Rhabdomyolysis: When your muscles break down

It’s important to listen to your body, especially when you’re doing intense exercises like Cross Fit or Hyrox, to ensure that you don’t run the risk of developing rhabdomyolysis. — Filepic

I read about a woman who went to a spinning class that was very rigorous. She kept up with it, but felt very tired afterwards. She could not seem to recover for days. She had very severe muscle aches. Her sister rushed her to the hospital and they found she had rhabdomyolysis. What is this?

Rhabdomyolysis (rhabdomyo = skeletal muscle, lysis = breakdown) is a disorder than causes your muscles to break down.

Yes, actually break down, meaning that your muscle cells die, disintegrate and dissipate.

When this occurs, the dangerous components of your muscle fibres then enter your bloodstream and go into your kidneys.

This can cause acute kidney failure.

Most people refer to it as ­“rhabdo” because its full name is too long and difficult to ­pronounce.

Oh. I am a very active person. I go to the gym regularly and I do spinning classes, as well as other things like weight-­lifting and running on the treadmill. Will this happen to me?

Rhabdomyolysis is relatively rare. But people who indulge in sports should be aware of this condition as there are always challenges in gyms and marathons going on in Malaysia, and we may be tempted to join them to prove to our friends that we can do it.

Rhabdo is caused by overexertion of your muscles in many cases, especially people who do very intense exercises like Cross Fit or Hyrox, without proper preparation.

It doesn’t mean you shouldn’t do such exercises, but you need to know what your body can take as it may not be the same as what your friends’ bodies can take.

Go at your own body’s pace and don’t try to overdo something just to keep up with your friends.

Many doctors also see rhabdo in people who don’t let their ­bodies recover properly after intense workouts.

They keep doing those exercises every day to prepare for a competition, without allowing their body to get enough rest in between.

Other causes of rhabdo include:

• Injury

   

  Yes, it may be an exercise-related injury, but it can also happen with large burns, electrocution or a crushing ­injury.

  When an injury causes your muscle fibres to rapidly break down, this can lead to sudden rhabdo.

  In work-related instances, a crushing injury is the commonest cause.

• Severe dehydration

   

  Your kidneys cannot clear toxic materials fast enough.

• Overheating
• Certain medications

   

  These include some antidepressants, antivirals and statins.

  Don’t panic however, as these side effects are rare.

  Psychoactive drugs can also cause rhabdo.

• Inactivity

   

  If you are physically inactive for long periods of time, such as if you broke a limb or had a stroke, this is also a risk factor.

How will I know if I have this rhabdo? I sometimes feel tired after a hard session at the gym and I have to rest the next day.

Rhabdo usually happens – if it happens at all – one to three days after your intense exercise or muscle injury.

If you have rhabdo, you may experience the following:

• Your muscles can start to swell quickly

   

  This is not the type of muscle swelling that comes with hours spent at the gym to bulk yourself up – this type is abnormal.

• Your muscles feel weak

   

  This is not the normal type of weakness you feel either after a good session at the gym.

  This one lasts longer than the amount of time you normally take to recover and may be more severe than what you normally experience.

• Your muscles feel tender and sore

   

  And this is not the good type of soreness either.

• Your urine turns dark, red or brown.

These are the more normal symptoms.

They can range from mild to very severe.

Some people mistake them for normal muscle soreness and tiredness until they find that it won’t go away with the usual amount of rest.

Some people also feel dehydrated, leading to decreased urination.

They may feel nauseous and lose focus.

Some people even lose consciousness and collapse.

You mentioned earlier that rhabdo could make us go into kidney failure. What is so toxic about our muscles?

Rhabdo causes your muscles to break down, releasing its components into your blood.

These waste components have a lot of potassium, creatine kinase, phosphate, myoglobin and urate.

Your kidney suddenly gets flooded with all these things.

This is when you start to have urine of a darker colour.

If your kidneys cannot keep up with this influx of muscle components, they will start to fail.

This is very dangerous as you can lose both kidneys.

Can rhabdo be treated?

Yes, you will be immediately put on intravenous (IV) fluids to flush the toxins from your ­system.

If it is too severe, you may need to undergo dialysis to remove these toxins.

You will also need to undergo dialysis if kidney damage happens.

After that, you need to help your muscles recover.

There will be plenty of physiotherapy and rest needed.

You may begin to feel better after a few weeks.

Some people have a lingering muscle soreness.

The danger to look out for is acute kidney failure.

But if you get past that and seek immediate medical help, you can overcome it.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, ­computers and entertainment. For further information, email ­[e-mail]. The information provided is for ­educational and communication purposes only, and it should not be construed as personal ­medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author ­disclaim all responsibility for any losses, ­damage to property or personal injury suffered directly or indirectly from reliance on such information.