It’s perfectly normal to feel soreness in your muscles after an intense workout. It’s a fact of life that’s responsible for spawning the well-known phrase: “No pain, no gain.”
There is a dark side, however, of this catchy phrase. For starters, pain is often the way your body tells you to stop what you are doing before you hurt yourself. In rare cases, that pain may be a warning sign of a rare, and potentially life-threatening, muscle injury known as rhabdomyolysis, or rhabdo.
The condition, which affects 26,000 people a year in the U.S., causes the rapid breakdown, or disintegration, of your muscle tissue. This releases toxic elements into your bloodstream where they can cause severe organ damage, including kidney failure.
Rhabdo Symptoms and Risks
Besides muscle pain, the most notable symptom of rhabdo is a marked change in your urine color. This could show up within a few days of an extreme workout, with your urine turning the color of dark tea, red or brown.
Other symptoms include:
- Severe muscle pain out of proportion to your workout
- Stiffness but only in specific muscles
- Muscle weakness in one muscle group
- Localized swelling of exercised muscles
- Cramp-like sensation that lingers
These symptoms won’t feel like your typical post-workout soreness, with the cramping and muscle discomfort causing significant pain. You’ll lose range of motion in certain muscles, which will stop contracting and relaxing in their normal way.
There’s no easy way to pinpoint your individual risk for this condition. And it’s not just exercise that has the potential to trigger the onset of rhabdo. Other causes include:
- Injury or trauma. Crushing injuries and severe burns can cause muscle fibers to break down.
- Medication. Certain medications, including antidepressants, antipsychotics and statins, can create problems.
- Medical conditions. Metabolic disorders and genetic conditions like Duchenne muscular dystrophy can increase your risk.
- Severe dehydration. Without enough fluids, your kidneys may struggle to eliminate body waste.
- Overheating. Heat can accelerate the breakdown of muscle tissue.
- Alcohol/drug abuse. These toxic substances can contribute to muscle deterioration.
Stay Safe in the Gym
Rhabdo was once considered limited to hardcore athletes, fitness fanatics and soldiers. But with the rise in popularity of intense workouts like spinning, ultrarunning and extreme weightlifting, it has become more common.
So, while it remains a rare disorder, here is what you can do in the gym to protect yourself:
- When you start a new exercise plan or routine, ease into it. You aren’t trying to set records or be first in your class.
- If you are resuming exercise after taking a break, give yourself some time to get back to your previous level. Start with lower weight levels or a slower pace.
- Don’t forget to drink lots of water. It’s common for people who get rhabdo from working out to be dehydrated. Drink water before, during and after you exercise.
- Avoid exercising in hot, humid conditions. If this is not an option, an acclimatization period can reduce your risk.
- Stay away from high doses of supplements containing creatine and don’t drink highly caffeinated energy drinks before working out.
- Listen to your body and understand your limits. If you are struggling, slow down or stop. Don’t be afraid to leave a class or ask your trainer to lower the intensity.
If you do feel general soreness after a workout, you are most likely fine. Rhabdo tends to be a more intense pain that’s focused on a specific area. If that happens, you should contact a doctor quickly.
Treatment generally includes rest and drinking fluids. But in severe cases, you’ll be given IV fluids to flush your kidneys and help prevent damage. Most people recover and can ease back into their exercise routine after a break – and with guidance from their doctor.
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