Whether you're a seasoned exerciser or a workout newbie, it's important to listen to your body. Fitness influencer Aly Teich didn't think her symptoms were anything to worry about until she found herself in the ER for a scary kidney condition called rhabdomyolysis.
What is rhabdomyolysis?
Rhabdomyolysis, aka rhabdo, is the result of damaged muscle tissue that leads to the release of muscle fibre contents into the bloodstream. When your muscle is damaged, it releases a protein called myoglobin. Your kidneys filter myoglobin out of the body, but the problem is that myoglobin breaks down into substances that can do serious damage to your kidney cells, potentially causing kidney failure.
Teich recently shared her story on Instagram in hopes that she can raise awareness about the dangers of overexercising and rhabdomyolysis. “As many of you know by now, one week ago today, I was admitted to the hospital for rhabdomyolysis,” Teich wrote in a lengthy Instagram post.
Long read on why I was in the hospital last week (home now!): As many of you know by now, one week ago today, I was admitted to the hospital for rhabdomyolisis – a condition when an overexerted muscle completely breaks down and the muscle tissue (made of protein) releases into your bloodstream causing your Creatine phosphokinase levels (CPK) to elevate. “Being in Rhabdo” is incredibly dangerous as it can lead to kidney damage and even failure if it’s not treated in time. How? The kidneys are not able to process these proteins, and as our kidneys are the filters for our bodies, it’s like getting “hair in the drain” for our kidneys and stops them from doing their job – which then can cause both kidney damage and failure. Rhabdo also effects your liver and is just an overall tax on the system. The treatment for rhabdo is aggressive IV fluid to flush your bloodstream of the muscle proteins, get them through your kidneys safely, and bring your CPK down to a safe level. The symptoms of rhabdo are usually extreme muscle soreness, coca-cola colored urine, extreme fatigue, swelling of the limbs, nausea, and sometimes vomiting, dizziness, and a racing heart. However, my symptoms were a little different – so what happened to me and what does this all mean? To start, what’s still a little confusing is that rhabdo usually happens when you have pushed a muscle to its limit. However, considering that I have been injured and have been doing fairly basic PT-driven workouts to strengthen my hip, it still doesn’t totally make sense to me. However, I’ll address that later. So, on Thursday, I did pull ups (which I hadn’t done in quite some time and this seemed to be the culprit). Friday I worked out with my trainer @kelvingary again, and commented to Kelvin that my forearms were sore, but having a body that’s almost always sore, I didn’t think much of it and went on with my workout. On Saturday morning I woke up and could barely move my arms. It felt like I had strained both of my biceps and forearms. However, having “overdone” it many times over the years, that’s just what I chalked it up to... (Parts 2-4 cont’d in comments below...)
Teich revealed that she was recently injured and was doing physical therapy-driven workouts to strengthen her hip. One day, she did some pull-up exercises and did a workout with her trainer the next day, mentioning to him that her forearms were sore. "But having a body that's almost always sore, I didn't think much of it and went on with my workout," Teich says. However, the next morning she woke up and could barely move her arms. “It felt like I had strained both of my biceps and forearms,” she added. Teich thought she had just “overdone it,” as she had done many times before with exercise.
“Then my arms started to swell a bit, but still my reaction was just, ‘well, that’s weird.’” But two days later, both her arms were so swollen that she couldn't recognise them. Once her legs began to swell, she knew something was wrong and called a friend who was a doctor. Her friend had asked what colour her urine was (one of the common symptoms of rhabdo is discoloured urine). While Teich's symptoms didn't all match up to rhabdo, her friend told her to head to the ER immediately to get checked out. Once there, she was hooked up to IVs and her blood was taken.
Within 45 minutes she learned she had rhabdomyolysis, and according to the ER doctors, she was “only a few hours away from having real kidney trouble.” “If I waited until Monday morning (as I was very close to doing for not wanting to ‘deal with going to the ER’) this could have been a very different story, and I might still be in the hospital or worse,” she added.
What causes rhabdomyolysis?
Rhabdo is most commonly caused by exercise-induced injuries-ranging from mild to extreme. And it can be pretty random and doesn't take seriously overtraining to occur. In Teich's case, her doctor's believed that it happened because of her mild workout and possibly a lack of hydration.
There are also a variety of other problems that can contribute to it, according to the NIH:
- Trauma injuries
- Drug use including cocaine, amphetamines, statins, heroin, or PCP
- Genetic muscle diseases
- Body temperature extremity
- Ischemia or death of muscle tissue
- Low phosphate levels
- Seizures or muscle tremors
- Extreme exertion, such as marathon running or calisthenics
- Long surgical procedures
- Serious dehydration
What are common rhabdomyolysis symptoms?
The NIH explains that there are various symptoms of rhabdo. These include:
- Discoloured urine, especially dark, red, or coca cola-coloured
- Decreased urine output
- Overall weakness
- Muscle stiffness or aching (myalgia)
- Muscle tenderness
- Weakness of the affected muscles
Other symptoms that may occur with this disease:
- Joint pain
- Weight gain (unintentional)
How is rhabdomyolysis treated?
Fluids containing bicarbonate are administered to prevent kidney damage, in addition to other medications, and some people may need kidney dialysis. In Teich's case, she was given two litres of fluid in an hour in the ER. When she was admitted into another hospital where she stayed for several days, she continued to receive fluids.
What is the prognosis?
Getting treated as soon as possible is crucial to prevent kidney damage and decrease the likelihood of kidney failure. Acute kidney failure occurs in many people. Recovery for those with milder cases could take weeks or even a month. But some people will continue to have problems with fatigue and muscle pain.
Teich was sent home from the hospital after less than a week, but was instructed to refrain from exercising for two weeks and to continue hydrating with water.