May 18, 2021 – Gyms and fitness centers usually have a lot of new customers in January, and also when the weather gets better in spring. This year, after a year of pandemic-related disruptions, these two trends could combine: people who want to get back in shape and lose the “COVID-19” just in time to look better at the pool and on the beach.
However, experts say that athletes and instructors need to be careful, as this can lead to an increase in cases of a rare but serious – even life-threatening – condition called rhabdomyolysis.
“We have a tremendous number of people who have become less physically active in the past year or more,” said Eric Rawson, PhD, professor of health, nutrition, and exercise sciences at Messiah University in Pennsylvania and a member of the American College of Sports Medicine .
“We have the possibility that some bad things may happen in terms of an increase in the incidence” of the disease commonly known as rhabdo. “We have never seen such a massive reduction in physical activity over such a long period of time.”
What is rhabdo?
Rhabdomyolysis is a disorder that involves muscle breakdown and damage. When muscles are injured, they release their contents, including a muscle enzyme, into the bloodstream. The enzyme can damage the kidneys and cause kidney failure in up to 40% of cases.
The disorder is dangerous but rare. One study found that 22 out of 100,000 people had it. It is easy to treat, but in rare cases can lead to death if it goes undetected.
The three main symptoms are:
- Muscle swelling
- Muscle weakness
-
Dark urine or less urination
Other symptoms can include:
In addition to extreme stress, this can be caused by trauma, drug use, severe dehydration, statins, and extreme temperatures.
It often happens when people do more repetitive resistance exercises than they are used to. And now too many athletes may return and fail to realize they are not as strong or fit as they were before COVID-19 when they were sent home in March last year. Instructors and coaches need to make it clear to newbies that they should take it easy, stay hydrated, and work their way into fitness.
“My arms were like jelly”
Marc Nair thought he would try something different to usher in a new year: calisthenics training.
He and a friend were the only beginners in a seasoned regulars class, and the instructor didn’t change his workout, which included 45 pull-ups in 30 minutes.
“It was difficult to say the least,” recalls Nair, who had previously run and had been doing intense interval training.
Use door? Also, be very simple at the beginning, you don’t want rhabdo, especially if you are in the burger town
– It’s not funny anymore (@AreChud) May 17, 2021
“The day after training, I couldn’t stretch my arms,” he says. “Two days later my arms swelled up. During the day they hurt and I felt acutely dehydrated. I knew then that something was really wrong. “
Nair, a Singapore-based photographer and poet, went to a hospital. His urine was dark and blood tests showed rhabdomyolysis. It took him a week of IV treatments in the hospital to reduce the swelling and remove toxins from his bloodstream.
“My arms were like jelly,” he says. “I decided to do the calisthenics training because I wanted to exert myself a little more. But sure, it wasn’t structured for beginners at all. “
Nairs Rhabdo happened a few years ago. He struggled in the gym for a few months, but regained his strength – and even installed a pull-up bar at home.
“I’m definitely stronger than before, but I don’t think I’ll be going back to a calisthenics class. The problem for me was not the training, but the trainer who was unable to adapt the intensity of the training to the needs of the participants. And that’s a bigger story about regulation in the fitness industry. “
Intensive classes
Marcelo Campos, MD of Boston agrees that coaches and classroom teachers need to change their approach to people who are not used to difficult, repetitive workouts, even if they were before COVID.
“I wish coaches would explain more carefully to people so they can better tailor and go slow and prep your body,” he says.
Some clubs have an aggressive approach to getting in shape quick and newbies need to be careful not to get into something that is too much too soon.
“The other day I saw someone in a shirt that said ‘Pushing till Rhabdo’.” Campos wrote for Harvard Medical School. “That made me wince. And I realized that while rare, some people don’t understand how serious rhabdo can be. “
“There is a genetic make-up for some people,” he says. “Link that with not being well hydrated. Add in an intense workout – usually either weight training, but it can also be cardio and cycling … and you increase your chances. People have to look carefully … when they come back after a break. They believe that the first time they can exercise more intensely, and that puts them at risk. “
He and other experts advise:
- Start slowly
- Build on goals as you gain strength, endurance, and confidence
- Stay well hydrated before, during, and after your workout
- Don’t get too hot
- Take breaks
- Avoid anti-inflammatory drugs like ibuprofen
- Avoid alcohol, which contributes to dehydration
“When you start a new job, learn a language, try to play a musical instrument, it takes time,” he says. “Our muscles are no different.”
And remember, while rhabdo is serious, it usually only comes on after very intense, repetitive workouts. So know your limits and listen to your body, not peer pressure or the instructions of a trainer to a group.
“People shouldn’t be afraid to do physical activity,” says Campos. “You just have to pay attention to what you are doing. It’s great that people are thinking about getting more exercise. We need that. But just do it so that they can watch what is happening to their bodies more closely and prepare their bodies for it. “
“Just don’t overdo it”
Rick Mayo is a seasoned trainer and gym owner, and he recalls getting rhabdo decades ago before he’d ever heard of it.
“I was in my early twenties and was very interested in bodybuilding and heavy lifting,” he recalls. “And these guys bet I couldn’t do £ 225 for 100 unbroken squats.
“Everyone is screaming and screaming and the music is booming and I just had a lot of coffee and I was like, ‘All right, let’s do this. ‘
Use door? Also, be very simple at the beginning, you don’t want rhabdo, especially if you are in the burger town
– It’s not funny anymore (@AreChud) May 17, 2021
“So I did 100 squats in a row. I felt like it was going to kill me. I was exhausted on the floor. The leg pump was just awful. “
For the next few days, his legs became swollen and sore, and his urine was cloudy, rusty in color.
“I wasn’t treated, which is a terrible idea in hindsight,” Mayo recalls. “Fortunately, I didn’t have kidney failure, but I could have. I was lucky that nothing worse happened to me. “
Mayo urges newbies to take it easy and start slowly. “Just don’t overdo it,” he says. “You want to be pushed. But taking you to the hospital for trying to get fit is ridiculous. It just isn’t necessary. “
WebMD Health News
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Harvard Health Publishing: “Rhabdo: A Rare But Serious Complication Of … Movement”
Rick Mayo.
Marcelo Campos, MD.
Eric Rawson, PhD, Professor of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA; Fellow at the American College of Sports Medicine.
Marc Nair.
Healthline: “Rhabdomyolysis: Causes, Symptoms, and Diagnosis.”
MarcNair.com: “Rhabdo the Terrible.”
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