RHABDO REVISITED. PLEASE READ & WATCH.

This is a reposting of a post from last year, but one that we think everyone should be reading at least once a year. I recently read of a woman at another CF gym who did 150 GHD sit ups in a workout….and got to spend a few days in the hospital because of it. This shit is no joke.

Let’s talk about Rhabdo folks.  This is CrossFit’s dirty little secret, something that you “hear about” happening to someone in another gym.  We joke about it on CrossFit t-shirts but if it happens to you, it won’t be that funny.

So what the heck is Rhabdo?  Per the NIH - Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents (myoglobin) into the bloodstream. Some of these are harmful to the kidney and frequently result in kidney damage.

What we’re talking about here in regular language is tearing enough muscle fiber to overwhelm and ultimately damage your kidneys.  Your kidneys are one of your body’s main filtration systems and are responsible for separating waste out into your urine (among some other jobs).  Myglobin will breakdown into substances that will cause blockages in and therefore the possibility of tissue death within your kidney.  In otherwords, you don’t want this happening.   Your kidneys are your friends.

So when, why and how do you get Rhabdo?  I have never had Rhabdo (remember, we’re not talking about a little bit of butt-arm, we’re talking full on Rhabdo) but do know people firsthand that have gotten it.  The most likely candidates to suffer the effects of this kind of one-shot overtraining are athletes.  It’s usually experienced CrossFitters, ex-military or other serious athletes – that (and this is the key) are coming off of a break.  The ideal candidate for Rhabdo is your CrossFitter, that after taking a month off for some reason, comes back and on his or her first day back decides to do Murph or Fran or any of the other extremely taxing workouts.  These athletes have the muscle memory to be able to perform the movements, the mindset to push themselves well beyond the healthy ranges of their physical comfort zones but a lack of current conditioning of the muscle for it to be able handle extremely high repetitions or heavy trauma.

My friend in L.A was a perfect example.  He had taken a few months off of CrossFit while traveling around the country and returned to do a workout with a high number of GHD Sit Ups.  GHD Sit Ups, Pull Ups (especially those with an emphasis on the negative) and Push Ups are the main three culprits in causing Rhabdo due to the location of the muscle used, and the movement’s inherent ability to inflict muscle trauma.

GHD Sit Ups are nasty as there is a high possibility of muscle tearing over a large muscle belly due to the stretching backwards in the movement.  Anytime that you have your bodyweight being supported through a movement by an ever fatiguing muscle through a workout, it’s going to cause damage.  We are all able to lower ourselves downward from the pull up bar long after we are unable to pull ourselves back up – it is this physiological ability that will allow us to continue to damage muscle tissue in one direction far more often than in the other.  This is why ecentric movements, like a negative (where you lower yourself downward slowly – think of slowly lowering yourself in a ring dip or from the top position in a pull up) are dangerous.

What are the symptoms of Rhabdo? The symptomology includes any of the following alone or in combination with each other:

• dark, red, or cola colored urine color (blood in your urine)

• severe muscle tenderness (not your daily soreness)
• weakness of the affected muscle(s)
• generalized weakness
• muscle stiffness or aching
• unintentional weight gain
• seizures
• joint pain
• fatigue

What do you do if you have the above symptoms and feel like you might have Rhabdo?  You immediately head to the emergency room.  Rhabdo will be confirmed or denied by detecting elevated muscle enzymes (CK) in your blood. The levels of these enzymes rise as the muscle is destroyed.  If you have it then you are going to be put on an IV of fluids and have your kidney function monitored.  This is all to prevent kidney failure and the possibility of a heart attack.

One other thing to note regarding Rhabdo that was recently brought to my attention is that it is more likely in people who are taking Statin drugs (cholesterol drugs).  As Lipitor is one of the highest prescribed drugs in this country and is a Statin, there are a lot of older male CrossFitters with a heightened risk of getting in trouble here.  If you’re on a Statin, please let us know and be slightly more vigilant in how you feel post workout.

Is this something that we should all be worried about?  Yes and no.  Eric, Jeff and I have personally done workouts that left us hobbled for days and haven’t had it.  I’ve known hundreds of CrossFitters that have trained to the point where they were too sore to move and they didn’t get it.  As a matter of fact, I only know 2 people personally, out of all of the CrossFitters that I do know that have gotten it, so the likelihood is rare.  That being said, it does happen and if it does, it’s serious so we should at least know the signs and symptoms as well as some preventative measures.

So folks.  If you are coming off of a long layoff and the workout is particularly nasty, scale yourself back.  I spent the last two weeks nursing a cold and neck injury and had to make the executive decision on Friday to jog around the block a few times and do some squats instead of the 240 reps at 135# that the master’s class was doing.  Did it suck to have to do something less fun?  Yes.  Was it the right call so that I’m not peeing blood this morning?  Yes again.

The way that we train in CrossFit is highly, highly effective.  Like any other high level training, it also needs to be respected.  Just because a workout is named after a brave ex-SEAL, doesn’t make it any less damaging to your muscle fibers.  At the end of the day, we’re all responsible for our own well-being.

Below are more good resources on Rhabdo.  If you have questions regarding this or anything that I’ve written above is unclear – please post them to comments and I’ll do my best to get them answered in a timely manner.

B MAC’S THOUGHTS

GLASSMAN’S THOUGHTS

ROBB WOLF’S THOUGHTS

Today’s Workout:
10-9-8-7-6-5-4-3-2-1
Power Snatch (115#/80#)
1 Round of Cindy Between Each Set of PS’s.
Workout ends with a round of Cindy.
Cindy = 5 Pull Ups, 10 Push Ups, 15 Squats

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