Rhabdomyolysis occurs through overexposure to severe or unaccustomed exertion.
Rhabdomyolysis, commonly known as “rhabdo”
, is defined as a clinical and biochemical disorder categorized by the disintegration of striated muscle, which causes myoglobinuria.
Myoglobinuria is the presence of myoglobin in the urine, usually associated with rhabdomyolysis or muscle destruction. Myoglobin is present in muscle cells as a reserve of oxygen.
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The myoglobinuria associated with rhabdomyolysis
is the most severe consequence of muscle disintegration and is reported to cause acute renal failure in 15-33% of hospitalized patients.
The effects. What and why..?
Due to the current increase in the application of popular extreme conditioning programs that propose high exertion and are typically directed toward the untrained general population, we need to examine the effects of exertional rhabdomyolysis.
Although rhabdomyolysis can occur from various causes
such as: exertion, trauma, infections, extreme temperatures, drugs, toxins, electrolyte and endocrine abnormalities, and congenital disorders (e.g. myopathies); we will refer to exertional rhabdomyolysis throughout the rest of this article (1).
We’ll identify the common signs and symptoms that overexertion and high-dose exercise programs can elicit that may lead to exertional rhabdomyolysis, and what preventative steps can be taken to reduce the likelihood of developing exertional rhabdomyolysis.
Causes and risks of exertional rhabdomyolysis
Exertional rhabdomyolysis occurs through overexposure to severe or unaccustomed exertion (particularly within environmental conditions of extreme heat), long duration repetitive movements (i.e. marathon running), intensive and repetitious weight lifting, or military training.
In addition, the chances of exertional rhabdomyolysis increase when the modality of exercise consists of predominantly eccentric actions (e.g. downhill hiking or jogging). An eccentric muscle action is when a muscle contracts as it is lengthened
. Just think when you lower the weight on a biceps curl, you bicep muscle is contracting as it is lengthening, which is an eccentric contraction. Essentially, the more strenuous or prolonged the exercise is, the more damage that occurs to the tissue.
Factors that have been demonstrated to increase the risk of exertional rhabdomyolysis are:
• Hypokalemia (low potassium resulting from excessive sweating)
• Sickle-cell trait (especially in high altitude)
• Extreme heat and humidity
• Exercise-induced asthma
• Pre-exertional fatigue
Below are research-based guidelines that you should be aware of in order to avoid exertional rhabdomyolysis from occurring.
• Exposure to high volume training combined with high intensity enhances the chances of developing exertional rhabdomyolysis for individuals not accustomed to those volumes or intensity levels.
• Chances for obtaining exertional rhabdomyolysis may drastically increase when additional variables (e.g. hydration status
, temperatures, humidity, frequency of training, training modality, diet and other health-related conditions) responsible for susceptibility of exertional rhabdomyolysis are present.
• Individuals should be closely monitored when suddenly changing training volume or exercise intensity, or introducing new exercises or training modalities, particularly exercise with high-intensity eccentric muscle actions.
• Pay close attention to the gradual exposure to intensive training if you are new to exercise. If you will train intensely over a period of time; closely monitor for excessive soreness and other signs of exertional rhabdomyolysis (e.g. urine discoloration, redness, muscle edema i.e. swelling).
• If these signs/symptoms are present, a clinical assessment by a medical professional is needed to confirm or negate the presence of exertional rhabdomyolysis. It’s prudent to seek medical attention immediately as early detection decreases strain of myoglobin on the renal system and reduces chances of obtaining acute renal failure
• The two primary recommendations for exertional rhabdomyolysis prevention consist of proper hydration (pre, during, and post-exercise) and proper exercise programming – proper manipulation of program variables such as training volume and intensity.
As you are aware, the need to apply the principles of progressive overload within you exercise programs is imperative for overall health and well-being. Although the possibility of someone having exertional rhabdomyolysis is low, it is best to be well-versed in the causes, signs and symptoms, and what to do in order to prevent this from happening!
To avoid any type of overexertion or overtraining during your exercise program, you need a tailored and structured program that shows you how to do the right type and amount of exercise to earn the body shape you desire.
My online transformation program is customized to the individual and provides personalized feedback
throughout the program. I will teach you how to utilize progressive overload throughout your transformation and will ensure you do not over train.
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