Rhabdomyolysis: A Runner’s Disease You Should Know About

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In rhabdomyolysis, damaged muscle cells release proteins into the blood, making it harmful. Overtraining or even running a marathon without ample preparation may cause this condition. Muscle pain, soreness, and swelling that persist beyond a normal duration indicate this condition. It can, at times, result in acute renal failure. Since the causes are varied, the treatment options differ.

Athletes must pursue strenuous exercise and training, but overtraining may leave them with injured muscles and its consequences. When a skeletal muscle injury releases muscle cell contents into the plasma, it results in a condition called rhabdomyolysis.

Studies have reported that strenuous exercise, even as simple as marathon running, can cause rhabdomyolysis in athletes. Since muscle injuries are common in athletes, they may be more prone to this condition, but there are many other factors associated with it too.1

Here’s what you need to know about rhabdomyolysis and training.

Rhabdomyolysis And Overtraining

Overtraining Can Cause Rhabdomyolysis

Athletes are usually prone to some form of muscle damage due to the nature of their training, but it is only rarely that it causes extensive muscle damage. Unknown to many, the most prevalent cause of acute exertional rhabdomyolysis in athletes is novel overexertion. This means that the athletes are doing too much or too fast of an exercise that is relatively new. It is said that acute rhabdomyolysis is more pronounced if the excessive exercise regime is of the muscle-lengthening contractions type like downhill running, plyometrics, or lowering weights.2

Specific muscle proteins are released into the blood when the muscle damage is profound. One of the released proteins called myoglobin, if present in high concentrations, especially in certain conditions like dehydration, heat stress, etc. can also result in an athlete having renal failure.

However, studies suggest that renal failures occur in athletes who have taken analgesics and have had a viral or bacterial infection. One condition or a combination of conditions can result in renal failure, but rhabdomyolysis in itself may not precipitate into kidney damage.3

Apart from overtraining, there are other causes of rhabdomyolysis. Let’s examine some of these causes and risk factors.

Other Causes Of Rhabdomyolysis

Direct Trauma Like A Car Crash Can Cause Rhabdomyolysis

Concerning athletes, the most salient cause of rhabdomyolysis happens to be overexertion caused due to overtraining. The other significant reasons are as follows:

  • Alcohol abuse
  • Muscle compression
  • Seizures
  • Direct trauma (whether minor or major)
  • Drug abuse
  • Hypothermia
  • Sepsis
  • Vascular or cardiac surgery

In healthy individuals, exertion in hot, humid conditions, hyperthermia (body temperature being above normal), or hypokalemia caused by potassium loss from sweating may result in exertional rhabdomyolysis.

At times, other toxins like carbon monoxide, snake or insect venom, mushroom poisoning, viral and bacterial infections like influenza A and B, Herpes simplex, human immunodeficiency virus (HIV), etc. have also been associated with rhabdomyolysis. A few endocrine factors like diabetes and thyroid disease are also associated with this condition.4

Look out for these tell-tale symptoms of Rhabdomyolysis.

Symptoms Of Rhabdomyolysis

Muscle Pain Is A Symptom Of Rhabdomyolysis

Muscle pain and swelling are the most commonly experienced symptoms of rhabdomyolysis, though it is not necessary that these symptoms exist.

Patients may have brown colored urine. Only 50 percent of the patients studied showed myoglobinuria (red or brown urine), indicating that a urine test need not be a certain clue to diagnosing rhabdomyolysis.

Patients may also experience weakness. If muscles feel sore, painful, or any swelling is seen beyond a normal period after excessive training or workout, then it is better to consult a doctor to rule out the possibilities of rhabdomyolysis.

Clinical diagnosis through various lab tests may be conducted to determine levels of creatinine kinase – an enzyme found in the skeletal muscles, the brain, and the heart. Those with a higher than usual level of the enzyme may be diagnosed with rhabdomyolysis.5

Tips To Prevent Rhabdomyolysis

Proper Hydration During Training May Prevent Rhabdomyolysis

Rhabdomyolysis due to overtraining is a common condition among athletes and runners. Trainers and instructors are now focusing on preventing the condition. A few suggestions based on certain studies are as follows:

  • Avoid strenuous exercises for extended periods of time especially if you are trying the exercises for the first time.
  • Conduct functional and fitness screening to identify if you are at a risk of exertional rhabdomyolysis.
  • Avoid dehydration and heat stress during training and include adequate rest periods while training.
  • Follow recommended methods of slow, progressive build-up to avoid over-exertion and fatigue.6

Treatment Options

It is better to consult a doctor if you observe a muscle swelling or soreness that seems to persist, especially if you have been training really hard on a new exercise routine.

Treatment options may vary from individual to individual depending on the causes and severity of the condition. However, initial stabilization and resuscitation of the patient are done while also making attempts to preserve the renal function.7

Therefore, it is essential not to overwork or overtrain your body, whether it be an everyday exercise routine or a competition. Rest days – time you give your body to heal and repair its muscles and tissues – should never be overlooked.

References   [ + ]

1.Gabow, Patricia A., William D. Kaehny, and Stephen P. Kelleher. “The spectrum of rhabdomyolysis.” Medicine 61, no. 3 (1982): 141-152.
2.Eichner, E. Randy. “Exertional rhabdomyolysis.” Current sports medicine reports 7, no. 1 (2008): 3-4.
3.Clarkson, Priscilla M. “Exertional rhabdomyolysis and acute renal failure in marathon runners.” Sports medicine 37, no. 4-5 (2007): 361-363.
4.Miller, Marc L. “Causes of rhabdomyolysis.” Up To Date Medication [электронный ресурс], Updated: Sep 19 (2014).
5, 7.Huerta-Alardín, Ana L., Joseph Varon, and Paul E. Marik. “Bench-to-bedside review: Rhabdomyolysis–an overview for clinicians.” Critical care 9, no. 2 (2004): 158.
6.Putukian, Margot. “Exertional Rhabdomyolysis (ER).”

Disclaimer: The content is purely informative and educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.

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