Before I gave myself rhabdomyolysis (rhabdo), I had never heard of it. In the past, it was an injury mainly reserved for Olympic athletes, marathoners and those pushing themselves to the extreme.
These days, with the advent of workouts like SoulCycle and Crossfit, emergency room visits from rhabdo patients have spiked with a 20-fold increase in recent years.
But even armed with that knowledge, I still would have assumed I was in the clear.
My rhabdo diagnosis wasn’t as obvious, and in fact, I didn’t feel like I’d gone too hard at all. At the time, I’d just started a new strength routine with a trainer who focused extensively on staying safe while lifting. Even the exercise that did me in seemed innocuous: negative pull-ups where I’d jump up and slowly lower myself down using my body weight as force.
After the third set, when I couldn’t hold myself up with my own strength, the trainer stepped in to assist me on the last three sets. This didn’t seem particularly concerning but looking back, it was a huge red flag: once I’d hit muscle exhaustion, I was in dangerous territory.
What is rhabdo?
Rhabdo is caused by overworking a muscle to the point where it starts to die. When that happens, a flood of toxins, dead cells and minerals are released into the bloodstream too quickly for the kidneys to flush them.
Rhabdo can also happen in non-workout injuries, such as car accidents and bad falls. People who lay immobilized on a hard surface for an extended period of time (like in the case of passing out after a hard night of drinking) can also contract rhabdo as the muscle suffers trauma.
Surprisingly, high doses of medications like statins or infections like HIV or sepsis can also trigger rhabdo, and unfortunately, it’s thought that those who’ve suffered rhabdo before are likely to be more susceptible to getting it again.
What are the warning signs of rhabdo?
The day after my upper body workout, I woke up super sore with a slightly swollen lat muscle, but I shrugged it off. I even bragged to my husband about how hard I must have gone at the gym, since I’d always equated my level of muscle soreness to a “good” workout.
As the week wore on, the soreness didn’t subside and three days later, my entire upper body was so puffy I looked like the Michelin man. It wasn’t until I spent some time Googling that I thought I might be in real trouble.
As a precaution, I headed to the hospital where I was immediately taken to the front of the line and hooked up to an IV and an EKG. Thankfully, my heart was fine but my creatine phosphokinase (CPK) numbers were beyond scary. Under normal circumstances, the CPK enzyme registers at 120 microgram per liter or less. Mine had skyrocketed to 55,000 and needed to be monitored every six hours.
In the end, I spent five days on a non-stop saline drip until my numbers dipped low enough for my doctors to send me home.
While nearly a week in an observation ward isn’t any fun, I was lucky. In cases without medical intervention, the kidneys can fail or the person could go into cardiac arrest from the sudden increase in potassium.
Even though I’m very fit and workout multiple times a week, the muscle group I injured wasn’t prepared for such a heavy load. Most cases of rhabdo happen when someone is doing a new exercise or when they’ve taken a break (even as short as two weeks) and try to jump right back in to their old routine.
Easing yourself in and stopping when you feel like you’ve hit your limit is paramount to staying safe. In my case, I should have backed off when I physically couldn’t do the workout myself.
Working with a trainer who knows about rhabdo can also go a long way in keeping you safe, but instructors can be a double-edged sword. If you’re going with the flow of a high-intensity class instead of listening to your body, it’s easy to overdo it.
I’m still all about beast mode, but I’m thankful to have a better understanding of my limits and the knowledge of what could happen if I blow past them.