In our previous blog, we covered what rhabdo actually is and what occurs in your body when someone is told that they have it, now learn how to be smart and prevent this! 

So, how do you keep this from happening to you? Believe it or not, it may have already happened and you didn’t know it! Most of the published medical studies on rhabdo in athletes (so-called “exertional rhabdo”) have included only more severe cases of the illness. Many exercise physiologists believe that more mild episodes of rhabdo happen much more frequently than are recognized or reported.

As an example, high myoglobin and elevated CK (up to 20-fold over normal) was found in 57 percent of 100 participants in an ultra-marathon race of 100 kilometers. None of these athletes required intravenous fluids or other invasive care. Another study of 300 military recruits in the first two weeks of basic training found 10% of them developed high myoglobin and CK, but again, none required invasive medical care. And certainly, there is probably some kernel of truth in the adage, “no pain, no gain.” In fact, a certain degree of soreness due to muscle trauma seems to be necessary for muscle growth and is probably needed to stimulate protein production and subsequent muscle development.

So, a better question might be, how do you prevent a severe case of rhabdo from happening to you? Unfortunately, it’s complicated. There is probably some genetic component (several studies have demonstrated that the presence of a particular kind of muscle protein raises an athlete’s risk of severe rhabdo), and there is probably some behavioral component. One study of a collegiate football team measured episodes of mild to severe rhabdo and found that the more severely affected athletes were more likely to report going to muscle failure routinely during lifting sessions, more often lifted relatively higher percentages of their body weight, and more often performed extra lifts. Finally, no activity is immune—rhabdo has been documented following heavy weights/low reps, light weights/high reps, cycling, swimming, you get the idea.

Bottom line, listen to your body. Staying hydrated is important and fueling your body appropriately is also crucial. If you redline during a workout, really pay attention to how you feel afterwards. If you seem exceptionally sore and certainly if you are swollen in any of your muscle groups, rest and rest and rest and drink lots of fluids. Rhabdo most commonly affects muscle groups in the arms and legs, but can also affect back and torso. And of course, if you have any change in the color of your urine (coca cola colored or tea colored), please seek medical care. Now, go get after it!!


We are excited to bring you a Monthly Medical Minute from Dr. Mary Reilly, MD, FACEP 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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