Continue your 5-3-1 program or see the board for a supplemental strength workout. You can download the 5-3-1 Program spreadsheet here.
3 X Max Strict Pullups
10 Rounds for time of:
Rest 1 min
What you need to know about Rhabdomyolysis
Today’s post is not meant to scare you all away from working out and pushing yourself, but it’s still a serious topic that should be addressed.
High intensity exercise is still good!
Inspiration for this post came from an experience a former client of mine experienced just a few weeks ago at another CrossFit gym (this did not happen at West Metro). She went in for a hard workout following a week of being sick and deconditioned. She rocked the workout, of course, but suffered severe muscle pain immediately after, in addition to vomiting, and low back pain. Over the next few days her arms swelled up, more each day, and she could not straighten them past 90 degrees. After she peed the color of coca-cola she knew something was up and went to the ER where they confirmed that she had a nasty case of Rhabdomyolysis, she spent 3 days in the hospital. This experience has given her a good wake-up call and made her realize that her body just wasn’t ready for that type of workout following her workout hiatus/being sick.
What is Uncle Rhabdo?
This is CrossFit’s cute term for Rhabdomyolysis. Rhabdo is a disease of the muscle that involves excessive breakdown of the muscle cells, leading to the following cell contents being spilled out into the blood stream:
- Myoglobin…toxic to the kidneys and steals oxygen from the blood
- Potassium… toxic to the kidneys and heart in high doses
- Sodium + calcium….leading to swelling and possible compartment syndrome
- Creatine Kinase
Uncle Rhabdo isn’t such a cute name anymore huh?
What are the signs and symptoms? (following an intense workout)
- generalized or specific myalgia (aka muscle pain)
- muscle tenderness
- dark urine
- low back pain (the kidneys can refer pain to the low back)
*Depending on the extent of damage done, most treatment includes immediate hydration through IV. Kidney dialysis may be administered as well, depending on the extent of damage.
Muscle tears are a normal part of exercise, to a certain extent. However, it’s the excessive tearing of the muscles that causes the above list to be found in the blood in higher levels than the body can tolerate.
Other causes of increased muscle breakdown:
- Dehydration….increased muscle breakdown from….
- Increased core body temperature (environment, overweight or un-fit people working at an inappropriate intensity).
- Severe collisions from a car accident, football games or falls in the elderly.
- Caffeine also increases core body temperature (so maybe that ginormous coffee, after a night of drinking, right before Saturday’s WOD, is not the best idea)
Obviously the above mentioned happens quite frequently, which means that there must be varying levels of rhabdo because death is a rare occurance. Football teams have had urine tests that show varying degrees of rhabdo following preseason (high intensity workouts following a long rest period, in addition to heat). Then there are those that have died playing football from heatstroke, most likely a resultant of rhabdo. There have also been non-athletes who have done intense workouts (CrossFit and others) that have similar experiences and end up in the hospital for immediate treatment.
Are there long-term effects?
The answer to this is really unclear. Most of what I have read states that long-term effects are unknown. Most of the research so far is looking into the effects of chronic rhabdo because this is a common thing among high intensity athletes. My thoughts are that repetitive damage to the body like this can’t be good….
Additional risks for getting Rhabdo
- Rhabdo is most often observed with novel, strenuous, overexertion…..those of you that take months off and then come in to try to find your Fran PR.
- Use of statins (cholesterol reducing medication; some evidence that they increase the normal levels of creatine kinase following exercise).
- African Americans have a greater genetic predisposition to muscle breakdown, so hydration is important
- Diets high in grains
- Electrolyte imbalances (dehydration, but also drinking too much water with not enough minerals/vitamins in it to help your body absorb the water)
- Hormonal imbalances
- Lactic acidosis (increased muscle breakdown)
- Vitamin E and selenium deficiencies
- Creatine kinase supplementation can put you at more risk for dehydration, so make sure you take it with the recommended amount of water.
(This is a bunch of info, so I’m putting the links/references at the bottom if you’re interested)
Take home message:
- remember to prepare your body before and after workouts, especially with proper hydration
- listen to your body
- if you experience any of the above signs/symptoms following a tough workout, just let someone know. Better to be safe than sorry.
- The goal of this post was to promote awareness on the topic and give you guidance of what to look for, as well as what you should do if you experience the symptoms
- Don’t be afraid of the workouts or freak out if you have low back pain after a workout. Well it’s still not good that you have low back pain….but you know what I mean.
- Rhabdo is often caused by a sudden, and drastic increase in the VOLUME AND INTENSITY of loading on your muscles, which causes muscle breakdown so severe that your body cannot physically recover. Eccentric motions (pull-up negatives, squats) under heavy loading are especially damaging to muscles, and therefore increase the chances of rhabdo, so these should be avoided in high amounts when first starting, or re-starting, exercise programs.
- Thus, listen to your coaches and your body about scaling back a workout when they say to, better to be safe than sorry when coming back to the gym after a hiatus.
1. ACSM position stand on Exercise and Fluid Replacement
3. CrossFit Seminars Training Guide