Rhabdomyolysis (Muscle Injury)
By: Marylin Salgado
March 24, 2019
When we workout, we fail to realize how important time, technique and safety are. We also fail to realize how important it is we give our muscles the respect they deserve and not overdo the reps or the weights. This blog is meant to educate you on a serious condition that will initiate from the muscles and end in the kidneys, leading to failure and in rare instances, can even cause death.
What is Rhabdomyolysis?
It is a syndrome caused by indirect or direct muscle injury. I will list some possible causes, but for the purposes of this blog, I will be focusing on injury caused by workouts and or training. During strenuous training or severe impact to a muscle, the dead muscle fibers release myoglobin into the bloodstream. Myoglobin is one of the most important proteins in our body. Binded with oxygen, it assists in providing extra oxygen and releasing energy to power up muscular contractions. And while you may be thinking, “let me work hard and pump this Myoglobin up”, high concentrations of Myoglobin released into the bloodstream, cannot be filtered by the kidneys. In turn, it causes the kidneys to fail. Kidney failure means your blood cannot be cleaned and filtered and requires a person to undergo Dialysis to have this done mechanically. While all this sounds very grim, to all you addicts who need to work out 7 days a week for 3 hours a session, overdoing it can kill you.
I have extracted a case study, enclosed below, from an article of the Case Reports in Emergency Medicine. This 23-year-old patient was diagnosed with Rhabdomyolysis, and as you can tell, it doesn’t take much.
Low-Intensity Repetitive Exercise Induced Rhabdomyolysis
- Case Study
Three days prior to arrival in the emergency room, a fit 23-year-old female patient exerted herself through low-intensity, high-repetition bicep curls with 10–15 lb weights after a hiatus of several months. Patient reported the use of creatine supplements in conjunction with her workout. The following day she noticed a great deal of soreness with tension in her upper extremities, specifically her biceps. The patient reported the incapability to fully extend her arms and commented that her urine was very dark and “tea color[ed].” She denied the occurrence of dysuria, fevers, chills, chest pain, and abdominal pain. However, the patient did report mild paresthesia in her arms prior to admission to the hospital, with improvement before examination.
(After further physical examination and labs, the MD’s concluded the following):
Using the correlation of the laboratory findings, the patient’s history, and physical examination, we have evidence to believe that we were successful in identifying and treating a severe case of exertional rhabdomyolysis acquired through low-intensity and high-repetition exercise .
Case Rep Emerg Med. 2015; 2015: 281540.
Published online 2015 Nov 26. doi: 10.1155/2015/281540
Another condition that affects most athletes is Exertional Rhabdomyolysis and occurs in less than 30 per 100,000 athletes per year. It most commonly occurs when athletes perform during hot and humid weather and needs to be treated promptly. It can cause cardiac issues and death.
Possible Causes of Rhabdomyolysis
- Crushed muscle from high impact injury such as an auto accident or construction job injury (building collapse, heavy equipment injury, etc.)
- Use of drugs or alcohol
- Venomous insect bite or snake bite
- Complete immobilization of an extremity
- Electric shock or third-degree burns
- Extreme muscle strain to an untrained athlete and to the trained athlete. The danger is for the elites who have a higher concentration of muscle to break down.
- As well as many other causes or injuries which can lead to Rhabdomyolysis
- Dark urine caused by high concentrations of Myoglobin in urine. This is because Myoglobin carries heme, which is bound to oxygen. Heme has iron and gives blood and muscles its red color.
- Low urine output or tea colored urine
- Swelling of the hands and feet
Rhabdomyolysis is treated by IV fluids in order to manage electrolyte imbalance, mainly potassium, calcium, and phosphorus. Dialysis will not be needed if your kidneys recover on time. If treated on time, rarely will the individual suffer from kidney failure. A surgical procedure, or fasciotomy, may also be performed to relieve tension or pressure from the muscle that has suffered the loss of circulation.
Final thoughts to all workout maniacs out there; slow down. If you feel a pinch, tinge or increase pressure in a muscle. Stop, stretch and call it a day. Muscle grows over time with lots of coordinated workouts and patience. Luckily, you can treat and reverse Rhabdomyolysis with prompt treatment. You can’t reverse death.
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