We, as runners, push our body to the max, and sometimes our body pushes back!
What is Rhabdomyolysis?
Rhabdomyolysis, or Rhabdo for short, is when muscle tissue starts to break down by releasing proteins and electrolytes into the bloodstream. This can permanently damage the kidneys and the heart and sometimes cause death.
What Causes Rhabdomyolysis?
Rhabdo is caused by heat exposure, physical exertion, and trauma (e.g., crush injury from a fall). As runners, we’re exposed to all the conditions of Rhabdo. So, we need to ensure that we’re careful by knowing the signs and symptoms of Rhabdo and how to prevent it.
What Are The Symptoms of Rhabdomyolysis?
One of the most common symptoms I’ve seen during my medic days in the military is very, very dark-colored urine. An individual with Rhabdo, their urine will resemble a cola color, much worse than what dehydrated urine looks like. Other symptoms may include muscle cramps, aches, and pains that are more severe than usual. An individual with Rhabdo may feel so tired that they can’t finish their exercise routine.
Symptoms may not appear right away for some people but several days after. If any of the symptoms do occur, seek medical attention right away.
How Rhabdomyolysis Is Diagnosed?
It is common, as previously mentioned, to mistake Rhabdo for dehydration based on the symptoms alone. The sure way to find out is to go to a medical facility and get repeated blood tests for Creatine Kinase (CK) or Creatine Phosphokinase (CPK). CK and CPK tests are the only accurate tests to diagnose Rhabdo. A urine test may be given, but that only checks for Myoglobin (a muscle protein) that clears the body quickly, but CK levels in the blood stay there for days.
Ensure to request a blood test.
What Is The Treatment For Rhabdomyolysis?
The good news is that rhabdomyolysis can cure itself in mild cases. Resting (no exercise or exertion for about a week), drinking fluids, and staying away from the heat are all needed to cure Rhabdo.
For moderate to severe cases, IV fluids are given to flush out muscle protein and electrolytes from the body. IV fluids can also prevent dangerous heart rhythms and reduction of kidney function. Hospitalization may be required to monitor heart and kidney function and watch for seizures and high potassium levels (see my article on Why Electrolytes Are Important For Runners).
How To Prevent Rhabdomyolysis?
First, we need to pay attention to our bodies. We must recognize the signs and symptoms of exhaustion. Ensure that we have proper training before tackling specific events. If the running race is in the mountains, make sure to train for the hills, or if it’s in the desert-like climate, do heat training. Acclimation is one of the critical components to preventing Rhabdo.
Don’t train or compete at an event if sick. Cold medications may increase the risk for Rhabdo.
The primary prevention for Rhabdo is staying Hydrated. Drinking water will reduce the risk of heat exhaustive, reducing the risk for Rhabdo.
Hopefully, non of us will ever experience Rhabdo, but if we do, don’t panic; stop what you’re doing and seek medical attention. Usually, it goes away just from taking it easy for about a week or two. Don’t worry your gains will not go away.
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