Guest Post -- Rhabdo

A medical post from Brennan; thanks in advance for breaking the science down into understandable parts!

 

So, I am going to start putting up some athletic information combined with some medical jargon to help the group train smart.

The first thing I am going to talk about is an issue that anyone that participates in a CrossFit program should be aware of. This condition is also one of the biggest arguments against the program itself. RHABDOMYOLYSIS (rhab·do·my·ol·y·sis). There are multiple causes of this syndrome but we are going to focus muscle exertion being the culprit. So what is this, beside a very large, hard to pronounce word? Rhabdomyolysis (Rhabdo for short) is “a syndrome caused by damage to skeletal muscle which results in free myoglobin which is than filtered by the glomerulus which appears in the urine which can lead to renal failure.”
 

Okay so by now some of you are wondering what I’m talking about. Skeletal muscles are the group of muscles we use to move ourselves and objects around us. Our body notices the stress (running, lifts, etc) and starts to increase blood flow and the production of various coenzymes such as ATP (used for cell energy) to allow us to sustain the work load.

Myoglobin is a protein in heart and skeletal muscles. When you exercise, your muscles use up any available oxygen. Myoglobin has oxygen attached to it, which provides extra oxygen for the muscles to keep at a high level of activity for a longer period of time. When muscle is damaged, myoglobin is released into the bloodstream. The kidneys help remove myoglobin from the body into the urine. In large amounts, myoglobin can damage the kidneys.

So what will you see if someone may have Rhabdo? The individual may have obvious muscle injury (excess swelling, tenderness, limited range of motion). They may also experience symptoms of severe dehydration (hot to touch with no sweat, extremely thirsty and infrequent tea-colored urine) and in later stages they may have severe flank/side pain.

If you start to believe someone may be going down this path what can you do to help them? Give them water. Give them water. Give them water. Notice anything? Also do not give them any electrolyte supplements and limit food which contains potassium. Get them to medical care ASAP.

Alas those most likely to experience this are those who have not progressively trained to high levels of activity….sorry newbies. The best way to avoid being one of those unlucky few is to know your limits. If your body is conditioned to handle heavy weight and endurance activity, it will be able to compensate. If you are new to the scene, do not try to push your body beyond its limits. Everyone has to start small and work smart. Slowly increase weight and intensity and allow your body to recover. Drink plenty of water and listen to your body. Remember sore muscles are good; sharp pain in joints or muscles is bad. If you don’t know if you are prepared for something ask Caroline or Justyn or some designated minions.

Reference: 2005 Griffiths 5-minute clinical consult