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Weekend Warrior Syndrome – Rhabdomyolysis

by Dr. Jason Barker April 03, 2018

Weekend Warrior Syndrome – Rhabdomyolysis


Rhabdomyolysis – otherwise known as “rhabdo,” is a condition where muscles breakdown rapidly, as a result of injury or damage. Rhabdo is a rare, but serious medical condition that can even be life threatening.

It occurs when the products of muscle breakdown overwhelm the body’s ability to clear them from the bloodstream. There are several muscle breakdown products but the ones that cause the most damage are Myoglobin and Creatine Kinase.   Excess amounts of these compounds can overwhelm and damage the kidneys, even causing kidney failure.

Typically, things like crushing injuries, certain medications, dehydration and extreme heat can cause it. However, exercise-induced, or exertional rhabdomyolysis is on the rise as more people push themselves into endurance or ‘extreme’ type sports, namely those involving repetitive movement or exercises, or new types of exercises that one’s muscles may not be adapted to.

Classic examples are a person who is new to a sport like CrossFit and performs numerous sets of pull-ups that they aren’t quite adapted to, or someone who goes to a spin class that isn’t ready for that level of intensity. Or, a runner who decides to tackle a half marathon without training enough.

Yet, one doesn’t have to be new to a sport or out of condition to develop rhabdo. Experienced and well-trained athletes are at risk during prolonged bouts of exercise in a dehydrated or heated environment. Or, a runner who decides to suddenly switch it up and go on a long, intense bike ride can be susceptible as well.

Symptoms of Rhabdomyolysis:

There are 3 classic symptoms that include:

  • Muscle swelling
  • Muscle weakness
  • Dark, tea or cola-colored urine

Other common signs include:

  • Nausea/vomiting
  • Painful muscles
  • Decreased urination
  • Fever
  • Bruising
  • Irregular heartbeat

Risk Factors

The most common causes of rhabdomyolysis include things like crushing injuries (car accidents, earthquakes, etc), medications, drug and alcohol abuse, and strenuous exercise.

Here are the biggest factors of exertional rhabdomyolysis in active and athletic people:

  • Jumping in, too much too soon. If you’re deconditioned start slowly before plunging into the same intensity workouts you used to do.
  • Minimize strenuous workouts in intense heat as best you can.
  • Watch for dehydration, especially if you’re a heavy sweater, or your sport requires you wear a lot of gear (football).
  • Excess repetitive workouts that are designed to tear your muscles down – we’ve all been in a class or gym where they push you on leg day or other repetitive exercises that are meant to ‘shred’ your muscles.
  • Switching sports – cross training is of course encouraged but a runner who decides to hammer a spin class, or a cyclist who decides to run a half marathon are good examples of how fit athletes can develop rhabdo!

You can’t prevent every single injury but preventing rhabdo can be fairly straightforward by avoiding the aforementioned examples and by doing the following:

  • Make sure you’re hydrated
  • Start easy in a new sport, regardless of your conditioning
  • Avoid the intense heat
  • Take time to rest and recover if you’re getting back into shape

If you notice those 3 main symptoms – dark urine, muscle pain or weakness, and swelling, you need to be seen by your doctor. The main goal in treating rhabdo is to prevent kidney damage or even failure and the sooner treatment is initiated the better the outcome. Treatment typically involves IV fluids, and monitoring blood levels of muscle-breakdown products like myoglobin, creatine kinase, electrolytes and kidney function.

It may take weeks to recover from a serious bout of rhabdomyolysis, so the best cure is of course prevention! Enzymes, trace minerals and certain botanical medicines found in our Musculoskeletal Injury MSI formula are great for helping heal up damaged muscles, once you've started the recovery process. 


Dr. Jason Barker
Dr. Jason Barker

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