Can Intense Workouts Cause Rhabdomyolysis? What To Know

Over the weekend, Tufts University announced that 12 players on the men’s lacrosse team had been diagnosed with rhabdomyolysis, a rare but serious condition where your muscles break down. Some of the athletes are now in the hospital for the condition, which can lead to disability and death if not properly addressed. The affected players came down with rhabdomyolysis after a voluntary 45-minute workout.

While rhabdomyolysis, or rhabdo, happened to college athletes in this situation, that’s not always the case. Rhabdo is a medical phenomenon that can occur in athletes and non-athletes alike, according to Dr. Lutul Farrow, the executive director of Cleveland Clinic Sports Medicine.

“At its very core, it’s just explained by damage to the muscle following extreme exercise,” Farrow said. “Essentially, the muscle cells themselves actually are overworked, and their cell walls break down and they spill all their contents, which is something we call myoglobin, into the soft tissues in the bloodstream.”

Beyond exercise, the Centers for Disease Control notes that rhabdomyolysis can occur after any kind of muscle damage, including damage from accidents and heat.

“In very severe cases, it could certainly be threatening to your end organs, especially the kidney, and can actually be life-threatening if not addressed,” Farrow said.

Here’s what to know about the condition:

Many people believe that someone with a high fitness level cannot get rhabdo, but that’s not true. Anyone, from marathon runners to professional athletes to people at the beginning of their wellness journey, can develop the condition.

“This is an overtraining thing, so certainly highly trained, highly fit athletes may have a higher threshold for getting this, but they are still at risk,” Farrow said.

Prolonged, intense physical activity is what puts people at risk, and this is especially true for people who have never worked out, or haven’t worked out in a long time. If you go out and do a long, high-intensity workout when you’re not used to it, it could lead to rhabdomyolysis, Farrow said.

“Some of the people who are most at risk, however, are people who are older and younger… who may not be accustomed to working out,” he said.

Certain medications put folks at higher risk, too, including diuretics, blood pressure medications and stimulants, according to Farrow.

Hot weather can also cause rhabdo, as muscles break down more quickly in the heat. When working out, you want to make sure you stay hydrated and be mindful of heat and humidity. People who work outdoors in physically demanding and/or hot conditions are also at risk of developing the condition.

According to the CDC, symptoms of rhabdo include severe muscle aches and pains, muscle cramps, dark-colored urine, weakness and tiredness. The problem is, these symptoms can be signs of many other conditions too, and it’s easy to simply dismiss some of them as the result of a tough workout that will get better in a few days. The only way to actually know if you have rhabdo is by seeing a doctor who can order blood tests to determine if you have the condition.

If you do suspect you have rhabdo, it’s important to see a doctor as soon as possible. As noted above, the condition can be life-threatening or lead to permanent disability. Instead of waiting to see a primary care doctor, Farrow recommends that you go to the emergency room for immediate treatment.

Folks “need to have high doses of IV fluids in order to flush the kidney safely,” he said. “There are other medications that the emergency department and the hospital will also get patients to increase their blood volume, [which will] bring more water into the bloodstream in order to effectively allow this protein to be flushed from the system.”

It’s important not to overlook severe muscle pain. If your muscles feel overly tight or painful, go to the ER — don’t chalk it up to routine soreness, Farrow said.

“First and foremost, it’s very rare,” Farrow said. “Health care providers may spend their entire career and not actually see a case of it.”

It’s estimated that roughly 26,000 people in the United States develop rhabdo annually. Therefore, you shouldn’t panic about this condition. Instead, do what you can to protect yourself from developing it. Stay hydrated and be mindful of hot weather, and pay attention to how hard you’re pushing yourself during exercise.

“Don’t be afraid to enlist the help of a personal trainer as you get back into your activities, and make sure they’re certified and they have experience,” Farrow said. Be sure to ask them questions about their exercise philosophy and training patterns to make sure you have the best personal trainer for you.

“And by all means, any time you feel like the workout that you’re doing is beyond your capabilities, don’t be afraid to tap out and just save it for another day,” Farrow said.

Listening to your body is crucial, and there’s nothing wrong with admitting you can’t do something — especially when pushing too hard could put you in danger.