What is Rhabdomyolysis?
Too Fast Too Furious: What is Rhabdomyolysis?
On September 16th, about fifty members of the Tufts University Men’s Lacrosse team participated in a 45-minute workout led by a recent Navy SEAL training graduate. Following the session, nine students were hospitalized for acute exertional rhabdomyolysis. We wanted to use this as an opportunity to brush up on what rhabdomyolysis is and how to keep high intensity training efforts safe and effective.
Rhabdomyolysis (myo- meaning muscle and -lysis meaning cell rupture) is caused by muscle damage, usually exertion-induced, followed by subsequent release of cellular contents into the bloodstream. Extremely elevated blood levels of Creatinine Kinase (CK), Myoglobin, a muscle protein, and electrolytes cause stress on multiple organ systems.
High blood levels of myoglobin can clog the kidneys and lead to acute kidney injury (AKI). Excessive release of electrolytes, particularly potassium, can cause hyperkalemia, which can lead to dangerous heart arrhythmias.
The hallmark diagnostic signs of this condition are extremely high CK levels and dark, tea-colored urine. Prompt recognition and treatment, including hydration and electrolyte management, are essential to prevent severe complications.
To me, this was surprising knowing that these are trained athletes at a very successful program (Tufts Men’s Lacrosse are current Division III champions). I'd guess that the workout in this case was very high intensity, likely with little rest intervals.
High intensity training, when dosed appropriately, is a proven tool for improving cardiovascular fitness, strength, and performance. As demonstrated by this story, it does come at a slightly higher risk than lower intensity training.
Staying adequately hydrated, allowing adequate heart rate recovery after high effort intervals, and respecting signs of fatigue are what we’d recommend to keep high intensity workouts safe but effective. Remember these cases are extremely rare and shouldn’t be a reason to avoid this type of training.
Feel free to reach out with any questions or comments. We’d love to keep the conversation going!
Citations:
Khan FY. Rhabdomyolysis: a review of the literature. Neth J Med. 2009 Oct;67(9):272-83. PMID: 19841484.
Line RL, Rust GS. Acute exertional rhabdomyolysis. Am Fam Physician. 1995 Aug;52(2):502-6. PMID: 7625324.
3 Tufts University lacrosse players remain hospitalized after workout with Navy Seal graduate
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