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Rhabdo- what?

November 27, 2012

Thank you to Jen C. for writing about her experience with Rhabdo.

Following the Merced Holiday Throwdown, prostate I developed a condition known to most CrossFitters as “Rhabdo”. Since that time I have done quite a bit of research on Rhabdomyolysis and have a few thoughts on my experience to share.

There is a lot of information available regarding this condition.  It is, side effects by definition, medications the excessive breakdown of muscle fibers that leads to the release of muscle fiber contents (myoglobin) into the bloodstream.  This is extremely dangerous because the release of myoglobin into your blood can poison your kidneys and lead to renal failure. The symptoms are fairly straightforward: extreme muscle soreness and pain, nausea, flu like symptoms, confusion, dark urine, and reduced or no urine output.

The causes of this disease aren’t as clear, especially when Rhabdo is contracted through sports related activity.  I am fairly certain I developed Rhabdo through a “perfect storm” of events during the day of competition at the holiday throwdown. The combination of high rep butterfly pullups and the extreme straining to make the chest to bar pullups in the final wod did a number on my lats (I did not obtain full range of motion with my arms until about 8 days post competition). In addition to a full day of physical exertion, I finished my evening with a night of celebratory drinking.  I do not think alcohol will make someone get Rhabdo post competition; however, I do think it does absolutely nothing for your body in regards to the healing, rebuilding process that begins to take place after a competition. I probably would have had Rhabdo either way, but I have a feeling that the severity of it would not have been as extreme.

On Sunday after the competition, I experienced extreme nausea and vomiting, confusion, disorientation and no urine output.  Initially, I hacked this up to be the hangover to trump all hangovers, but when the symptoms got worse instead of better and continued into Monday, I became concerned. After a doctor visit and some bloodwork, my suspicions were confirmed, I had Rhabdomyolysis.  Treatment for this is typically immediate hospitalization and fluid administration. However, by the time I had been diagnosed, I was past the worst of the condition.  Plenty of rest and fluid consumption was all I needed to get back on my feet.

Three weeks post-injury, I am now back to working at about 95% capacity.  Initially, I saw a huge loss in my pulling strength (due to the extreme breakdown of my latissimus dorsi muscles) but have recovered almost completely.

Rhabdomyolysis is a very interesting condition, especially for athletes, mostly because there will never be a point in a wod or competition when you will be able to say, “I better not do this next rep because I can feel Rhabdo settling in”.  Some will say that new, inexperienced CrossFitters are most at risk because they have not built up the muscular conditioning to withstand the extreme load placed on them.  Yet, the athletes at highest risk seem to be those with a reasonable baseline level of fitness they have obtained through some non-CrossFit training, or those who are returning to CrossFit after a layoff. These athletes have sufficient muscle mass and conditioning to go hard enough to hurt themselves, but do not have the protection that develops with regular exposure to real intensity (Me!).

I am no doctor or seasoned strength and conditioning coach, all I have to base these thoughts off is my limited experience with CrossFit. I have come to believe that Rhabdomyolisis is much more common than most think, and it is fairly easy to contract.  I do not think CrossFitters need to be hyper aware of this condition (even when 75 pullups are programmed in the wod) but from here on out I will be very adamant about fluid consumption and electrolyte intake during and after efforts like this.

Even after this somewhat extreme experience, I am still going to do wods with high rep pullups. I’m still going to do competitions and I’m still going to train to be the best CrossFit athlete I can. However, I am now much more aware of this condition and the circumstances that can cause it. I will never go out drinking after a day filled with that kind of competing or training again.  After all, CrossFit is supposed to enrich our lives, not take away from it, or end it altogether.  It was incredibly sobering to learn the full severity of Rhabdomyoalisis and the potential risk I had put myself in through doing something regarded by most accounts as “healthy”.  Every time we train we partake in a conversation between our mind and body that tells us to stop or slow down, it is up to you to determine the point at which you should give in to this battle.  It is just as important to train smart as it is to train hard.

Did you get a chance to hop up on the Speal Bar today?

Workout of the Day

Strength

Snatch

2 reps EMOM for 5, 70% of 1RM

At the end of 5 minutes, use that weight and do as many reps as possible for 90 seconds

Metcon

100 Burpees for Time

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