A 17yearold boy developed a severe case of rhabdomyolysis after lifting weights with his dad and brother. The district athletic club is a collaborative fitness hub housing more than five types of group, oneonone, and selfguided training businesses, including crossfit new haven, balanced yoga, turn spin studio, dac personal training, and the dac fitness center all centrally located in an inviting and innovative, 15,000 square ft. Pistner california university of pennsylvania abstract. Myoglobin is the protein released into the bloodstream when skeletal muscle is broken down. In fact, crossfit has an unofficial rhabdo mascot, uncle rhabdo.
How to tell if your workout is too intense womens health. Michael ray of crossfit flagstaff, az states rhabdomyolysis is a medical condition that may arise when muscle tissue breaks down and muscle cells are released into the bloodstream. Crossfit workouts, just like all high intensity workouts, have the potential to cause rhabdo under the right circumstances. Heres everything you need to know about rhabdomyolysis or rhabdo the serious condition that can happen if you push your body too hard, too fast in the gym. Exertional rhabdomyolysis, the exerciseinduced muscle breakdown that results in muscle painsoreness, is commonly diagnosed using the urine myoglobin test accompanied by high levels of creatine kinase ck. Rhabdomyolysis may result from any traumatic or medical injury to the sarcolemma the myocyte cell membrane of the skeletal muscle cells. Cluster of exertional rhabdomyolysis in three young women. On this warm texas evening, she performed a partner. Michael ray crossfit flagstaff january 2010 rhabdomyolysis is only occasionally seen in athletes. Three young women, aged 1824 years, presented to general practice with signs and symptoms of exertional rhabdomyolysis in 2016. The crossfit journal is a chronicle of the empirically driven, clinically tested, and community developed crossfit program. Return to play and future workup should be determined by the risk stratification of the athlete.
A case series of 11 patients presenting at a single academic institution. The company states that exertional rhabdomyolysis can be found in a wide variety of sports and training populations and argues that its critics have conflated crossfits high awareness of. Exertional rhabdomyolysis is a syndrome with many causes. Researchers are warning that a potentially fatal kidney condition, that has been linked to crossfit, is on the rise. Rhabdomyolysis can lead to the lifethreatening systemic complications of acute kidney injury aki, compartment syndrome, and disseminated intravascular coagulopathy patient concerns. The incidence exerciseinduced rhabdomyolysis is increasing in the healthy general population. Google crossfit and rhabdo together and youll see about 31,900 results and thousands of blogs about crossfitters experiences with this condition. Crossfits dirty little secret eric robertson medium. One day, a very fit, young, physical therapist colleague of mine went to crossfit.
Presenting symptoms were severe muscle pain and swelling, significantly reduced range of motion in affected muscles and, in two cases, darkcoloured urine. Rhabdo jokes are frequent at the gym and on crossfit. Rhabdomyolysis, apart from being a subtly pleasant and melodic sounding word, is an uncool, serious and potentially fatal condition resulting from the catastrophic breakdown of muscle cells. Rhabdomyolysis is a rapid breakdown of skeletal muscle tissue. Exertional rhabdomyolysis after crossfit exercise program. Mean age of all patients with exerciseinduced rhabdomyolysis was 31 years range. The muscle damage causes inflammation leading to tenderness, swelling, and weakness of the affected muscles. Crossfit induced rhabdo greg glassman we warned of rhabdomyolysis in a previous issue crossfit journal 33, may 2005 and return to the topic this month not only to repeat our warning but to share the lessons weve since learned about. We warned of rhabdomyolysis in a previous issue crossfit journal 33, may 2005 and return to the topic this month not only to repeat our warning but to share the lessons weve since learned about exertional rhabdo.
Rhabdomyolysis is a disorder that causes rapid destruction to the sarcolemma, or cell membrane, of skeletal muscles. Full recovery can be expected with early diagnosis and treatment of the many complications that can develop in patients with this syndrome. Uncle rhabdo, a cartoon depiction of a rhabdo sufferer, serves as a reminder to affiliate owners and crossfit coaches that the possibility of contracting rhabdomyolysis is a legitimate risk if proper precautions are not taken. Treatment of exerciseinduced rhabdomyolysis kirstie b. I turn to this blog when i have a story to tell apparently once every two years. Hopefully youre somewhat familiar with this medical condition, thanks to all the media coverage about how crossfit is dangerous. Treatment modalities should include rest and hydration. Crossfit induced rhabdo by greg glassman crossfit journal.
Before the first rhabdo case was brought to our attention, we regularly warned of crossfits potency wherever we had the opportunity. One molecule in particular, myoglobin, is toxic to the kidneys and can, in only the. Mitigate clients risk of rhabdomyolysis rhabdomyolysis, while rare, can develop from highintensity or highvolume exercise, including crossfit or any other process that damages muscle cells. In fact, in a 2010 study by guis et al, elevation of creaktine kinase occurs in 35% of medicationinduced cases, while significant rhabdomyolysis surfaces in 0. Mike ray explains why, how the condition is treated and how smart trainers minimize the risk for their athletes. My experiences with crossfit, running and rhabdo yes, crossfit can lead to rhabdomyolysis. Thats why exercise built around intense burstssuch as spinning and crossfithave been under fire for rhabdo in these recent examples. Rhabdomyolysis is the result of both physical and nonphysical factors such as strenuous exercises, including marathon running 11, military training 12, and high intensity resistance training, medication, crushing injuries, and metabolic disorders 6,10. In urban adults, alcohol and other drug abuse, muscle compression, and status epilepticus are common causes of rhabdomyolysis. Of all presenting crossfit related injuries at our institution, 11 2. Symptoms related to the expected complications of rhabdomyolysis include.
Exerciseinduced rhabdomyolysis was diagnosed in 297 patients, with 42 of these cases caused by crossfit. Rhabdomyolysis symptoms, diagnosis and treatment bmj. Exertional rhabdomyolysis in a 21yearold healthy man. Some crossfit adherents have had a problem with muscle overuse and development of rhabdomyolysis, at least since 2005, when a u. Rhabdomyolysis rhabdo causes, symptoms, treatment, and. The dark urine color is due to myoglobin being excreted in the urine by the kidney as it tries to rid the body of the muscle breakdown products. Exertional rhabdomyolysis evaluation requires a history, physical examination, and serology for definitive diagnosis. The teen was new to physical fitness and was admitted to the hospital for five days. Called rhabdomyolysis, the condition causes muscles to break down or leak. One of the first articles in the national press that identified rhabdomyolysis as a potential hazard of crossfit appeared in the new york times in 2005. Exertional and crossfitinduced rhabdomyolysis request pdf. To this date only a handful of cases have been documented of rhabdomyolysis after crossfit. Rhabdomyolysis rhabdo is a rare but serious health condition sometimes caused by working out at very high intensity.
Sporadic cases may be caused by overexertion or dietary imbalances, whereas chronic cases may be caused by inherent defects in intracellular calcium regulation recurrent exertional rhabdomyolysis or glycogen metabolism polysaccharidestorage myopathy. Rhabdomyolysis is a complex and multifactorial clinical disorder, with multiple potential inherited and acquired causes table 1151. Rhabdomyolysis often simply referred to as rhabdo is a medical condition that may arise from breakdown of muscle. The subsequent release of intracellular ions, myoglobin, creatine kinase ck, and urates into the circulation results in electrolyte disturbances, acidaemia, disseminated intravascular coagulation, renal failure, and multiorgan failure. Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. Rhabdomyolysis is a clinical picture which is rarely seen in children. My experience with rhabdomyolysis now 2 wks out of hospital. Rhabdomyolysis is a complex medical condition involving the rapid dissolution of damaged or injured skeletal muscle. After a prolonged and extreme crossfit exertional program, patient reported fatigue, shortness of breath, muscular weakness, and sleep disturbance, and went to the ed 3 days later. How to tell if your workout is too intense pushing yourself too hard can lead to serious problems, including rhabdomyolysisthe condition being linked to crossfit by caitlin carlson. Our mission is to provide a venue for contributing coaches, trainers, athletes, and researchers to ponder, study, debate, and define fitness and collectively advance the art and science of optimizing human performance. How to prevent exertional rhabdomyolysis crossfit workouts are a combination of aerobic exercise, bodyweight training, gymnastics movements, and olympic lifting.
Short of knowing that you have a genetic condition that may increase your risk, here are several training tips that should substantially reduce the risk of rhabdomyolysis. He reports having had 5 previous days of exercise but did not involve crossfit type training. A 21yearold man had bilateral lower limb pain and soreness, dark brown urine after lower exremity. Theres been a lot of press linking crossfit and the risk of contracting a condition called rhabdomyolysis, an extremely rare medical condition that occurs when muscle tissue breaks down and the contents of muscle cells are released into the bloodstream. In this case report here it is presented a patient who has biochemical and clinical signs of rhabdomyolysis and admitted to. The suit claims mimms suffered from rhabdomyolysis which occurs when tiny shreds of muscle fiber are absorbed by the bloodstream and ultimately poison the kidneys as a result of performing a crossfit workout under the direction.
1015 1112 782 851 485 840 1427 1489 655 332 1149 1224 1179 1211 854 1029 1218 83 740 1358 1430 223 706 1409 260 1387 790 247 1168 84