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Dan
Dan Sullivan holds a BA in Communications, Psychology, and Business Economics as well as a Masters Degree in Exercise Physiology. He is a certified Crossfit instructor in addition to being a Certified Personal Trainer by the National Academy of Sports Medicine, and has worked in the fitness industry since 1998.
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Rhabdomyolysis and the Athlete

by: Dan Sullivan

Have you ever finished a killer workout and known it was going to leave you sore in another day or two? This post workout pain and stiffness is a condition commonly known as Delayed Onset Muscle Soreness (DOMS). Many exercise enthusiasts will look to this soreness as the ultimate arbiter of whether or not they have had a good and effective workout. Admittedly, DOMS is often correlated with positive exercise outcomes -- most often increases in muscular strength and power.

However, DOMS is also a mild form of a much more serious condition known as rhabdomyolysis. Rhabdo, for short, is the breakdown of muscle fibers to the extent that cellular contents are released into the blood stream. Of specific concern is the release of the protein myoglobin into the bloodstream, as it is harmful to the kidneys and can cause permanent damage.

There can be many causes of rhabdomyolysis. the National Institute of  Health lists several risk factors including:

• Alcoholism
• Crush injuries
• Drug use
• Genetic muscle disease
• Heat stroke
• Ischemia or necrosis of the muscle (lack of oxygen to or death of the tissue)
• Low phosphate levels
• Seizures
• Severe exercise exertion (marathon running or strength training)
• Shaking chills
• Trauma

For fitness enthusiasts, it is the severe exercise exertion that is the most common concern. If you are doing drugs or drinking alcohol while working out you may have another problem all together. CrossFit is often maligned, and occasionally revered, a la “Pukie” The Clown, as such an intense program that it regularly causes rhabdo. In reality any exercise routine that is misapplied can cause this condition.

How can you tell if you are suffering from rhabdo and not simply DOMS? There are several signs and symptoms of rhabdomyolysis:

• Abnormal dark urine color (think coca-cola)
• Decreased urine production
• General weakness
• Excessive muscle stiffness or aching
• Muscle tenderness
• Fatigue
• Joint pain
• Seizures
• Weight gain

It is true that there have been at least five cases of rhabdomyolysis confirmed to have been caused by CrossFit. This is certainly not the norm, and these statistics pale in comparison to the numbers of people that have done CrossFit without injury. Be certain, working out does carry the potential for injury, but a properly designed and progressed program can reduce these risks.

If you are new to CrossFit, or looking to increase the intensity of your current workout, consult your physician before starting this new routine. Next, do your homework and seek out a CrossFit affiliate or health club with a good reputation and knowledgeable, experienced staff. Make sure you are provided with some sort of introductory workout routine that will identify strengths, but more importantly weaknesses. Make sure you address weaker areas and progress slowly toward more advanced levels. Lastly, listen and pay attention to what your body is telling you. If you feel tired take a day and rest - it's often more important than the workout.





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