7/22/2011

You Need to Read This!

by Coach Ian J McHugh

On a serious note, let's discuss Rhabdomyolysis, a.k.a. Rhabdo. "We can dispense with much medical detail with a quick and easy description of rhabdomyolysis as a potentially lethal systemic meltdown initiated by the kidneys in response to the presence of shed muscle-fiber debris and exhaust in the bloodstream. There are several causes and types of rhabdo, classified by the underlying cause of muscle breakdown. With CrossFit we are dealing with what is known as exertional rhabdomyolysis. It can disable, maim, and even kill." (Glassman, Greg; 2005)

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Generally those who are most likely to suffer from exertional rhabdo are those who have been exposed to too much work (exercise) in too little time. Who are these types of people?

Former athletes, gym-goers, or CrossFit athletes who have taken some time off from training and come back weeks, months, or even years later and try to push themselves as hard as they did when they had been training.
Beginners who have never exercised, or even those who have exercised but with low intensity.
There even seems to be some "non-exercise risk factors" that could lead a person to developing rhabdo.

Factors in the Development of Exertional Rhabdomyolysis (Brown DO, Thomas; 2004)

Exercise Factors

Athlete's experience and fitness level

Intensity

Duration

Type (concentric vs eccentric)

Nonexercise Factors

Metabolic myopathies

Malignant hyperthermia

Illness

Sickle cell trait

High ambient temperature

What are Symptoms of Rhabdo?

dark, red, or tea colored urine
weakness of affected muscles
weight gain from water retention
joint aches and pains
muscle tenderness or aching
generalized weakness
fatigue

It is important that if you have any combination of these symptoms that you see your doctor and have your creatinine kinase (CK) levels tested, as well as your kidney function to make sure no kidney damage has occurred.

What can you do to try and prevent Rhabdo?

1) "Exercise wisely. A good rule of thumb is never to increase your workout more than 10% a week. For example, don't increase the miles you run, the weights you lift, or the number of times you do an exercise more than 10%. When it's hot and humid, don't increase your activity by even this much." (http://www.med.navy.mil/sites/nhoh/SiteCollectionDocuments/Rhabdomyolysis.pdf)

2) "Hydrate your body adequately, especially after exercise. Serious athletes are at risk of dehydration and possibly rhabdomyolysis. Drinking large amounts of water after exercising can help your kidneys flush out the myoglobin." (http://www.ehow.com/how_5653026_avoid-rhabdomyolysis.html)

3) Also checkout this helpful prevention list, How to Avoid Rhabdomyolysis, from eHow Health.

Please know at CFMG our #1 priority is safety. Our job is to help you become stronger, faster, and healthier. We would never try to put you in harm’s way. This is why we prescribe "On Ramp" workouts for those who need to scale workouts down or are just getting started with CrossFit. We also offer a free filtered water source so our members can continue to hydrate before, during, and after their workout. Please know that "rhabdomyolysis can develop at any level of physical exertion" (Brown DO, Thomas; 2004) so if you feel like you need to scale the WOD down, you probably should.

Sources:

1) CrossFit Induced Rhabdo; Glassman, Greg; 2005

2) Exertional Rhabdomyolsis, The Physician and Sports-medicine - VOL 32 - NO. 4; Brown DO, Thomas; 2004

3) What is Rhabdomyolysis?; www.med.navy.mil

4) How to Avoid Rhabdomyolysis; eHow Health