What's All The Rave About Rhabdo? (Rhabdomyolysis)

On today's 'what on earth are you talking about' segment (not a thing, but potential?) we introduce you to a little known condition called Rhabdomyolysis, otherwise known as "Rhabdo". You may actually have heard about Rhabdo before if you train in CrossFit, as it has a bit of a reputation amongst that crowd. But don't be fooled - while there may be jokes about it, it's not a laughing matter at all.

So, what is Rhabdo?

It is when skeletal muscle cells (striated myocytes) are damaged and broken down, resulting in the release of toxic intracellular components like potassium, phosphate, myoglobin (oxygen-carrier protein in a muscle cell), creatine kinase (CK), lactate dehydrogenase (LDH) and aldolase into the bloodstream, which can lead to systemic complications – particularly of concern is kidney damage/failure.

Symptoms

• Onset within 24-72hrs after extreme, prolonged, repetitive, unfamiliar (novel/new) exercise

• Muscle pain (usually large proximal girdle muscles)

• Weakness

• Swelling

• Dark, tea/cola/treacle-coloured urine

• *Can also be asymptomatic (non of the above), or not all symptoms.

Causes

Causes are varying, and can include trauma, exercise, drug use and infections. Rhabdo can be caused by non-traumatic exertion especially in untrained individuals, hot conditions; possibly eccentric exercises; hyperthermia; muscular dystrophies (especially if occurs in childhood); metabolic myopathies. It can also be caused by non-traumatic non-exertional events/activities such as drugs (cocaine, heroin, ecstasy, alcohol, antimalarials, corticosteroids, colchicine, statins, diuretics); toxins; diabetes, thyroid disorders; electrolyte disorders; infections.

Prevalence (more frequent in):

• Males

• African-Americans

• Those younger than 10 years old or older than 60 years old

• People with a BMI greater than 40 (morbidly obese)

Complications

• Acute Kidney Injury = AKI (most common)

• Arrhythmias

• Compartment syndrome

• Volume depletion

• Uncontrolled bleeding

• Death

Treatment

• If suspected, early medical assessment is required

• If the case is mild, theoretically treatment may include rest and adequate hydration (as per doctors orders)

• Aggressive IV fluid therapy, with or without bicarbonate and / or mannitol, for AKI prevention

• Careful monitoring of restoring electrolytes (potassium most important to rectify due to cardiac issues)

So Rhabdo is a bit of a weird disease, but can be very dangerous is left un-treated or treated in a blasé way (looking at you CrossFit community!). If there is any thought that you may have Rhabdo or are concerned about any symptoms, we advise that you speak to your doctor as soon as possible.

If you simply have sore muscles, or are wanting a change in your exercise routine, book in to see one of our physiotherapists today for either some hands on treatment or exercise training! Book online now here, or call us on (08) 9448 2994

#rhabdo #Rhabdomyolysis