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A Word of Caution - Pushing too hard

krazyfranco's picture
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started by krazyfranco on July 14, 2009

Hopefully you won't lump this posting in with the ubiquitous summertime "Flip-flops are dangerous" and "Shark Attack" articles that pop-up each summer, but I just learned about a condition that I thought was relevant for our bunch of crazy triathletes.

What is Rhabdomyolysis?
Rhabomyolysis is the rapid breakdown of skeletal muscle (the muscle in your arms and legs, as opposed to smooth muscle, like your heart).

What causes Rhabdomyolysis?
Well, lots of things, including crush injury and medication, but more importantly for us it can be caused by extreme physical exercise, something we excel at here at Trifuel. It is even more likely when accompanied by dehydration, and when the body runs out energy supplies (bonking).

What happens if Rhabdomyolysis occurs?
When your muscle starts to rapidly breakdown, bad things happen.
Electrolyte imbalance occurs the kidneys can injured by the protein myoglobin found in muscle, but now in the bloodstream. Also, Muscle takes on extra fluid and swells. This can lead to a complication called Compartment syndrome, where muscle swells so much it cuts off circulation and nerve activity to the effected parts of the body.

Why am I telling you all this?
A few reasons.
1. I just learned about it myself, and it is relevant for endurance athletes.
2. Personal Anecdote: Recently, I had the opportunity to shadow a physician on ICU rounds, and met a patient w/ Rhabdomyolisis & compartment syndrome. What struck me was that this pretty young, otherwise healthy individual came home after a day of work (physical labor), felt normal when he went to bed, then woke up with kidney injury and compartment syndrome as a result of Rhabdomyolisis, from dehydration and lack of calories throughout the day. That person is now looking at extended hospital time and even longer rehab before they are back on their feet. It can happen to anyone.

Why am I telling you all this?
Just a reminder to be careful out there. The sport of triathlon is dangerous, in many ways. Know your limits. Always stay adequately hydrated and fueled., especially in these hot summer months. Replace your fluids and calories quickly after exertion. Be aware of how you are feeling, and be aware of the consequences of pushing too hard. In our culture of "Mind over Matter," know that there can be very serious to pushing it too hard. We should keep this in mind when we mentor newbie triathletes as well, or those looking to go for longer and more intense racing and training.

Be safe!

-krazyfranco

Hard days hard, easy days easy.

jtrimom's picture
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jtrimom posted 35 weeks ago.

thanks for sharing- that's scary stuff!

Taper Naked

maggiemeans's picture
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maggiemeans posted 35 weeks ago.

blood tests determine if someone has this? how did they figure out the person had it?

krazyfranco's picture
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krazyfranco posted 35 weeks ago.

"The most reliable test in the diagnosis of rhabdomyolysis is the level of creatine kinase (CK) in the blood. This enzyme is released by damaged muscle, and levels above 5 times the upper limit of normal (ULN) indicate rhabdomyolysis." - From the Wikipedia article linked.

The more obvious symptom was the swelling of the lower extremity, to 2-3x normal size.

Hard days hard, easy days easy.

tri-ac's picture
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tri-ac posted 35 weeks ago.

that's what hit me when I restarted swimming as an adult (when I decided to try triathlons)
i ended up having genetic testing to determine whether I had a pre-disposition to it...nothing conclusive learned other than "stay trained" so that it doesn't happen again (my dr's words, not mine) (one of my first posts here)

it's def. not a good thing to deal with!

Ironmom's picture
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Ironmom posted 35 weeks ago.

Thanks for the reminder. This comes up in extreme exercise circles (martial arts, Crossfit, military) frequently but it's a good reminder that it could happen to us endurance athletes as well. Hydrate, hydrate, hydrate!

Blue Skies, -Robin-
http://ironmom.blogspot.com/

jonovision_man's picture
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jonovision_man posted 35 weeks ago.

krazyfranco wrote:
The more obvious symptom was the swelling of the lower extremity, to 2-3x normal size.

*snicker*

(Sorry I know it's a serious topic, but the kid in me can't resist)

jono

cutiger95's picture
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cutiger95 posted 35 weeks ago.

krazyfranco wrote:

The more obvious symptom was the swelling of the lower extremity, to 2-3x normal size.

I received several e-mails today offering the same effect :-) Said it would please my wife or loved one.

Just joking but this is serious and thanks for reminding me. I almost went out tonight for my quick 1 1/2 hr ride with only one water bottle. Happened to read this earlier and took both bottles with me. Glad that I did as they both emptied prior to my return and then I took in a recovery shake which I will skip a lot of the time.

Amish's picture
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Amish posted 35 weeks ago.

well that scares the crap out of me...especially given that I ran 11 miles yesterday without water or gels, and followed it today with a 45 mile ride (the only calories I had came around mile 10, and it was just a bag of those "powershotz"; ran out of water in the middle and didn't get any until the end) ... I guess I must tread carefully.

SueR's picture
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SueR posted 35 weeks ago.

seriously, you eat crap and smoke, you die...you train lots and think you are healthy, you die...bummer all around!
It's a good point for me too, I tend to forget to drink and train in the heat of the day and not do proper recovery nutrition. I need to be more attentive to details like that not only for performance. It still scares me less than sharks though....

TryScott's picture
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TryScott posted 35 weeks ago.

jonovision_man wrote:
krazyfranco wrote:
The more obvious symptom was the swelling of the lower extremity, to 2-3x normal size.

*snicker*

(Sorry I know it's a serious topic, but the kid in me can't resist)

jono


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