One of the most difficult-to-pronounce sports injuries has been in the news this week, following the hospitalization of Paralympic snowboarder Amy Purdy. The bronze medal winner of the 2014 Paralympic Winter Games is recovering from a serious condition called Rhabdomyolysis.Rhabdomyolysis (say it with us: raab-doh-my-oh-LIE-sus) is a condition that typically results from a severe muscle injury or overexertion, explains sports medicine specialist Dr. Steve Yoon, Director of orthobiologics and regenerative medicine at the Kerlan-Jobe Orthopedic Clinic in Los Angeles. Dr. Yoon says that Rhabdomyolysis occurs when muscle, “releases a protein called myoglobin into the blood stream which can be associated with achiness, extremity swelling, weakness, and possibly impaired kidney functioning.” According to a 2004 study cited by Physiopedia, an estimated 26,000 Rhabdomyolysis cases are reported annually in America.Sports medicine researchers estimate that around 33% of Rhabdomyolysis cases result in kidney failure. Additional consequences can include heart arrhythmias, cardiac arrest, and, though rare, death.According to Purdy’s Instagram updates, she was released on Monday after being in the hospital for nearly a week. “I was so strong up until last Saturday, now I can barely move my arms without fatigue. I’m going to be neck deep in healing. The recovery on this is supposed to take some time since the muscle fibers in both upper arms were damaged. But all of this is minor compared to what it could have been!” she posted on Instagram on October 31st.If caught quickly and treated before symptoms get out of control, however, Rhabdomyolysis sufferers can survive without lasting damage. Here are five things you need to know about Rhabdomyolysis — including how to spot it, what to do if you get it, how to treat it, and how to prevent it from happening to you.
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What Does Rhabdomyolysis Look Like?
One of the first things a person with Rhabdomyolysis will typically notice, says Dr. Yoon, are achy muscles and fatigue. Some sufferers will chalk this up to being on the mend from a heavy workout, so this hallmark may go unnoticed. But when limbs start to swell — like Amy Purdy’s arm did, following a particularly strenuous set of pull-ups — people begin to catch on that something’s not quite right in their body.Other symptoms of Rhabdomyolysis include brown-colored urine — a result of excess myoglobin and creatine kinase being eliminated from the body — as well as nausea, vomiting, and fever.
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What Causes Rhabdomyolysis?
Overexertion and trauma are the typical culprits. Doing high-endurance sports or activities involving heavy lifting can increase one’s risk. (Though, despite a popular misconception, CrossFitters have no higher prevalence of Rhabdomyolysis than power lifters, gymnasts, or rugby players.)According to the National Collegiate Athletic Association, jumping into an intense workout following a period of time off, progressively overloading one muscle group with fast reps to failure within one workout, and pushing past fatigue in an effort to get in shape ASAP can increase an exerciser’s risk of Rhabdomyolysis. Dr. Yoon says that certain medications and physical states can also render the body more vulnerable to the condition: acetaminophen and antihistamine have been implicated in cases of Rhabdomyolysis. So have psychiatric medications (namely: antipsychotics and some antidepressants), statins and illegal substances, like cocaine and heroin.Dehydration is a huge contributor to Rhabdomyolysis, says Dr. Yoon, so exertion in high temperatures can create a perfect storm. Some infections, like influenza and herpes, have also been linked to the condition.Additionally, studies show alcohol consumption increases one’s susceptibility to Rhabdomyolysis by disrupting the balance of electrolytes in the body and increasing dehydration. In rare cases, excessive consumption of caffeine may also court the problem.
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How to Treat Rhabdomyolysis?
In most cases, Rhabdomyolysis is treated with an intravenous saline solution that helps flush excess myoglobin from the blood stream while rehydrating the body’s cells, says Dr. Yoon. This helps relieve stress from the kidneys as they process the excessive myoglobin released from muscle.In some extreme cases, dialysis may be recommended to prevent kidney failure. And if a muscle group or area of the body is experiencing an extreme loss of circulation, doctors may surgically intervene to relieve pressure via a procedure called a fasciotomy.
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What If Rhabdomyolysis Happens to You?
Dr. Yoon advises following Purdy’s lead and heading to the emergency room stat if you notice muscle swelling or your urine is a darker than normal color. (The sooner you’re seen by a physician, the swifter you’ll receive that saline IV that could save your kidneys.)If you’re unsure, it’s never a bad idea to schedule an appointment with your general practitioner within 24 to 48 hours. He or she can determine whether you require immediate assistance — and can an ER doc — by testing your blood for high levels of creatine kinase, which spike when a muscle spills its proteins into the blood following a traumatic injury or overexertion.
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How to Prevent Rhabdomyolysis?
Stay hydrated, advises Luga Podesta, MD, director of sports medicine at St. Charles Orthopedics in New York.The American College of Sports Medicine recommends drinking 16 to 20 ounces of fluid 4 hours before an athletic event and 8 to 12 ounces of fluid within 15 minutes of starting your exercise regimen.If you’re hitting the trail, the gym, the water, or the AstroTurf for less than an hour, aim to throw back between 3 and 8 fluid ounces of water every 15 to 20 minutes. Any longer and you’ll want to shoot for 3 to 8 fluid ounces of a sports drink — which contains carbohydrates, salt, and potassium to keep you adequately fueled — every 15 to 20 minutes.“Proper hydration can be an art,” Dr. Podesta admits. “If you’re not sure whether you’re properly hydrated, check the color of your urine. The darker it is, the less hydrated you are. Ideally, it should be clear or light yellow.”Another helpful way to ensure you don’t succumb to the same fate as Purdy? Take the advice she offered on her Instagram account during her treatment: “You have to listen to your body…when it is telling you to stop…Stop!”Rest between sets, refuel, and don’t feel down on yourself if you simply can’t push through an entire workout or need to slow down your routine due to fatigue.As Purdy remarked upon her release from the hospital on October 31st: “There is no need to injure ourselves getting stronger.”
One of the most difficult-to-pronounce sports injuries has been in the news this week, following the hospitalization of Paralympic snowboarder Amy Purdy. The bronze medal winner of the 2014 Paralympic Winter Games is recovering from a serious condition called Rhabdomyolysis.
Rhabdomyolysis (say it with us: raab-doh-my-oh-LIE-sus) is a condition that typically results from a severe muscle injury or overexertion, explains sports medicine specialist Dr. Steve Yoon, Director of orthobiologics and regenerative medicine at the Kerlan-Jobe Orthopedic Clinic in Los Angeles. Dr. Yoon says that Rhabdomyolysis occurs when muscle, “releases a protein called myoglobin into the blood stream which can be associated with achiness, extremity swelling, weakness, and possibly impaired kidney functioning.” According to a 2004 study cited by Physiopedia, an estimated 26,000 Rhabdomyolysis cases are reported annually in America.
Sports medicine researchers estimate that around 33% of Rhabdomyolysis cases result in kidney failure. Additional consequences can include heart arrhythmias, cardiac arrest, and, though rare, death.
According to Purdy’s Instagram updates, she was released on Monday after being in the hospital for nearly a week. “I was so strong up until last Saturday, now I can barely move my arms without fatigue. I’m going to be neck deep in healing. The recovery on this is supposed to take some time since the muscle fibers in both upper arms were damaged. But all of this is minor compared to what it could have been!” she posted on Instagram on October 31st.
If caught quickly and treated before symptoms get out of control, however, Rhabdomyolysis sufferers can survive without lasting damage. Here are five things you need to know about Rhabdomyolysis — including how to spot it, what to do if you get it, how to treat it, and how to prevent it from happening to you.
What Does Rhabdomyolysis Look Like?
One of the first things a person with Rhabdomyolysis will typically notice, says Dr. Yoon, are achy muscles and fatigue. Some sufferers will chalk this up to being on the mend from a heavy workout, so this hallmark may go unnoticed. But when limbs start to swell — like Amy Purdy’s arm did, following a particularly strenuous set of pull-ups — people begin to catch on that something’s not quite right in their body.
Other symptoms of Rhabdomyolysis include brown-colored urine — a result of excess myoglobin and creatine kinase being eliminated from the body — as well as nausea, vomiting, and fever.
What Causes Rhabdomyolysis?
Overexertion and trauma are the typical culprits. Doing high-endurance sports or activities involving heavy lifting can increase one’s risk. (Though, despite a popular misconception, CrossFitters have no higher prevalence of Rhabdomyolysis than power lifters, gymnasts, or rugby players.)
According to the National Collegiate Athletic Association, jumping into an intense workout following a period of time off, progressively overloading one muscle group with fast reps to failure within one workout, and pushing past fatigue in an effort to get in shape ASAP can increase an exerciser’s risk of Rhabdomyolysis. Dr. Yoon says that certain medications and physical states can also render the body more vulnerable to the condition: acetaminophen and antihistamine have been implicated in cases of Rhabdomyolysis. So have psychiatric medications (namely: antipsychotics and some antidepressants), statins and illegal substances, like cocaine and heroin.
Dehydration is a huge contributor to Rhabdomyolysis, says Dr. Yoon, so exertion in high temperatures can create a perfect storm. Some infections, like influenza and herpes, have also been linked to the condition.
Additionally, studies show alcohol consumption increases one’s susceptibility to Rhabdomyolysis by disrupting the balance of electrolytes in the body and increasing dehydration. In rare cases, excessive consumption of caffeine may also court the problem.
How to Treat Rhabdomyolysis?
In most cases, Rhabdomyolysis is treated with an intravenous saline solution that helps flush excess myoglobin from the blood stream while rehydrating the body’s cells, says Dr. Yoon. This helps relieve stress from the kidneys as they process the excessive myoglobin released from muscle.
In some extreme cases, dialysis may be recommended to prevent kidney failure. And if a muscle group or area of the body is experiencing an extreme loss of circulation, doctors may surgically intervene to relieve pressure via a procedure called a fasciotomy.
What If Rhabdomyolysis Happens to You?
Dr. Yoon advises following Purdy’s lead and heading to the emergency room stat if you notice muscle swelling or your urine is a darker than normal color. (The sooner you’re seen by a physician, the swifter you’ll receive that saline IV that could save your kidneys.)
If you’re unsure, it’s never a bad idea to schedule an appointment with your general practitioner within 24 to 48 hours. He or she can determine whether you require immediate assistance — and can an ER doc — by testing your blood for high levels of creatine kinase, which spike when a muscle spills its proteins into the blood following a traumatic injury or overexertion.
How to Prevent Rhabdomyolysis?
Stay hydrated, advises Luga Podesta, MD, director of sports medicine at St. Charles Orthopedics in New York.
If you’re hitting the trail, the gym, the water, or the AstroTurf for less than an hour, aim to throw back between 3 and 8 fluid ounces of water every 15 to 20 minutes. Any longer and you’ll want to shoot for 3 to 8 fluid ounces of a sports drink — which contains carbohydrates, salt, and potassium to keep you adequately fueled — every 15 to 20 minutes.
“Proper hydration can be an art,” Dr. Podesta admits. “If you’re not sure whether you’re properly hydrated, check the color of your urine. The darker it is, the less hydrated you are. Ideally, it should be clear or light yellow.”
Another helpful way to ensure you don’t succumb to the same fate as Purdy? Take the advice she offered on her Instagram account during her treatment: “You have to listen to your body…when it is telling you to stop…Stop!”
Rest between sets, refuel, and don’t feel down on yourself if you simply can’t push through an entire workout or need to slow down your routine due to fatigue.
As Purdy remarked upon her release from the hospital on October 31st: “There is no need to injure ourselves getting stronger.”
