How Can You Prevent Rhabdomyolysis
You may not be able to prevent rhabdomyolysis that occurs as a result of an accident. But you can reduce your risk of developing exercise-induced rhabdomyolysis. To lower your risk of getting rhabdomyolysis, you should:
- Start an exercise program slowly, and listen to your body. If you feel especially sore or tired during a workout, stop and rest. Dont push yourself beyond safe limits.
- Stay hydrated and avoid getting overheated. Take breaks in the shade if youre doing physical activity in the heat.
- Dont abuse alcohol or take illegal drugs.
- Talk to your doctor about any medications youre taking that may increase your risk of developing rhabdomyolysis. Be especially careful if you have diabetes or liver disease.
How Can Kidney Disease Be Prevented
Preventing the risk of kidney disease entails taking care of your heart and weight. This might mean eating a healthy diet, staying hydrated, exercising, quitting smoking, and limiting alcohol consumption. For most people, simply scaling back drinks to one or two a week is enough to dodge this particular bullet. For many others, especially those who are struggling with alcoholism or who have a history of alcoholism in the family, a complete ban on alcohol might be the safest option.
WebMD also recommends getting tested regularly, especially if you have a higher chance of developing kidney disease than the general population. If you have a history of kidney problems in your family, if you have other kidney-related problems like diabetes or high blood pressure, or if you are dealing with alcohol abuse, regular testing can uncover the warning signs of kidney disease, opening the door to preventative treatment.
Testing can include urine tests to check the chemical composition of urine, an imbalance of which would suggest that the kidneys are in trouble blood pressure readings and glucose tests to measure blood sugar and hemoglobin A1C, which shows the average blood sugar level in the last three months.
Indulging Your Sweet Tooth Too Often
Having excess sweet foods like desserts, candy, and packaged snacks and sodas can be bad for your kidneys. A study confirmed that consuming too much fructose could bring a rise in uric acid levels and ultimately lead to cardiorenal disease.6
Those with diabetes are already at high risk of developing renal problems too much sugar in your diet can worsen this situation. Be sure to read food labels and pick foods that are low in sugar and high in fiber.
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What Are The Symptoms Of Rhabdomyolysis
Rhabdomyolysis symptoms can range from mild to severe. Symptoms usually develop one to three days after the muscle injury, though some people may not even notice muscle soreness. The main signs of rhabdomyolysis include:
- Muscle swelling.
- Weak, tender and sore muscles.
- Dark urine that is brown, red or tea-colored.
Some people also experience dehydration or decreased urination, nausea, or loss of consciousness.
I’m So Busy How Can I Find Time To Exercise
Anyone can work some exercise into the daily schedule. You can do many exercises at home, outdoors or even at work. Here are some suggestions:
- Exercise while watching TV. You can do stretching exercises or use free weights or exercise equipment such as an exercise bike.
- Exercise around the neighborhood. You can bike to the store, work in the garden, mow the lawn, or take out a ball or Frisbee and offer to play a game with the kids.
- Exercise at work. Park your car at a distance or get off the bus a stop early and walk 10 minutes to the office. Take the stairs instead of the elevator, take a brisk walk on your lunch hour, or join the team if your company participates in recreational sports.
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How Can You Avoid Rhabdomyolysis
Rhabdomyolysis often sneaks up on you theres not one moment of pain that clues you in. Its insidious, says Nelson. By the time its fully happening to you, its too late to stop it.
The best way to avoid it, he says, is to be aware of how hard youre pushing yourself in a workout. If you know youre going way beyond your limits or doing something youve never done before, youre at risk, he says. You have to be aware of muscle strainwhen that becomes extreme or unusually painful, thats when it could happen.
You can also protect yourself by diligently hydrating before, during, and after workouts . Avoid exercise conditions that could also cause heat stroke, and gradually work your way up to new workouts.
Alcoholism And Kidney Disease
The human body has dozens of vital organs, and the kidneys are among the most important. They regulate water intake and outtake, they balance the amount of minerals in the body, and they produce vital hormones, according to the Kidney Foundation of Canada. Threats to the normal functioning of the kidneys are serious medical problems, and alcoholism is a contributing factor to kidney disease.
If you or a loved one has pre-existing kidney issues or are concerned about alcohol consumption and kidney health, it may be time to seek professional help. Our admissions navigators are available 24/7 at Who Answers? Who answers the helpline calls. to discuss treatment options and give you the information you need to begin your road to recovery.
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The Role Of Creatine Kinase
Creatine kinase, or CK, is a protein found in every muscle, including those used during exercise and the ones that keep your heart beating. CK is involved in the production of energy required for muscle contraction. When muscle cells are damaged, CK, myoglobin, potassium and other substances enter the bloodstream, to eventually be broken down or eliminated by the kidneys.
Genetic And Metabolic Disorders
Some people develop rhabdomyolysis because of genetic conditions such as problems with metabolism of
- lipids or fats
- purines, which are in certain foods, such as sardines, liver, asparagus
Metabolic problems, such as the following, can also trigger rhabdomyolysis:
- hypothyroidism or low thyroid hormone levels
- diabetic ketoacidosis, or a buildup of ketones in the body
- electrolyte imbalances
Many types of infection and inflammation can cause rhabdomyolysis, including:
- viral infections
- snakebites
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What Should You Do If You Think You Have Rhabdomyolysis
If you develop atypical muscle pain and weakness, especially after increasing your workout load or introducing a new repetitive exercise, you should be evaluated, Wang says. Yes, a lot of people who develop rhabdo dont go to the doc, but the majority of the time these cases are mild and hydration and rest helps. But there have been a few cases of people dying from untreated rhabdo, so bear that in mind. You know how much soreness and what recovery timeframe is typical for your body, so if you feel like somethings wrong, youll heal a lot faster with medical expertise.
The definitive diagnosis of rhabdomyolysis can only be made with a blood test measuring the muscle enzyme creatine kinase, Wang says. That means you need to go to the doc. A sports medicine expert or even a primary care physician office can run the blood test, but if you cant be seen within a day, it can definitely warrant an ER visit, Wang adds. And if you develop that dark urine, 100 percent go see someone.
More Than Muscle Injury
The medical term for skeletal muscle cell rupture is “rhabdomyolysis,” or “rhabdo” for short. When muscle cells rupture or explode, the intracellular contents are released into the bloodstream. These cellular contents include enzymes, such as creatine kinase electrolytes, such as potassium and proteins, such as myoglobin.
Myoglobin, in particular, is a big, red protein that can block the kidney filtration system, or renal tubules, that serve as kidney plumbing.
It also can dissociate into toxic byproducts that injure kidneys. In rare cases, too much myoglobin in the bloodstream can stop kidney function altogether, as happened with a 27-year old marathon runner who died from kidney failure.
In a study we conducted on college swimmers, we saw a cluster of rhabdomyolysis, in which six out of 34 swimmers were hospitalized after participating in a 20-minute or so “arm competition” to see how many pull-ups, rows and bench presses they could complete.
Cases of “symptomatic rhabdo,” or those needing medical treatment, appear to be increasing within collegiate sports teams at an alarming rate, with the characteristic appearance seen in football players returning to January practice after a season-ending holiday layoff.
To date, 17 cases of team rhabdo have occurred from doing “too much, too soon, too fast” and include a variety of sports such as football, swimming, lacrosse, soccer, track, basketball, softball, volleyball and golf.
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What Exactly Is Rhabdomyolysis
Rhabdomyolysis can occur as a result of genetic and metabolic disorders, as well as trauma like a crush injury. But for the sake of this conversation, were talking exclusively about exertional rhabdomyolysis, which is caused by one thing: someone working out way to hard too freaking hard.
Some basic gym biology: When you lift weights, youre causing micro tears in your muscles. When the body repairs those tears, the muscle becomes stronger and bigger. Technically, rhabdo is the same muscle damage, but taken to such an extreme that the fibers cant repair, trainer and kinesiologist Joel Seedman, Ph.D., C.S.C.S., owner of Advanced Human Performance in Atlanta.
During a workout, pushing your body to this edge depletes your muscles of all their energy, leading to a chain of events culminating in the death of muscle cells, explains David Wang, M.D., a primary care sports medicine physician at the Hospital for Special Surgery in New York. As the cell dies, it releases its contents into the bloodstream, causing pain, swelling, and potentially organ damage.
Yes: Working out too hard can actually cause organ failure. As blood moves toward damaged muscle tissue to clear it out, the blood is also shuttled away from the rest of your body, including your kidneys, Wang explains. Simultaneously, the damaged tissue releases myoglobinsproteins toxic to the kidneysthat quickly collect in the kidneys and cause a blockage.
Will Cases Increase As Gyms Reopen
Most regular gym-goers havent had access to the equipment available at commercial gyms for the last four months or so. People who have kept up with exercising during lockdown have likely modified their normal routine given the circumstances. This could leave them more vulnerable to exertional rhabdomyolysis when returning to normal gym training. Indeed, we know that prolonged confinement results in loss of strength even when continuing to exercise regularly, which could also increase risk.
Gym goers should be aware of the three main rhabdomyolysis symptoms:
If exercisers have these symptoms, they should seek medical attention immediately.
When returning to the gym or your local CrossFit box, dont push too hard in those first few sessions back. Your body might find workouts difficult that were once routine.
Give your body time to familiarise itself with kit and exercises that were not part of your routine in lockdown, and increase training volume gradually. Plan to get back your previous fitness in weeks not days and remember that despite your best efforts, your baseline fitness may not be what it was before lockdown.
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Other Healthy Changes That Help In Getting Rid Of Kidney Stones
Along with exercises, you need to ensure that you stay hydrated at all times. Remember to drink a lot of fluids as dehydration caused due to the workouts can further aggravate the symptoms of kidney stones.
Drink enough water before, after, and during the workout. Certain beverages like cranberry juice and lemonade can be taken as they will keep you hydrated and will also help in breaking the stones.
Certain dietary changes can also aid the process. For improved results, you should reduce the intake of salt, minerals, and oxalate-rich foods. Moreover, try to avoid preserved and processed foods as they can put extra pressure on the kidneys.
It is important to discuss the exercises with your doctor. Usually, exercises that can strain the abdomen and the kidneys are not recommended. Strenuous activities can lead to stones irritating the walls of the urinary tract. Such heavy physical activities can worsen the pain due to kidney stones.
You must have understood by now that proper and regular exercise along with necessary changes in the diet and lifestyle, can do wonders in providing relief from kidney stones. However, if any of the exercises cause the worsening of the condition, discontinue the exercise and contact your urologist immediately.
Kidney Damage Can Occur From Overly Intense Muscle Use
It’s well established that the basic formula for healthier living and improved physical strength is achieved through a combination of sensible eating and regular exercise, where some lifting of weights is an integral component. This goes for middle-aged adults as well as those a decade or two younger.
That said, weightlifting, to keep muscles vibrant and strong, should not be overdone. And for beginners or those who haven’t done it in a while, lifting should be approached in a manner that doesn’t overwhelm the exerciser. Starting slowly, and with lighter weights, and then building progressively is essential in order to avoid a threatening, but often-overlooked, condition known as rhabdomyolysis.
Rhabdomyolysis, or rhabdo for short, occurs when muscle damage is done after trying to lift too much weight, or lifting with such frequent repetition that it prevents the taxed muscles from resting. When this happens muscle fibers break down and die. These fibers then enter the bloodstream and can create kidney problems, and in some cases, kidney failure. Some severe cases may require kidney dialysis.
In addition, it can strike both the fit and flabby among us.
How do you know whether you’re in danger of being afflicted by rhabdo? There are symptoms to watch for, but since they aren’t specific to this condition it’s hard to tell whether a specific weight-training workout, or an intense stationary bike-riding session, is the culprit.
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What Happens When You Exercise
As is well known, intense exercise often injures muscle tissue, causing CK to be released into the bloodstream. Although the increase in CK levels is usually moderate , an increase of up to 100 times above normal is occasionally seen in runners at the end of a marathon. Our laboratory technicians have already observed a CK level of 1,000 times higher than normal in a healthy young woman who had decided to get back in shape!
After a muscle is injured, it takes a certain amount of time for CK levels to return to normal. They should decrease by half every 36 hours. For example, a level that is 100 times higher will take 10 days or so to return to normal.
Constantly Holding It In
Not urinating often enough can be bad for your kidneys. Natures call is meant to be answered in a regular, timely manner and if you dont, your body and kidneys in particular retain all the toxins meant to be expelled. Over time, this can actually lead to incontinence as well as kidney stones and other forms of kidney damage.
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Rhabdomylosis And Genetic Disorders
Besides exercise cases, Dr. Mark Tarnopolsky sees people with rare genetic disorders, such as McArdle’s disease that occurs in about one in 100,000 people who can’t break down sugar in the muscle and develop rhabdomylosis.
Less commonly, he treats people have CPT II deficiency, which makes it difficult to break down fat after longer-duration activity. He said it occurs in about one in 200,000 people.
It’s normal to have a few aches and pains in the first 48 hours after exercising, but people should watch for more serious signs of trouble, Tarnopolsky says.
“I think where people should be concerned and seek medical attention is if their urine goes dark, if their urine goes brown or red or tea colour. Those are the people who definitely need to go to an emergency department, they will likely need an intravenous, and they’ll need lots of hydration to protect the kidneys and ride them through that period.”
Tarnopolsky also advises people to seek medical attention if the muscle soreness worsens after two or three days.
Jay Armitage, 33, of Toronto, had rhabdomylosis in May. Armitage said she hadn’t exercised for three months during a busy period at work and was getting dehydrated while flying. Then she did an intense, 60-minute class of kettle bells and squats. Her legs were shaking as she walked out.
“When I woke up in the morning, I was in incredible pain. I couldn’t raise my arms above my shoulders,” Armitage recalled.
With files from CBC’s Kelly Crowe and Laura MacNaughton
Sitting For Long Periods Can Cause Kidney Disease
Even if you exercise daily and eat healthy sitting is a risk factor for developing kidney disease.
A recent study in July 2018, by the American Cancer Society, showed if you sit for six hours a day or more, your risk of dying early jumps almost 20%. Compared to people who sit fewer than three hours a day.
The study authors created a 14 point list of the major ways people die from sitting for too long. Kidney disease is listed as one the ways people died earlier than they should.
The other ways sitting can kill you are: heart disease, diabetes, cancer, COPD which is short for chronic obstructive pulmonary disease, musculoskeletal problems, Parkinsons disease, peptic ulcers, stroke, lung disease, Alzheimers and other disorders.
Lead researcher Alpa Patel said, The message is we should move more. Ms. Patel was a director of the American Cancer Study presented here.
128,000 women and men were part of the study. The study was for 21 years. Just over 2 decades and everyone at the start of the study was free of major diseases, including kidney disease. During the course of the study 49,000 people had died.
David Katz MD from Yale Prevention Research Center in Conn., said:
- Sitting for long periods of time is bad for your health. This has also been shown in many other studies.
- This study and others show excessive sitting to an increased risk of dying early from a variety of causes. Everything from heart disease to suicide.
The remedy is simple:
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