Rhabdomyolysis is a word that not many people have ever heard or experienced. But recently, it has unfairly made the headlines with regard to difficult training programs such as CrossFit. I am not a CrossFitter, but this issue is part client and part trainer problem and not simply a CrossFit problem. Truth is, “Rhabdo” as many people refer to it, is very common in MANY challenging training programs such as military bootcamps, police and fire academies, even professional football, and body building. It is a deadly condition that should be studied by anyone who is a trainer, but also taught to students who are seeking challenging workout programs in harsh environments.
Defined, from a 2010 US Armed Forces study on active duty cases, Rhabdomyolysis is the breakdown of muscle cells with release into the bloodstream. If not treated, Rhabdomyolysis can be fatal and you can have kidney failure, heart attack, or stroke. It is definitely not a condition to make light of or wear as a badge of honor.
How Do I Know if I have Rhabdomyolysis? (muscle / joint pain, brown urine)
The symptoms of this usually self-induced condition starts with extremely sore and painful muscles, swelling, and weakness. Dark or brown color urine is another symptom that should get you to the hospital regardless, but it is what happens when proteins enter the blood stream and the kidneys start to fail.
What causes Rhabdomyolysis? (extreme temperatures, overexertion, some medications, snake bites, crushed limbs, etc)
Rhabdomyolysis usually requires a perfect storm of things to occur. Yes, extremely intense workouts and military evolutions are common events that yield this condition. Add in high temperatures and humidity, poor hydration / electrolyte replacement, poor nutrition, drug or alcohol use, medications, and even weight loss supplement use can increase your chances of getting rhabdomyolysis. For instance, if you are in poor condition and do a new and challenging workout plan and you are on high cholesterol medication, you could get rhabdomyolysis by simply doing 50 squats. It is amazing to think that a hard workout can have the same effects on your body as a car crash or a snake bite where your muscles are either crushed or poison breaks down your muscles.
Overexertion is Relative:
Your overexertion may not be someone else’s. After going through SEAL training and several years in the Teams, I only saw Rhabdo once and that was during a pre-BUDS screening program that was a 48 hour non-stop physically exhausting event. Most Special Ops candidates have prepared for the grueling events of their training and Rhabdomyolysis is condition that is rarely seen even during Hell Week. So, if you go into a workout and the workout states that your group is going to do 100 pullups, 200 pushups, and 300 squats and you can only do 5 pullups — STOP! Reduce the numbers and do something much less than that. In fact, if you cannot do 100 pullups in under 10 sets, I would not even try this workout. Now your legs can likely handle the 300 squats “during” the workout, but after the workout you will likely experience pain for 2–3 days. Depending on other elements such as your health, medications, heat, hydration, what might be Delayed Onset Muscle Soreness (DOMS) in some could be Rhabdomyolysis in you.
Know Your Limits — Know Your Client’s Limits:
Like I said in the introduction of this article, this is YOUR responsibility not to push yourself beyond your exercise / fitness foundation and limits. It is also your trainer’s job to pull the reigns on new clients and reduce workout intensity and time and observe how clients handle an assessment that would be easy to any of your long term clients. No group training program is perfect for a single person specifically, it is both the client and trainer’s job to figure out how to improve fitness individually. We should be able to trust our trainers as their goal is to push us harder than we would push ourselves, BUT we also have to trust and know our limits.
The best bet is to start off easy if you are in poor shape and deconditioned. Start off with a gradual training program that progresses in time, intensity, repetition, and distance at 10–15% each week. Exercise several days a week is required to go from deconditioned to healthy enough to join in group training programs. Never jump into an advanced program without preparing properly.