Rushing into intense exercise after a break can cause “rhabdo”, potentially leading to kidney injury

By Sarah MooreJan 27 2020

New evidence is coming to light warning people from rushing too quickly into intense exercise, which is often synonymous with new year’s resolutions to achieve health goals.

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Studies have shown that when the body is inactive for a significant amount of time, suddenly engaging in exhaustive muscular exercise can cause muscle cell membranes to burst, spilling their contents into the bloodstream and wreaking havoc on the body.

While it is rare, and most people planning to take up new year’s resolutions to get fit will not be affected by this, there have been several reports of college students becoming ill in this way.

Increased incidences of rhabdo are being reported

Experts in sports medicine have revealed that skeletal muscle ruptures are becoming a more common occurrence. “Rhabdomyolysis”, generally known in its abbreviated form as “rhabdo”, is the process where the intracellular contents of the cells that make up the body’s skeletal muscle are released into the bloodstream following their rupture. Subsequently, enzymes, electrolytes, and proteins are added into the bloodstream where they can cause harm to the body.

In particular, the protein myoglobin has been seen to block the kidney filtration system due to its large size. The protein can also breakdown into byproducts that are toxic to the kidneys, and in severe cases, elevated levels of myoglobin can even lead to kidney failure.

Scientists have begun looking at the impact of rhabdo more closely. A recent study saw six out of 34 college swimmers being hospitalized following a challenge where the college athletes competed to see how many pull-ups, bench presses, and rows they could do in 20 minutes.

The study highlighted the increasing rate at which rhabdo is being diagnosed in college sports players, signaling the need for increased awareness and better prevention techniques. This is especially important at the beginning of the year when many healthy athletic students, who are used to physical activity, return to practice after having time off.

This time off can increase the likeliness of suffering rhabdo because the muscle cell membranes need time to completely re-adapt to training stress.

Athletes and amateurs alike should be aware of the signs of rhabdo

Players of several sports, including basketball, football, soccer, track, lacrosse, softball, volleyball, and golf have been reported to have suffered from rhabdo. But it is not just athletes that are at risk.

There have been more than 90 cases of rhabdo recording following spinning classes, and recently 119 students at a high school in Taiwan were hospitalized with it following a push-up challenge assigned by a teacher.

Data shows that rhabdo can be caused by hours of excessive activity, but also from as little as just five minutes, depending on the circumstance.

The key message is that our bodies require adaptation to handle the stress of intense exercise, and even those accustomed to it require a period to re-adapt following a break.

Generally, only cases of rhabdo that cause acute kidney injury or debilitating symptoms require medical treatment. However, the signs of subclinical rhabdo should be paid attention to.

Symptoms such as excruciating muscle pain, muscle swelling so severe that it limits movement, nausea or vomiting, and dark colored urine, are indications of subclinical rhabdo and anyone experiencing these should seek medical advice.

Avoid doing too much too fast, experts advise

The cases that are emerging that are demonstrating the dangers of rhabdo are to be taken as a reminder of the importance of implementing proper training practices.

While rhabdo is still rare, allowing our bodies to properly acclimate to physical activity is essential in preventing exercise and sport-related injury.