Q&A: What is rhabdomyolysis?

A: Rhabdomyolysis, or rhabdo, is a rare condition in which damaged muscle tissue fibers break down and release protein into your bloodstream. Rhabdo can cause pain, fatigue and, if untreated, lead to kidney failure. Yet, this condition is often overlooked or dismissed in its early stages as it is commonly mistaken for general muscle soreness. To recognize or prevent complications from rhabdo, it is important to know your risk factors.

Rhabdo can stem from a number of factors, such as genetic or metabolic illnesses or high-energy traumatic injuries in which an extremity is “crushed” (such as a car crash), leading to a loss of blood flow to the muscle causing cell death. But, one of the more rare — and easily overlooked — instances is exertional rhabdo, which results from extreme physical exertion or activity.

Exertional rhabdo presents a serious risk to athletes, marathon runners, body builders and anyone else with high-intensity fitness routines. Hot, humid environments (such as those found in a gym), low hydration and frequent strenuous physical activity, such as explosive weight training or lifting, can contribute to the breakdown of muscle tissue.

Patients who develop rhabdo often experience swelling, high degrees of pain and muscle soreness, and discoloration or darkening of urine. Although this is a rare condition, it is very important to recognize and address any potential symptoms, as rhabdo also includes complaints associated with the entire body, such as fatigue and weakness, as well as feeling restless and sluggish.

If you begin to experience these symptoms, talk with your doctor about getting a blood test to determine whether you have rhabdo.

Treatments for rhabdo often include IV fluids to help maintain urine production, prevent kidney failure, and dilute the amount of muscle tissue fibers and protein in the bloodstream. In rare cases, your doctor may recommend dialysis to help your kidney filter out additional waste products while you are recovering. With early diagnosis and treatment, you can expect a full recovery from rhabdo.

To prevent the development of this condition, pay attention to your body. When exercising outside in extreme heat or in a hot indoor environment, it is important to keep your body properly hydrated to prevent injury and the potential development of rhabdo. Also, remember to pace yourself. When ramping up your typical amount of exercise, plan ahead and be mindful of your body’s limits.

Kevin O’Donnell, MD, is a sports-medicine specialist and orthopedic surgeon at Mercy Fitzgerald Hospital and Mercy Philadelphia Hospital.