080610 WEDNESDAY “Uncle Rhabdo”

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Rhabdomyolysis is a very serious and life threatening condition that has the potential to sideline any CrossFit athlete. With a little experience, a little knowledge, and a little self control, the threat Rhabdomyolysis presents can be avoided if not completely negated.

The ‘very simple’ explanation is that “Rhabdo” is caused when muscle destruction causes the release of chemicals (broken down muscle components) into the blood stream. This muscle breakdown can be caused by exercise or even injury to muscles (such as in a car accident). The kidneys (that filter the blood) are overwhelmed, and soon fail. Extreme discomfort, a hospital visit, and/or death can follow.

CrossFit has a unique relationship with Rhabdo due to to the fact that it’s appearance in any kind of ‘fitness’ environment was previously unheard of. After a few cases appeared during CF’s early years (and many more cases since), “Uncle Rhabdo” (Pukie’s angrier, darker cousin) is still an important threat to any CrossFit gym.

Below are two articles that were provided in the CrossFit Journal about Rhabdomyolysis.

CrossFit Journal 33, May 2005 “Killer Workouts” PDF article

CrossFit Journal 38, Oct 2005 “Rhabdo” PDF article

Any CrossFit workout of sufficient intensity has the possibility of inducing Rhabdo to some degree, but the following factors seem to play the biggest roll.

1. Negative contractions (i.e. eccentric movements) – anything with an abundance of ‘decelerating weight receiving’ activities done at with high repetitions such as burpees, jumping pull ups, etc. Eccentric movements tend to cause more muscle soreness than other movements, so this can be your guide.

2. Ego – The drive to beat a fellow gym member or to best some score can sometimes cause an athlete to ignore the ‘inner voice’ that warns that you might need to hold back today. Generally it takes a certain type of person to drive far enough past your comfort zone to enter into muscle destroying territory. That being said, at CrossFit we challenge our comfort zone and our egos every workout. The good news is that with regular CF training, your experience and your body’s conditioning will lessen the possibility of Rhabdo. The bad news is that people who used to be in ‘great’ shape before coming to CrossFit, or have long ago participated in sports that demanded the mental fortitude for maximum output are in the most danger. These people have generally developed a mental pushing force that far exceeds their bodies current capabilities. They will need to be ‘reined’ in by more experienced CF players.

3. Heat – Warm weather and humid weather also play a roll. When working out on extremely hot days, try to stay as cool as possible (shade, etc), and pay more attention to intensity.

4. Dehydration – Due to either a lack of water, or a night of heavy drinking before, can also lead to muscle breakdown. Drink your water. Be extra careful working out hard after a night of ’12 oz curls’.

Symptoms (when to get worried):The primary symptoms observed by athletes are generally

Muscle fatigue (fairly normal after a CF workout)

Extreme muscle soreness (somewhat normal after a CF workout)

“Tea” or pink colored urine (BINGO)

With the third symptom being the most telltale, and the time you should think about calling the hospital. The second symptom will need to be judged based upon ‘how sore’ you think you are. And the first symptom isn’t much to work with because it is all too common after a good hard CF workout.

When you do go in for blood/urine examination, make sure you tell them that you suspect Rhabdomyolysis – otherwise it may take many hours for the doctor to figure out exactly what is wrong with you (as that Rhabdo isn’t common from working out). Depending on the severity (we are fairly confident that many CF athletes have experience mild forms of Rhabdo without even knowing it), you may be in the hospital for a couple days to weeks. And you may not be able to train for weeks or months. Either way, you can expect a loss hard earned performance and muscle mass.

Be careful with “Uncle Rhabdo”. Watch your intensity on hot days, drink water, and make sure that you keep your ego in check. As with any time you risk serious injury, it is better to err on the side of caution than to loose not only the future time training, but also dozens of hours already spent in the gym.

-jj

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Workout:

Overhead Squat

5,5,5,5,5

At weight each set. Post loads used to comments.

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A short Video Article about, CrossFit, New Jersey CrossFit (aka CrossFit Jersey Shore) and Rhabdo.

http://abclocal.go.com/wpvi/story?section=news/special_reports&id=6173089

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  • Mark L.

    Great advice! Especially the urine color advice (having your urine any really strange color combined with any other symptoms is probably worth a call to a medical professional even if you don’t suspect Rhabdo). Kidney’s are fragile and one of your most important organs.
    I think it’s funny you called it “Uncle Rhabdo”, like he’s a character that rides around in a white van with no windows, and he is not allowed to live within 2,500 feet of a school zone. SCARY!

  • Luca Z.

    Cool posting JJ

  • J Jones

    Mark – I am always suspicious of unmarked white vans. . .

    Luca – Thanks.

    On a side note, after not overhead squatting for months, I got a single for bodyweight (205lbs) last night!

    My previous PR was in the 165 range.

    I started to do the 5×5 OHS workout above, but felt so strong, I dropped down to sets of three to go up in weight (starting at 175). 185 for 3 felt strong so I did singles for 195 and 205. I had some gas in the tank too. I am pretty sure I could do 210 or 215.

    I attribute the jump in performance due to the copious amount of stretching I have been doing for my hips. A tight psoas muscle has been adding to a lumbar problem (back pain) for over a year now, and hampering my performance.

    The recent ‘forced’ month rest I think also contributed.

    15 reps with bodyweight here I come. . .and I have 6 whole months left before the deadline!

    -jj

  • Craig

    6:30 at the Shed with Bosco.

    JJ & Bryan dragging a tire sled with rope pulls and harneess, followed by sledge hammers and tire flips. Awesome site.

    I did 1000m row, plus Diane w/modified HSPUs.

  • J Jones

    Using the rope we did (the long one) you MUST use gloves. Luckily I dropped some off when I delivered “THE MACE”

    -jj

  • Mark L.

    Craig… what was your time on Diane? I know you were tired from the 1000m row, but I’d like to try to compete against something tonight and I’m pretty good at both DL and HSPU.
    Jeremy… stretching definitely helps with squats. I think when we’re tight the mechanics (as “designed”) get all screwed up, and the same weight feels a lot heavier. Tight hips, and hams sort of come with the territory for all athletes unless they make a concerted effort to fight it to the finish and dedicate a lot of time like you did. Stretching should be part of every athletic program.
    A good book to see how far behind you are (versus where you were “designed” to be) is “The Wharton’s Stretch Book”. If you follow their routine, it works FAST! You’ll be able to lick the back of your knee in less than a couple months with daily work! (not that you’d want to do that, but it’s nice to know you can in case you spill some ice cream on there or something).

  • Craig

    Trail run tomorrow at 6:30AM. Anyone?