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Rhabdomyolysis – Know Thyself

Rhabdomyolysis – Know Thyself

2012-04-18 By Jerred Moon

Have you heard the hype? I fee like it goes in waves with high intensity exercises programs…They are perfectly safe….they are dangerous…what is the deal?

I know what some of you are saying…Wow, Jerred, back up…what was that…Rhabdo-what? Alright let’s start there.

What is Rhabdomyolysis?

From the smarties at WebMD:

Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from a breakdown of muscle fibers and release of their contents into the bloodstream. This can lead to complications such as kidney (renal) failure. This occurs when the kidneys cannot remove waste and concentrate urine. In rare cases, rhabdomyolysis can even cause death. However, prompt treatment often brings a good outcome. Here’s what you need to know about rhabdomyolysis.

In fitness it really just means you beat the crap out of your muscles…badly. Microtears turn into macrotears and bad things happen.

So what’s the deal with this Rhabdomyolysis?

I have had a lot of friends, who have a distaste for CrossFit, kindly let me know that “CrossFit can cause rhabdomyolysis”. My response is always, “Yea it is incredibly dangerous, you should stay on the couch, where it is safe”.

One thing to note is some of the causes:

  • Use of alcohol or illegal drugs such as cocaine or amphetamines
  • Extreme muscle strain, especially in someone who is an untrained athlete – If you found this article after already getting rhabdo and are offended at the term “untrained athlete” (I get a lot of angry emails), notice is says “extreme muscle strain” before “untrained athlete”; ANYONE CAN GET IT so if you have muscles (elite muscles or untrained muscles) and you extremely strain them…rhabdo.  
  • Crush injury such as from an auto accident, fall, or building collapse
  • Long-lasting muscle compression such as that caused by lying unconscious on a hard surface during illness or while under the influence of alcohol or medication
  • Use of medications such as corticosteroids or statins, especially when given in high doses
  • Electrical shock injury, lightning strike, or third-degree burn
  • Very high body temperature (hyperthermia) or heat stroke
  • Seizures
  • Metabolic disorder such as ketoacidosis
  • Disease of the muscles (myopathy) such as congenital muscle enzyme deficiency or Duchenne’s muscular dystrophy
  • Viral infection such as the flu, HIV, or herpes simplex virus
  • Bacterial infection leading to toxins in tissues or the bloodstream (sepsis)

As you can see from that ridiculous list above it takes quite a bit to induce rhabdomyolysis. When is the last time you felt like you were in a car accident after a workout…wait, don’t answer that.

Rhabdomyolysis in exercise alone is caused by a lot of eccentric movement, eccentric movement allows the body to lift around 120% more than concentric movement. If that eccentric movement is coupled with high intensity volume you are now starting to get dangerous (if your body isn’t ready for it). Lastly, heavy high-rep abdominal movements like GHD sit-ups can be a culprit too. For some reason it doesn’t matter how out of shape you are, everyone thinks they have “strong abs”.

Fact of the matter is rhabdomyolysis can happen to anyone. However, high intensity routines make it more prevalent because people are more likely to actually push themselves.

Mainly rhabdomyolysis can just come from lack of education and bad training, either you being a bad trainer for yourself or a bad trainer training you. That is why you need to learn things for yourself.

Three rules to not get rhabdomyolysis:

  1. Drink a lot of water
  2. Don’t do crap (way) beyond your capacity (this is not an excuse to not push yourself).
  3. Work up to stuff…Increase intensity OR volume, NOT intensity AND volume.

Got Rhabdo? 

  • You probably pushed yourself too hard for too long
  • You may have been dehydrated
  • You possibly did a poorly programmed workout
  • You are competing in something maybe you shouldn’t be?

Bottom Line

I work with special operations…I’ve seen rhabdo, but those guys are normally pushing it to the LIMIT and are perhaps a bit dehydrated; they aren’t untrained, but they are doing a lot more than most ever should…and for good reason. If you are competing in the CrossFit Games Open (with no shot at regionals) or just got it from your CrossFit Box doing a poorly programmed WOD…You need to reassess your priorities, your atmosphere, your coach, your hydration, your nutrition, etc. Yes, anyone can get it. But you really shouldn’t. Know thyself!

Why Rhabdomyolysis is a Mental Disorder

***Note: This is 100% a personal opinion*** (as if that needed to be stated)

I actually do not think that most people are even capable of getting rhabdomyolysis. Why you might ask?

Most human beings are incapable of pushing themselves extremely hard (which it will take to get rhabdomyolysis). Rhabdomyolysis is more prevalent in athletes who had it once, lost it and think they still have it. That is the simplest way I can put it. When your mental capacity does not match you physical capability you are at risk for rhabdomyolysis.

While it is great that you have the mental capacity, because most don’t, if you have been out of the game for awhile…be sure to work back up to things.

My References and Things You Should Read About Rhabdomyolysis:

Rhabdomyolysis Revisited – CrossFit Journal 

Looking at Rhabdomyolysis – Eat, Move, Improve 

CrossFit Induced Rhabdomyolysis – CrossFit Journal 

Rhabdomyolysis – WebMD

photo , photo

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Filed Under: Fitness Development Tagged With: CrossFit, Rhabdomyolysis, WebMD

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