Rhabdomyolysis or ‘Rhabdo’ has received a lot of attention in the media, as fitness fanatics and regular gym goers have been struck down with extremely serious and debilitating conditions, which can lead to severe kidney damage and in extreme cases can be fatal.
It’s important as trainers, experienced gym-goers or for those new to the gym to look out for the symptoms of Rhabdo and that you can do to help prevent this life-threatening condition affecting you or anyone you know.
What is Rhabdomyolysis?
Rhabdomyolysis is the result of the breakdown of muscle tissue that leads to the release of muscle fibre contents (a protein called myoglobin) into the bloodstream. These substances are harmful to the kidney and often cause kidney damage.
There are a lot of causes for Rhabdo, however, those that relate directly to exercise are caused by overexertion and dehydration, which are most likely to affect people unfamiliar with training at high intensity or for a prolonged period of time. They can be caught out by pushing themselves too far and by not keeping hydrated while exercising. The muscles are simply overworked to a point that they break down, and that leads to this breakdown being released into the bloodstream.
- Muscle tenderness and/or swelling
- Abnormal muscle stiffness or aching
- General weakness or weakness of the affected muscles
- Dark, red, or tea-coloured urine
- Decreased frequency or volume of urine
- Nausea and vomiting
Other symptoms that may occur with this disease:
- Joint pain
- Weight gain (unintentional)
What are the Treatment Options?
Those suffering from Rhabdomyolysis will need to get fluids containing bicarbonate to help kidney damage prevention. They may need to get intravenous fluids (IV) or need kidney dialysis. So if you suspect someone may have Rhabdomolysis, ensure they receive medical attention immediately and that they are taken to the Emergency Department.
Sufferers may experience Hyperkalemia (high potassium levels), low blood calcium levels (hypocalcemia) or kidney failure, which all need to be treated immediately.
Preventative Steps You Should Take
The number one most important step to take is to ensure you drink plenty of fluids before, during and after prolonged or high-intensity exercise. This will help keep you hydrated and flush out myoglobin from your kidneys.
Remember: Call your health care provider, or attend your local emergency department if you have symptoms of Rhabdomyolysis.
The Long-term Outlook
Depending on the amount of kidney damage, (acute kidney failure can occur in some patients), the quicker the treatment, the lower the risk of ‘permanent’ kidney damage.
Returning to regular activities will depend on the degree of damage to the kidneys and may range from a few weeks up to a long term continuum of fatigue and/or muscular pain.
O’Connor FG, Deuster PA. Rhabdomyolysis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 115.
Sauret JM, Marinides G, Wang GK.Department of Family Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences, 14215, USA. American Family Physician: 2002, 65(5):907-912.
Shafuddin AA, Weisbord SD, Palevsky PM, et al. Acute kidney injury. In: Taal MW, Chertow GM, Marsden PA et al. eds. Brenner and Rector’s The Kidney. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 30.