a Couple, Less Threatening Symptoms?
For instance: I’m sore and feel weak, and stiff, but sometimes this happens when I have a ‘good’ workout, or push the line into slight overtraining.
- First of all, let someone else know what you’re experiencing, and your suspicions of Rhabdo. Many times others notice symptoms before we do. Do not keep this to yourself.
- Be mindful of how you feel each day.
- Drink plenty of water.
- Get plenty of rest/sleep.
- Gentle massage may be okay, but not deep, as it will stimulate the release of toxins.
- Pay attention to your urine, if it changes color, immediately get to the doctor.
Frankly, most cases of Rhabdo don’t require hospitalization, and many people recover within a week or so. But you never know. Others show very little symptoms, some not at all, and with specific individuals it can be a serious threat, especially those who are on statins or other medications, have hypothyroid, or an electrolyte imbalance they’re not aware of. Worse case scenario, kidney failure, and death can result. Nothing to mess around with. The main point to get here is recognizing the symptoms and taking the appropriate action. The outcome is much more favorable the earlier you get help.
What Does This Mean To Athletes?
This means as athletes we need to pay attention to our training. Always consult your physician BEFORE engaging in physical exercise, particularly if you haven’t been consistent with exercising in the past, or you took a significant break due to illness, or injury.
When you’re good to go, start SLOWLY! There’s no rush. So your neighbor has been running steadily for months, and they talk you into running with them. Does this mean you have to keep THEIR pace? Go THEIR distance? Heck no! Ditto for sports teams where players run themselves crazy to impress their coach and/or teammates. Team, when a new season begins, take it SLOWLY! If you want to go like a madman (or mad-woman), then you’d better plan on maintaining that shape during your off season, as well. This is even more important if you have other health factors as a risk, or exercising in cold or heat.
The same is true for weekend warriors, the marathoner, and strength and endurance athletes. Ditto ‘TIGHT’ Team. ‘TIGHT’ workouts are EXTREME, condition yourself appropriately, you’ll make gains soon enough, in the meantime enjoy the journey!!!! I counsel my team to not eat heavy for up to two hours before a workout, or doing a DVD. I encourage them to drink water, but not large amounts within an hour of the DVD, or training. Yes, sip/drink as necessary, throughout your workout, but ideally you want to begin hydrating right after your workout, and continuously afterwards throughout the day/night until your next workout. This way you maintain hydration. I find those who drink large amounts during EXTREME training often throw it right back up.
This holds especially true for ‘TIGHT’s Series Two. These workouts are where it’s at, but you MUST work your way up to them, condition yourself consistently, refuel appropriately, rest/sleep as necessary, and back off, modify, or scale down when the need arises. It does not mean you’re a slacker, quite the opposite, it shows you have respect for your body, it’s functions, and ultimately you will become stronger as a result.
Pay attention to pain. Pay attention to feeling weak. Pay attention to swelling, your meal plans, hydration, and state of mind. These things cannot be taken for granted.
Whenever the body is pushed to it’s max, whether mentally, physically, and/or emotionally, it takes its toll. The body needs time to recover, heal, and rebuild. Deny the process and pay the price. Listen and reap the rewards.