Want to know how to dampen the spirits of Crossfitters everywhere—tell them a specific workout places them at risk for the dreaded “rhabdo.” Those two syllables can strike fear in the hearts of athletes all over. Some even refer to it as CrossFit’s dirty little secret, but really is it? And more importantly, how can you try to avoid it?

Rhabdomyolysis or “rhabdo” can result from any kind of muscle trauma, including crush injuries, burns, and, you guessed it, heavy exercise. So, how does a medical catastrophe that happens to burn victims or accident patients happen to folks in the business of getting fitter? In the case of athletes, rhabdo happens because an athlete has literally worked her muscles so hard that the muscles have totally run out of their local energy stores.

You know how when you feel you don’t have anything left to give after a super hard work out—well, in the case of rhabdo, it’s actually true. In science-speak, once your muscle cells don’t have the energy to function, they lose the ability to maintain cell integrity and they literally start falling apart. This muscle cell death results in the release of muscle cell contents, including proteins, into the bloodstream.

The classic presentation of rhabdo is extreme muscle pain, weakness, and dark tea-colored urine. Creatine kinase or CK is one of the muscle proteins that is released and the degree of elevation in CK is used as a marker for the diagnosis and severity of rhabdo. Myoglobin is another protein that is released, and as the kidneys work to clear the proteins from the blood, the urine becomes dark or tea-colored as a consequence of all the myoglobin. The ultimate dreaded complication from rhabdo is kidney failure, basically due to overwhelming the kidney’s ability to clear all the protein that is being released from the dying muscle cells.

So how do you keep this from happening to you? Be on the look out for part 2 of this blog from Dr. Mary Reilly to learn tips on how to keep healthy and doing what you love to do!

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We are excited to bring you a Monthly Medical Minute from Dr. Mary Reilly on various topics and how we can continue to learn to keep safe, healthy, working towards our goals in and out of the gym!

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