Rhabdomyolysis Symptoms and Causes

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is rhabdomyolysis?

When it comes to fitness, there might be too much of a good thing. Motivated people might be persuaded by coaches and personal trainers to push beyond their body's limits, but not listening when the body rebels may lead to significant metabolic injuries that could be life threatening. Whether it is in a gym, training facility or in front of your television trying to keep up with a video, there are potential dangers from lifting, crunching, and straining too long and too hard. Lessons can be learned from elite athletes who have been known not to listen.

They might be called the unlucky 13. At the end of a strenuous workout, a baker's dozen University of Iowa football players ended up in the hospital with rhabdomyolysis (rhabdo=skeleton +myo=muscle + lysis=breakdown), a condition in which muscles break down quickly and spill their contents into the blood stream. Myoglobin is a protein that is contained in muscle cells, and if enough is spilled into the blood stream, it can clog the kidney's filtering system and lead to kidney failure and a variety of other serious medical consequences and complications. While muscles routinely get sore after physical activity, rhabdomyolysis takes that muscle injury to a higher level.

Rhabdomyolysis causes

Rhabdomyolysis is the result of massive muscle destruction, and there are many causes such as:

  • Extremely aggressive workouts lifting weights, extreme workout videos, or extreme cross-training. This is especially true if the participant goes from little activity to completing an hour or longer workout. Muscle cell damage causing kidney failure is possible for any person who overdoes an exercise program, and developing rhabdomyolysis should not be considered a badge of honor; nor should the wise decision to stop when appropriate be considered failure.
  • Injury suffered by victims of a blast injury from an earthquake, bombing, or lightning strike.
  • If a person falls and lies motionless for many hours (for example, due to a stroke , intoxication, or drug overdose) the weight of the body in effect crushes its own muscle and rhabdomyolysis occurs.
  • Non-injury causes include side effects of certain medications such as statins used to treat high cholesterol, and some psychiatric medications.

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Rhabdomyolysis symptoms

The most common symptoms of rhabdomyolysis include:

The muscle damage causes inflammation leading to tenderness, swelling, and weakness of the affected muscles. The dark urine color is due to myoglobin being excreted in the urine by the kidney as it tries to rid the body of the muscle breakdown products.

Symptoms related to the expected complications of rhabdomyolysis include:

  • symptoms of kidney failure, which may include swelling of the hands and feet;
  • shortness of breath as excess fluid builds up in the lungs,
  • lethargy;
  • weakness;
  • symptoms of hyperkalemia (elevations in potassium in the blood) such as weakness, nausea, lightheadedness, and palpitations due to heart rhythm disturbances); and
  • disseminated intravascular coagulation, a disruption of the normal blood clotting process, may occur as unexplained bleeding.

Contact your doctor or go to the nearest Emergency Department if more serious symptoms and signs of rhabdomyolysis occur such as:

Rhabdomyolysis prevention

It is strange that 13 players would get sick at one time. There are always lessons to be learned about the body.

  1. A little pain never hurt anybody, but a person needs to know when "too much is too much."
  2. Water is vital for the body to function and thirst is the body's signal that we need to hydrate.
  3. Finally, let urine be your guide. Clear urine is a sign that the body is well hydrated and the kidneys are removing excess water. Concentrated urine is just the opposite; the kidneys sense dehydration and want to conserve as much water as possible. Brown urine is a sign that bad things may be about to happen.

Rhabdomyolysis Symptoms and Causes Resources

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Doctor written main article on Rhabdomyolysis

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE: abcnews.go.com. Thirteen University of Iowa Football Players Hospitalized.
<http://abcnews.go.com/Health/university-iowa-football-players-hospitalized-muscle-condition/story?id=12780810>


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Reviewed on 1/12/2017

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