The Center for Podiatric Care and Sports Medicine

Rhabdomyolysis Risk Factors: White Plains Sports Medicine Doctors Discuss Symptoms and Treatment

Posted by on Monday, September 11th, 2017

Rhabdomyolysis is the stuff of nightmares. You’re a reasonably fit individual, pushing yourself hard at the gym. Over the next few days, your muscles ache and your legs wobble. Soon, you experience excruciating throbbing and nausea. Your urine turns brown. At the hospital, you’re diagnosed with a life-threatening condition known as rhabdomyolysis in which overworked muscles die and leak their contents into the bloodstream, placing a toll on the kidneys and causing severe pain. White Plains sports medicine doctors at The Center for Podiatric Care and Sports Medicine hope to shed some light on how this rare occurrence happens, rhabdomyolysis risk factors, and what can be done to prevent it.

white plains sports medicine doctors
Know your limits when starting a new exercise like spin class, caution White Plains sports medicine doctors familiar with rhabdomyolysis. Image Source: Wikimedia user LocalFitness.

High-Intensity Spin Classes Can Lead to Rhabdomyolysis

People tend to think of cycling classes as a “low-impact” activity for cross-training. High-intensity spin workouts through chains like FlyWheel and SoulCycle have become wildly popular in recent years. The bad news? One report cited at least 47 cases of people developing rhabdomyolysis after taking a spin class. Of these 47 individuals, 42 were taking their first spin class ever. Researchers didn’t want to dissuade people from engaging in strenuous exercise such as cycling, but they wanted people to know that it’s a good idea to “take it easy” the first time as the body gets used to the increased demand. “It’s not an activity where you start off at full speed,” said Alan Coffino, chairman of medicine at Northern Westchester Hospital and co-author of the report.

Doctors at New York Presbyterian/Weill Cornell Medical Center published a 2014 report on a 24-year-old patient who hobbled in with swollen legs “as tight as drums” following her first spin class. She required immediate surgery to relieve the dangerous buildup of pressure. Another study identified 29 ER visits related to exercise-induced rhabdomyolysis at New York Presbyterian Hospital from 2010-2014. Other workouts that led to rhabdomyolysis included weight lifting, running, P90X, and CrossFit. The vast majority of patients were fit but simply pushed themselves too hard, to the point of severe muscle trauma.

Your Profession May Put You At Risk

Professions where rhabdomyolysis tends to occur most frequently include physically demanding jobs such as:

  • Soldier (400 cases among active duty military each year)
  • College athlete (often seen in clusters of teammates after a grueling workout)
  • Firefighters (26 cases in wildland firefighting from 2008-2016)

Therefore, if you work in one of these fields or another job which requires you be active and on your feet most of the day, keep an eye out for symptoms of rhabdomyolysis and seek treatment right away if you’re concerned.

Drugs Increase Your Risk Factor

  • One study found that 10.5% of patients with rhabdomyolysis were also taking antipsychotic drugs like quetiapine (Seroquel).
  • 1.5 in 100,000 Statin users develop rhabdomyolysis, particularly when cyclosporine (Sandimmune) and gemfibrozil (Lopid) are combined.
  • Performance-enhancing drugs, like creatine supplements and anabolic steroids, are associated with rhabdomyolysis.
  • Illegal drugs like heroin, cocaine, amphetamines, methadone, and LSD have been connected with rhabdomyolosis. One study revealed that 24% of cocaine users had rhabdomyolysis.

Rhabdomyolosis Treatment and Prevention in White Plains

Olympic Bronze Medalist Snowboarder and “Dancing With the Stars” Contestant Amy Purdy recalls her run-in with rhabdomyolysis. She was returning to training after three weeks off, and her exercise class included a circuit of challenging pull-ups by the dozen. “About halfway through, I realized my arms were completely fatigued,” she said. The following morning, she couldn’t straighten her left arm. It was sore, then stiff, then extremely swollen. At the hospital, doctors flushed her kidneys with water for eight days. Purdy says “thousands of people” contacted her through social media with similar cases of pull-up-induced rhabdomyolysis. Don’t wait until your urine turns brown; come in for evaluation at the first sign of unbearable pain.

White Plains sports medicine doctors offer these tips for preventing rhabdomyolysis:

  • If taking spin classes, ride the stationary bike at a moderate pace, skipping some of the standing phases or recommended weight increases.
  • Complete one set of weight lifting exercises rather than multiple sets and repetitions. Gradually add to your routine.
  • Leave a class or instructor if you feel pushed to your limits.
  • Return to exercise with less intense activities like walking, yoga, or the elliptical trainer.

If you are suffering from rhabdomyolysis or think you might be, stop by The Center for Podiatric Care and Sports Medicine. Our board-certified foot doctors and surgeons have all the tools necessary to provide the latest treatments and expert advice. Contact us today to learn more.

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.