A news article popped up on my twitter feed when one of the people I was following posted up this article from The Columbus Dispatch on March 9, 2013.
Image above: “Kelly Becker and her parents, Betsy and Bill Becker of Dublin, have pressed Ohio State officials to develop a more-thorough report of the incident that hospitalized Kelly and to make it public.” Image and description from The Columbus Dispatch
It’s interesting to see how I’ve been hearing more articles and news of exertional rhabdomyolysis, especially in the athletic community.
So what’s rhabdomyolysis? According to the A.D.A.M. Medical Encyclopedia via PubMed Health, “Rhabdomyolysis is the breakdown of muscle fibers that leads to the release of muscle fiber contents (myoglobin) into the bloodstream. Myoglobin is harmful to the kidney and often causes kidney damage.”
If this sounds familiar to one of the blog posts I have written before, it should. In my blog post “CROSSFIT: GOOD, BAD OR JUST A FAD?“, I included an article where a cross-fitter was admitted into the hospital for rhabdomyolysis. You can read that article here.
Image from The Columbus Dispatch.
Here are some of the symptoms according to PubMed Health:
- Abnormal urine color (dark, red, or cola colored)
- Decreased urine production
- General weakness
- Muscle stiffness or aching (myalgia)
- Muscle tenderness
- Weakness of the affected muscles
Other symptoms that may occur with this disease:
- Joint pain
- Weight gain (unintentional)
According to the article, “The workout included pull-ups (she did 56), chin-ups and triceps-crunching dips without rest during a 20-minute workout. Two days later, they pushed football blocking sleds” (The Columbus Dispatch 2013). After finishing the workout, she immediately sensed things weren’t right. She recalls having weakness and tingling in the upper extremities while driving home after practice. That same night she could not get a proper night of sleep because of the pain and the next day noticed that her urine color was the same as cola.
“I knew absolutely that something was wrong” – Kelly Becker
“[R]habdo can have potentially serious consequences: renal failure, compartment syndrome, death. Those are fairly serious” said Kelsey Logan, a physician who serves on the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports.
Some of the cases of rhabo, short for rhabdomyolysis, have left athletes requiring surgery because of compartment syndrome. According to PubMead Health, compartment syndrome is, “Compartment syndrome is a serious condition that involves increased pressure in a muscle compartment. It can lead to muscle and nerve damage and problems with blood flow.” (You can learn more about it or rhabdomyolysis in the references listed at the bottom on the post.) In the more severe cases, amputation might be needed or even death can occur!
Some other documented cases, according to the article, included:
- “three members of the Miami University women’s soccer team were hospitalized after two days of conditioning sessions that included pull-ups, chin-ups, push-ups and bench presses with dumbbells while lying on an exercise ball.“
- “Five football players from Wooton High School in Virginia were hospitalized, one for 19 days, after performing triangulated push-ups during a conditioning session.”
- “Thirteen members of the University of Iowa football team were hospitalized four days after the team underwent a conditioning session that included the completion of 100 back squats using weights. Players also performed barbell snatches, pull-ups, dumbbell rows and a weighted sled-pushing exercise.“
- “Twenty-two members of the McMinnville, Ore., High School football team were taken to the hospital, and 13 were admitted, after a conditioning session in which repetitive, intensive chair-dips and push-ups were performed inside a small room on a 92-degree day. Three of the stricken players had to have surgery on their arms because of triceps compartment syndrome.”
- “Donnie Wade Jr., 20, of Dallas, died during an intense physical-training session during a fraternity hazing ritual at Prairie View A&M University. Wade collapsed during a drill, and the Harris County medical examiner attributed his death to “acute exertional rhabdomyolysis.” The family’s wrongful-death lawsuit alleged that Wade was deprived of fluids while undergoing exercises that included running bleachers, leg lifts, pushups and jumping jacks.“
- “Seven swimmers (four men and three women) at the University of South Carolina were hospitalized after a workout that reportedly included as many pushups as they could do in a minute followed by 60 seconds of squats — a sequence repeated for 10 minutes. One swimmer said they were being asked to exercise “to failure,” meaning to keep going until their muscles gave out.”
‘”Because (rhabdo) is rare, and coaches or trainers have not seen it, they can’t understand how they caused it,” said Priscilla Clarkson, a leading expert on rhabdo as an exercise science professor at the University of Massachusetts. [Even] Kelly Becker noticed that the condition isn’t mentioned in the NCAA Sports Medicine Handbook’ (The Columbus Dispatch 2013).
Heck, I haven’t really heard of rhabdo until fairly recently – and there’s not a lot of awareness out there in the athletic community, let alone the general public. I think that some coaches some athletes are misinformed that you if you are not puking or hurting/feeling the burn through your workout, you’re not working out enough. I think that is totally absurd. There are safe and effective ways to train other than just to failure and leaving yourself a gelatinous blob on the floor.
The one thing that pops into mind is the recent fad of Crossfit. I think that many young athletes view this exercise craze as the best way to get in shape for their sport. They will do crazy things like lifts, squats and throws to failure all with no rest in between rounds and sets. Even rhabdo shows up in the Crossfit community, as an example in the earlier link to the article above. Again, you can read why I think Crossfit is not really good conditioning for athletes in my blog post here.
- Take adequate rest in between sets, exercises and days. You know your body best, not the coach!
- Drink plenty of water: before, during and after working out.
- If you sense something is not just right, have a medical professional check it out such as your family/team doctor or your team’s athletic trainer.
- It’s better to play it safe. If you’re not comfortable doing it, tell the coach. If you showing symptoms, air on the side of caution and have it checked out. Better to be sidelined for a couple of days than have your season or career be thrown down the drain.
Rhabdomyolysis – A.D.A.M. Medical Encyclopedia – PubMed Health