We’d like to make everyone aware that there is a small, yet significant possibility of catastrophic trauma from intense training, Eugene Allen writes in “Killer Workouts.” Rhabdomyolysis (Rhabdo) is a potentially fatal condition, marked by high concentrations of potassium in the blood.
In most cases of rhabdomyolysis is develop as a result of muscle injury or strain, or other external causes (such as medication or intoxication). However, the cause is not always directly evident. Pain, tenderness, weakness and swelling of the affected muscles may be present. If the swelling is very rapid, low blood pressure and shock may be present due to depletion of fluid from the bloodstream. Other symptoms are non-specific and result either from the consequences of the breakdown in muscle tissue, or from the condition that caused the muscle breakdown.
Swelling of the damaged muscle occasionally leads to compartment syndrome, the compression by swollen muscle of surrounding tissues in the same fascial compartment (such as nerves and blood vessels), leading to damage or loss of function in the part of the body supplied by these structures. Symptoms of this complication include decreased blood supply, decrease in sensation, or pain in the affected limb.
Release of the components of muscle tissue into the bloodstream leads to disturbances in electrolytes causing: nausea, vomiting, confusion, coma and cardiac arrhythmias (abnormal heart rate and rhythm). Furthermore, damage to the kidneys may lead to dark (tea-colored) urine or a marked decrease (oliguria) or absence (anuria) of urine production, usually about 12–24 hours after the initial muscle damage. Finally, disruptions in blood clotting may lead to the development of a state called disseminated intravascular coagulation.
Creatine kinase is the muscle energy enzyme elevated in the blood of patients with Rhabdomyolysis.
One of the causes of Rhabdo is extreme physical exercise (particularly when poorly hydrated), as well as exercising when it is very hot and humid. Other Rhabdo invitations are heavy alcohol consumption, cocaine usage, delirium tremens (alcohol withdrawal), tetanus, prolonged seizures, status epilepticus and the use of a cholesterol-lowering drug called Mevacor (lovastatin is the generic name).
The primary diagnostic indicator of rhabdo is elevation of serum creatine phosphokinase (CPK). Rhabdo can raise CPK levels to five times the norm. This is an advanced indicator. Post WOD warning signs may be harder to come by. Extreme weakness or fluid build up may be cause for concern. However, if you’re pissing what resembles Coca-Cola, find an emergency room STAT.
The risk of Rhabdomyolysis can be reduced by cooling down after exercise, vigilance and common sense. The warning label for Caveman Training is a strict adherence to our charter: mechanics first, consistency with those mechanics and then intensity. Highly fit athletes are not immune to Rhabdo, however increased work capacity is an excellent prophylactic measure.
If in doubt, consult your doctor right away!