W
hether you’re a regular
CrossFitter or brand new
to an exercise regimen,
there’s a little known
condition you might want to be aware
of. Even when I studied Exercise
Physiology in graduate school, we
didn’t learn about this syndrome nor
was there ever a focus on the dangers
of it. I’m talking about rhabdomyolysis,
specifically of an exertional origin.
This condition is sometimes
associated with CrossFit due to the
nature of the training programme,
which includes high intensity exercises,
but it can happen with any type
of muscle overexertion and there
are other causes as well (such as
crush injuries, certain infections and
medications). If you’ve never heard
of this particular condition, you’re not
alone, but it’s important to recognise
the symptoms in order to seek medical
attention if needed.
This potentially life-threatening
syndrome results from the breakdown
of skeletal muscle fibres with leakage
of muscle contents into the body’s
circulation system. When injured/
overused muscle fibres die and release
their contents into the bloodstream,
the toxins can impair the kidneys
and cause serious complications.
Fortunately, with prompt diagnosis and
treatment, a full recovery is expected.
Let me back up a little and say that
under typical exercise conditions, tiny
tears in your muscle naturally occur
as you put your muscles under the
stress of exercise. This often results
in some soreness, especially if you’ve
just started a new programme or have
recently increased your intensity. It
is through the process of repairing
those micro-tears that you actually get
stronger and build more muscle.
Sometimes the soreness from
a workout takes a day or two to
manifest. You may have noticed feeling
more sore the second or third day
after a workout. This is called delayed
onset muscle soreness, or DOMS,
and it occurs over time as metabolic
and physiological processes happen.
health
If you build up your exercise activity
gradually, DOMS is less of an issue.
Normal muscle soreness goes away
on its own in a couple days. With
rhabdomyolysis, the soreness may be
extreme and you may have muscle
swelling as well as dark colored
urine or lack of urine. Unlike DOMS,
rhabdomyolysis is a serious condition
that requires medical attention. It can
happen when someone jumps into
heavy activity without building up to it.
While rhabdomyolysis is not
commonly considered, a mum I know
here in Hong Kong was hospitalized
with it a few months ago. I spoke with
her about the whole experience and
here’s what she had to say.
What were you doing that lead to
the condition?
I was doing a “negative pull-ups”
workout that was designed for 5
rounds of 3 reps with a 2 minute
break between each round. This was
a modified version of the pull-ups
workout that others in the gym were
doing, designed to focus on and build
up the arm muscles to eventually be
able to do a pull-up. The movement
requires standing on a wooden box
and grabbing the pull-up bar from a
standing position. Then you step off
the box and try to do a slow, controlled
extension of the arms, holding yourself
in a hanging position before coming all
the way down.
By about the 7th negative pull-up,
I felt like I was just “dropping”. I could
no longer have the control to do the
slow extension to lower myself and
straighten my arms. Surprisingly, I
was able to continue with another
20 minute workout after that which
included banded pull-ups and
“wall balls”.
How long after did you notice
something was wrong?
Immediately after the workout, my arms
started to feel dysfunctional. I couldn’t
control the muscle enough in a bent
position to wash my face or my hair.
I thought it was just a more extreme
Spring 2020
21