Monday, February 3, 2014

Rhabdomyolysis: What You Need To Know--By: Abi Reiland




CrossFit is associated with intensity, athleticism, and pushing boundaries. Unfortunately, CrossFit is sometimes also associated with Rhabdomyolsis. Any athlete (and really any person) is susceptible to rhabdo, and any CrossFitter should consider themselves an athlete. Rhabdo is not common, but the potential always exists, so we want to be sure you’re armed with the information you need to be proactive.
 
What Is Rhabdo?
Rhabdo is the breakdown of muscle tissue (at a more rapid and extreme pace than is typical with normal activity), resulting in damaged cells entering the bloodstream. Common symptoms might include tenderness, pain, weakness, and swelling of the targeted area. The myoglobin protein is a component of those damaged cells and is harmful to the kidney. Typically, when the myoglobin is significant enough to have a detrimental affect, an individual might notice darker-than-usual urine 12–24 hours after the initial damage occurred. In addition, the changes in the bloodstream can affect electrolytes, which sometimes causes symptoms like nausea or vomiting.


Having said that, the best way to diagnose rhabdo is through creatine kinase (an enzyme released by damaged muscle tissue) blood testing. It’s not uncommon for concentrations to be 100,000 U/I, and those concentrations rise over the first 12 hours then often remain elevated for 1–3 days, depleting steadily after hitting peak. In most cases, individuals are treated with IV fluids to prevent myoglobin deposits in the kidney and neutralize the bloodstream. Treatment does not immediately reverse affects, so individuals must consult their doctor for acceptable activity during the recovery period. Although warning signs like tenderness and weakness might be common after a difficult workout, it’s important to pay close attention to your body and address anything abnormal like swelling or uncommon pains.

Why Does Rhabdo Occur?
Rhabdo is typically associated with strenuous exercise and overuse, infections, crush injuries, elevated or reduced sodium levels, low potassium, unusually high or low body temperature, particular medications and dehydration (or a combination of factors). But even hereditary muscle conditions (people are often unaware of) can leave some individuals at greater risk and prone to rhabdo. Working out with a killer hangover often means severe dehydration. And in combination with a really challenging workout with high repetitions targeting the same muscles, that extreme muscle breakdown can occur. Other times, recovering from an illness and coming back to the gym too soon and going too hard, can certainly lend a hand in developing issues. So exhibit some caution.  When you’re feeling healthy and well, challenge yourself but be sure you’re listening to your body.  And when you’re not feeling great, scale or modify your workout accordingly.  Following really strenuous workouts, it’s a good idea to rest and recover, and again, note any abnormal physical reactions.


How is Rhabdo Prevented?
There’s no guaranteed way to avoid rhabdo, but keeping yourself healthy is a good place to start. Stay hydrated, develop body awareness, and when in doubt, exhibit some caution. If it’s super hot outside remember that you may need to lighten up a bit. If you’re still recovering from a bug, ease back into things until you’re feeling 100%. And when it comes to new movements, you’ll work new muscles so just exhibit some accountability when it comes to your limitations.

Although the creepy CrossFit clown character pokes fun at rhabdo, it’s something that athletes should be educated and informed about. It’s a condition that if left untreated can produce very serious health problems and can begin with something as simple as soreness and swelling. Get in tune with your body and know the red flags. Follow any activity that seems more taxing than most with caution. And let yourself recover. It’s not always about the whiteboard and the clock and personal records, so don’t feel silly slimming a workout down when you think it’s necessary. Sometimes it’s OK to just get through it at a more comfortable pace and scale to allow your body its much-deserved rest and relaxation.

Abi Reiland Owner / Trainer CrossFit 8035

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