As summer approaches, many people jump into intense workout routines to lose weight or tone their bodies. However, engaging in high-intensity strength training over a short period can strain muscles and lead to a condition known as rhabdomyolysis. In such cases, excessive exercise can actually be detrimental to one’s health.
Medical experts explained that rhabdomyolysis occurs when skeletal muscles, such as those in the arms and legs, do not receive adequate energy and oxygen, leading to the destruction or death of muscle cells. This condition causes the breakdown of muscle cell components, including myoglobin, which then leaks into the bloodstream. These substances can damage the kidney tubules and potentially result in severe acute kidney injury.
The kidneys, which act as the body’s natural filter, are essential for processing metabolic waste from food intake, regulating fluid and electrolyte levels, and secreting various hormones.
Recently, a military trainee collapsed during training and was later hospitalized, where he died just two days later. The trainee had undergone rigorous activities, including running in full gear, push-ups, and sprinting. Medical personnel initially diagnosed him with rhabdomyolysis due to excessive heat and strenuous exercise. Although the final cause of death was attributed to heatstroke, this incident highlighted the previously unfamiliar term “rhabdomyolysis” and its serious implications.
Causes of rhabdomyolysis can be broadly divided into physical (traumatic) and non-physical (non-traumatic).
Traumatic causes of rhabdomyolysis include accidents, while non-traumatic causes often involve excessive exercise, infections, and drug or alcohol abuse. Mainly, non-traumatic cases arise from strenuous activities following alcohol consumption or exercising in hot and humid conditions.
Rhabdomyolysis may not always show symptoms but can present as muscle pain, swelling, or dizziness. If severe muscle pain or weakness continues after exercise or urine turns a cola-like color, this could indicate rhabdomyolysis.
If symptoms persist and urine appears dark, one should suspect rhabdomyolysis to distinguish it from simple muscle pain. Diagnosis can be confirmed through urine and blood tests, which show elevated levels of myoglobinuria.
Early and proactive treatment generally leads to a favorable outcome. However, delays in treatment or complications such as acute kidney injury can be life-threatening, with a reported mortality rate between 8% and 10%. If acute renal failure occurs, it might require emergency dialysis and can lead to multiple organ failure, raising the mortality rate to 42%. Therefore, preventing acute kidney injury is critical, with adequate fluid supply being the primary focus of treatment.
Correcting electrolyte imbalances is also crucial to reduce kidney damage. If complications such as acute kidney injury persist or electrolyte imbalances remain, emergency dialysis might be needed. Most patients can stop dialysis once kidney function is restored.
In severe cases, compartment syndrome can occur, which may require surgical intervention. This condition involves muscle swelling that increases pressure within muscle compartments, compresses arteries, and obstructs blood supply to the extremities, potentially leading to muscle and tissue necrosis within 4 to 8 hours.
“To prevent rhabdomyolysis, it’s important to gradually increase exercise intensity based on one’s physical abilities rather than jumping into high-intensity workouts. Staying hydrated and taking breaks during exercise is also crucial,” advises Professor Yang Ji Hyun of Kangbuk Samsung Hospital’s nephrology department.
Professor Min Ji Won from the Catholic University of Korea Bucheon St. Mary’s Hospital’s nephrology department adds, “Gradually increasing exercise intensity according to your capabilities and avoiding excessive muscle strain is essential. Regular breaks and hydration during activities are key to prevention.”