All should be cautious when pushing themselves during training

| April 27, 2017 | 0 Comments
:  Rhabdomyolysis can occur in people after extreme exercise.  In addition to military recruits, it has been documented in patients who are marathon runners and weight lifters.  Symptoms of rhabdomyolysis include dark red urine, decreased urination, extreme weakness, nausea and prolonged muscle aches or tenderness.  If you have any of these symptoms, you may have rhabdomyolysis and should schedule an appointment with your Primary Care Manager. (Courtesy TAMC)

Rhabdomyolysis can occur in people after extreme exercise. In addition to military recruits, it has been documented in patients who are marathon runners and weight lifters. (Courtesy TAMC)


Dr. Grace S. Chen, M.D.

Tripler Army Medical Center
HONOLULU — The next time you go on your next ruck march, please consider training for it!

We are born with two kidneys, organs that filter blood and make waste products into urine, but when we aren’t taking care of our bodies and we aren’t training properly, we could be doing more harm than good.

Rhabdomyolysis is a condition in which damaged muscle breaks down very quickly, releasing a substance that is filtered by the kidneys. When it breaks down, it can damage kidney cells.

Military estimates
There is a wide range of estimates of rhabdomyolysis in the military. A large retrospective review of over 500,000 Soldiers showed that there was an average of 7-8 cases per 10,000 people. Another study diagnosed 40 percent of military recruits with rhabdomyolysis within the first six days of basic training.

Rhabdomyolysis can occur in people after extreme exercise. In addition to military recruits, it has been documented in patients who are marathon runners and weight lifters. It can also occur in people who are deconditioned and try to accelerate their training program too quickly.

Direct muscle trauma from large-scale disasters can cause rhabdomyolysis from muscle breakdown. Tortured or assaulted patients can be at risk for rhabdomyolysis, too. Seizures can cause rhabdomyolysis by the prolonged trauma to the muscles.

Rhabdomyolysis can also be caused by tissue compression from long periods of immobility. This can happen in older patients found on the ground (unable to get up) after a fall. As pressure in the muscle increases, blood flow decreases and muscle tissue dies. The dead muscle releases myoglobin, damaging the kidneys.

Temperature factor
Hot and cold temperatures can bring about rhabdomyolysis. In cold temperatures, muscle blood flow is decreased, and muscle cells die in freezing temperatures. On the contrary, increases in body temperature increase metabolic demand. When oxygen delivery cannot keep up, the cells are not able to get oxygen and die.

Certain substances can make people more susceptible to rhabdomyolysis. Alcohol has a toxic effect on muscle cells. In addition, people who get drunk may be immobile for a long period of time.

Recreational drugs such as cocaine, methamphetamines, ecstasy and PCP are stimulants. They can cause increased muscle activity, which can cause rhabdomyolysis by increasing cell oxygen demand. When the increase demand is not met, cells die and release myoglobin.

Symptoms of rhabdomyolysis include dark red urine, decreased urination, extreme weakness, nausea and prolonged muscle aches or tenderness. If you have any of these symptoms, you may have rhabdomyolysis and should schedule an appointment with your primary care manager.

Prevention
You can prevent rhabdomyolysis by making sure you are properly hydrated. Avoid alcohol, caffeine and recreational drugs if you will be doing any type of strenuous exercise. In hotter climates, it is important to drink even more water as there are a lot of water losses that occur through sweating.

In addition, try to condition properly for a race or other competition. For instance, instead of deciding to lift 200 pounds on your first day of weight training, increase the weight you lift gradually. Instead of running 10 miles on your first day, try to increase from 1 to 10 miles over a period of a few months.

Exercise caution with aggressive workout routines.

Exercise caution with aggressive workout routines.

TAMC Tip

Scheduling a Checkup

Monday, May 11, is National Women’s Checkup Day, and this week is National Women’s Health Week.

Tripler Army Medical Center logoThe day is dedicated to encourage women to visit their health care professionals to receive or schedule checkups.

National Women’s Health Week encourages women to take simple steps to live a healthier life.

  • Make an appointment with your health provider for a check-up, vaccination or test. Schedule at least one health screening during May.
  • Write down a list of questions to ask your health provider. Take it with you to your appointment and write down the answers.
  • Tell your health provider if you have noticed any changes in your body, lifestyle, habits or work that may require changes in medicines, screenings and health routines.

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Category: Health

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