HOW CAN YOU TELL IF YOU HAVE RHABDO (SIMPLIFIED)?
I’ve been helping people with injuries related to sport and specifically CrossFit for years now. What I want to talk about today is Rhabdomyolysis and more specifically, how you can tell the difference between this and regular muscle soreness or injury after exercise?
This is important so keep reading…..
I have seen many cases over 9 years and there’s a few key points I want to highlight immediately:
1. It can happen to anyone participating in high intensity exercise and is not exclusively seen in CrossFit.
2. It can happen to beginners, intermediates and advanced level athletes.
3. You won’t always have Coca Cola colored or brown stained urine. This happens with extreme cases but I have seen plenty of mild to moderate cases where urine colour is bright yellow or mildly stained brown at best.
So what is it?
Like with any exercise that loads muscle tissue to the degree that it creates micro tearing and adaptation, so too occurs with Rhabdo. However, in this case, the load is so great it causes muscle cell breakdown and these cells are released into the bloodstream which presents as an elevation of the protein creatine kinase – causing a systemic problem and the need to filter these cells through the kidneys.
What’s the big deal?
Muscle cells are not meant to be present in your bloodstream or in your kidneys. They are larger than the cells our kidneys normally filter and the stress to this organ can result in kidney failure when it is extreme and untreated.
How can you tell it’s Rhabdo versus muscle strain?
Clients will often come to me and tell me they are sore in a particular area as per normal with a muscle strain and it usually requires further questioning to ascertain the complete picture and assess for the possibility of ‘rhabdo’.
Clients with ‘rhabdo’ have presented to me with a similar story:
1. Pain AND swelling in the affected area (eg biceps, triceps, abdominals, quadriceps) developed rapidly following the cessation of exercise.
2. They cannot move the affected area through its normal range of motion. For example they cannot straighten their arms if the biceps have been affected. It is painful but more than that it is actually “stuck” in a bent position.
3. They are drinking water more often and still feeling thirsty.
4. Their urine colour is not normal, either really yellow (dehydrated) or slightly stained brown. In severe cases it is absolutely brown in colour.
5. They generally feel fatigued, sometimes unwell but it’s vague. In extreme cases they feel nauseated or like vomiting.
6. Often they felt sore from a workout in the preceding days and trained again anyway. It was then that the symptoms progressed. This is not always the case but I’ve seen many where it is.
So why am I sharing?
Because I want athletes (and coaches) to recognise the difference in presentation to a straight forward muscle strain or DOMS (delayed onset of muscle soreness) and help prevent doing further harm to themselves. Blood tests are essential where you suspect this to confirm the diagnosis. Athletes need to rest adequately, drink plenty of water and in severe cases present to hospital for treatment (ie IV fluids).
It’s OPEN time and the risk for this type of injury is higher as we all ramp up intensity and sometimes repeat the workouts, stressing exactly the same muscles in a short time period.
Stay well hydrated in this heat and take care of your bodies. ?