exertional rhabdomyolysis


What do you know about acute exertional rhabdomyolysis? Doctors say that intense and sudden exercise and physical activity if a person is not physically fit, it leads to a phenomenon called acute rhabdomyolysis following exercise.


When your muscle cells break down after exercise or strenuous physical activity, they die and their remains enter the bloodstream to be excreted through the kidneys. Doctors call skeletal muscle lysis, rhabdomyolysis (Rhabdo means striated and myo means muscle)

Following rhabdomyolysis, the remnants of striated muscle cells broken by blood flow to the kidneys and are excreted in the urine.

In the following you will read more about “Acute exertional rhabdomyolysis”


What is rhabdomyolysis?

Medical history of rhabdomyolysis

What factors can be associated with acute rhabdomyolysis?

Genetic diseases and rhabdomyolysis

What are the signs and symptoms of rhabdomyolysis?

What is the diagnosis of emergency rhabdomyolysis?

Treatment of emergency rhabdomyolysis

Prevention of rhabdomyolysis


It's great if you have a tendency to exercise but are aware that without physical fitness if you start doing strenuous exercise you will get a condition called emergency rhabdomyolysis, so be patient and gradually improve your fitness. And do bodybuilding and sports activities according to the basic plan.


Exercise is a science If you are thinking of correcting your out-of-shape limbs, be aware that in this way you should not blindly follow the instructions of friends and acquaintances or sports programs on TV and the Internet, it is necessary to take advantage of the guidance of trained and skilled sports coaches.


What is rhabdomyolysis?

This complication is a very common disorder among people who have suddenly decided to do bodybuilding and heavy exercise, and in this case, doctors refer to it as acute exertional rhabdomyolysis.

The muscles of these people are so unprepared that they will be destroyed after heavy training and high pressure on the skeletal muscles, and toxins are released following this cell destruction or cell lysis, which can be very harmful.

One of these toxins released following exertional rhabdomyolysis is called myoglobin.

Myoglobin is a substance that will be extremely harmful to your kidneys and can impose a heavy burden on the kidneys and cause acute kidney failure or acute kidney damage.

Other released toxins that enter the bloodstream can trigger a very dangerous process called diffuse intravascular hemolysis.


That means, following the toxins of red blood cells in the bloodstream, they are widely destroyed and broken slippery.


Medical history of rhabdomyolysis

It is interesting to take a look at the medical history of rhabdomyolysis.

It is said between 19401941, German army forces bombed the city of London. After the rain bomb, the injured who came out from under the heavy debris suffered severe and extensive destruction of the skeletal motor muscles due to the pressure of the debris. Doctors discovered that the injured had undergone a process now known as rhabdomyolysis, or rupture of striated muscle cells.


What factors can be associated with acute rhabdomyolysis?

  • Intense physical activity and heavy physical work in a person who is not physically fit (exertional rhabdomyolysis).
  • People who are under the heavy debris caused by earthquakes and accidents.
  • Sometimes even looking for very tight braces and splints
  • Third degree burns
  • Severe physical trauma
  • Crash injuries
  • During infectious processes (viral infections, fungal infections)
  • Malignant hyperthermia
  • Snake bites
  • Specific genetic disorders
  • Some disorders lead to an increase in thyroid hormone
  • Some electrolyte disorders
  • Diabetic ketoacidosis in insulin-dependent diabetes
  • Some drugs
  • Alcohol
  • LSD
  • Compounds containing amphetamines
  • Cocaine and its derivatives
  • Cyclosporine
  • Erythromycin
  • Itraconazole
  • Corticosteroids
  • Anesthesia drugs
  • Zidovudine
  • lithium
  • Statins family:
  • Atorvastatin, Rosovastatin
  • Theophylline
  • Clofibrate
  • Phenobarbital
  • Isoniazide
  • Amitriptyline and its families
  • Sometimes sertraline, fluoxetine and their groups
  • Alprazolam, clonazepam and their groups


In addition to the above, items in the following are also considered as causes of rhabdomyolysis:

  • Lightning
  • Strokes
  • Diets high in fat
  • Prolonged seizures
  • Long time coma
  • Blood potassium deficiency
  • Blood magnesium deficiency
  • Blood phosphate deficiency
  • Extensive wounds
  • And people who have been subjected to severe physical torture

Foods such as liver and asparagus, which have a precursor to a protein called purine, are said to cause rhabdomyolysis if consumed in large amounts.


Genetic diseases and rhabdomyolysis

There are some genetic diseases that are associated with rhabdomyolysis:

  • Carnitine deficiency
  • Muscular dystrophies
  • McArdle disease
  • Lactate dehydrogenase deficiency


What are the signs and symptoms of rhabdomyolysis?

  • Muscle weakness
  • Feeling bored and unhappy
  • Fatigue
  • Pain
  • Bruising
  • Nausea
  • Vomit
  • Fever
  • Darkening of urine (tea-colored urine)
  • Lightheadedness
  • Vertigo
  • Feeling of irregularity in the heartbeat


What is the diagnosis of emergency rhabdomyolysis?

When you see a doctor with one or more of the above symptoms looking for a suitable underlying factor, such as strenuous exercise and physical activity, the doctor will request tests to improve the health of the motor muscles in addition to obtaining a thorough history and appropriate clinical examination. And check the function of your kidneys.

These tests include:

  • Request for an enzyme called creatine kinase or CK in the blood:

This enzyme is present in the muscles, heart and brain

If you have muscle damage, this enzyme will rise

Of course, there are specific subtypes for the heart, brain, and skeletal muscle that indicate the source of this increase.


  • Myoglobin excreted in the urine is examined:

Following rhabdomyolysis, there is excretion of myoglobin in the urine, which doctors call urinary myoglobin.


  • Blood creatinine and urinary creatinine are measured to determine if kidney function is impaired.


  • Blood potassium levels are measured:

If there is an increase in the following in the above tests (along with other accompanying symptoms) it will probably indicate the presence of rhabdomyolysis.

  • Blood k
  • Blood cr
  • Urin  cr
  • Blood CK


Treatment of emergency rhabdomyolysis

The first and most important principle of treatment is to get enough fluids. Your doctor will dehydrate you with a serum containing bicarbonate to flush myoglobin out of your urine.

Emergency dialysis may be used to detoxify the body in very severe cases where acute kidney damage has occurred.

In mild exertional rhabdomyolysis, you need to give your muscles enough rest, drink plenty of fluids to regain muscle strength, and prevent kidney damage.


Prevention of rhabdomyolysis

To prevent emergency rhabdomyolysis, pay attention to the following points:

  • Avoid heavy weight loss diets
  • Do not do strenuous exercise
  • Increase the intensity of your exercise fundamentally and gradually
  • If you have to participate in sports competitions such as marathons, etc., you must use a consultant and a trained guide.
  • Avoid supplements containing creatine, ephedrine, amphetamines, and high levels of caffeine alone.
  • Do not take corticosteroids and steroids arbitrarily
  • See your doctor right away if you have any suspicious symptoms.
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