Raising Awareness: This post is not being written to scare you…but just to make you aware.

CrossFit is an intense training program that can be scaled to meet the abilities and limitations of any individual. However; problems arise when athletes do not scale or choose not to follow the Coaches orders. We scale you because it is neccessary….not because we are trying to be mean. Also…you CAN NOT come into our facility on a poor diet, lack of rest, and dehydrated and expect to WOD. The whole reason we do what we do is to be healthy, to have more active and useful life, and to extend years of health to our life. If you are feeling beat up…Stay home. If you are feeling stressed more than usual…Stay home. If you are under nourished and havent slept in a few days…Stay home. You have got to be hydrated and you have got to make sure your electrolytes are where they are susposed to be. If you decide to come in on a day when you know that you should be resting please be sure to let a Coach know what is going on with you, Scale and Modify accordingly. Also, if you have taken a few weeks off and then you make your way back to the box….Ease into it! If you left and you were WODing LV3 and its been more than a week or two…you need to start over at LV1 until you can work your way back up to LV3…etc. Don’t try to be a hero…its your health, and your body, and your life and you only have one….please be kind to it!!!

Here are some helpful tips and resources on Rhabdo:

http://journal.crossfit.com/2010/01/rhabdo-pdf.tpl

http://journal.crossfit.com/2011/06/rhabdomyolysis-revisited.tpl

 

This is CrossFit’s term for Rhabdomyolysis. Rhabdo is a disease of the muscle that involves excessive breakdown of the muscle cells, leading to the following cell contents being spilled out into the blood stream:

  • Myoglobin…toxic to the kidneys and steals oxygen from the blood
  • Potassium… toxic to the kidneys and heart in high doses
  • Sodium + calcium….leading to swelling and possible compartment syndrome
  • Creatine Kinase

Uncle Rhabdo isn’t such a cute name anymore huh?

What are the signs and symptoms? (following an intense workout)

  • generalized or specific myalgia (aka muscle pain)
  • muscle tenderness
  • fever
  • nausea
  • vomiting
  • dark urine
  • low back pain (the kidneys can refer pain to the low back)

*Depending on the extent of damage done, most treatment includes immediate hydration through IV. Kidney dialysis may be administered as well, depending on the extent of damage.

Muscle tears are a normal part of exercise, to a certain extent. More info from a post a while back by Sean here. However, it’s the excessive tearing of the muscles that causes the above list to be found in the blood in higher levels than the body can tolerate.

Other causes of increased muscle breakdown:

  • Dehydration….increased muscle breakdown from….
  • Increased core body temperature (environment, overweight or un-fit people working at an inappropriate intensity).
  • Severe collisions from a car accident, football games or falls in the elderly.
  • Caffeine also increases core body temperature (so maybe that ginormous coffee, after a night of drinking, right before Saturday’s WOD, is not the best idea)

Obviously the above mentioned happens quite frequently, which means that there must be varying levels of rhabdo because death is a rare occurance. Football teams have had urine tests that show varying degrees of rhabdo following preseason (high intensity workouts following a long rest period, in addition to heat). Then there are those that have died playing football from heatstroke, most likely a resultant of rhabdo. There have also been non-athletes who have done intense workouts (CrossFit and others) that have similar experiences and end up in the hospital for immediate treatment.

Are there long-term effects?

The answer to this is really unclear. I’m continuing to research this but most of what I have read states that long-term effects are unknown. Most of the research so far is looking into the the effects of chronic rhabdo because this is a common thing among high intensity athletes. My thoughts are that repetitive damage to the body like this can’t be good….

Additional risks for getting Rhabdo

  • Rhabdo is most often observed with novel, strenuous, overexertion…..those of you that take months off and then come in to try to find your Fran PR.
  • Use of statins (cholesterol reducing medication; some evidence that they increase the normal levels of creatine kinase following exercise).
  • African Americans have a greater genetic predisposition to muscle breakdown, so hydration is important
  • Diets high in grains (not completely sure why right now…)
  • Electrolyte imbalances (dehydration, but also drinking too much water with not enough minerals/vitamins in it to help your body absorb the water)
  • Hormonal imbalances (sounds like this just throws your body out of whack)
  • Lactic acidosis (increased muscle breakdown)
  • Vitamin E and selenium deficiencies
  • Cocaine
  • Creatine kinase supplementation can put you at more risk for dehydration, so make sure you take it with the recommended amount of water.
  • (CF SOUTHBAY)

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