When intensity kills

LUKE AIR FORCE BASE, Ariz. -- Pushing the body's physical limits during exercise is a means to muscular improvement; but sometimes the body pushes back - hard. 

In recent worst-case scenarios two Luke Air Force Base Airmen were hospitalized after their bodies hit them with exertional rhabdomyolysis.

"Rhabdomyolysis is an extreme breakdown of muscle cell that results in the release of muscle fiber contents into the bloodstream," said Christina Crawford, 56th Medical Operations Squadron physical therapist. "In simpler terms, by breaking down the muscles during intense athletic activity you release muscle debris into the bloodstream. When the workout is too intense, the debris becomes toxic and poisons the kidneys."
In both cases the Airmen were newly recruited into CrossFit. 

"That's what CrossFit is, high intense exercises," said Capt. John Wilson, 56th Fighter Wing flying executive officer and CrossFit instructor. "For those who get it from CrossFit, it's because they haven't eased their way into it." 

Those suffering from "rhabdo" will experience symptoms such as excruciating muscle pain, weakness or swelling, and red or brown urine (not caused by blood). 

Generally most people will experience muscle soreness 24 to 48 hours after a workout, according to Ms. Crawford. If the soreness becomes a severe pain and limits movement, seek medical attention. 

Aside from exercise, additional factors can bring on rhabdo. 

"[Exertional rhabdomyolysis] is generally correlated with exhaustion, dehydration, high humidity, high temperatures and long practices," said Greg "Coach" Glassman, CrossFit founder, in an October 2005 CrossFit Journal article. 

The answer to avoiding rhabdo? Steer clear of shocking muscles with something they're not used to, i.e. gradual introduction, according to Captain Wilson. 

Unfortunately, it's easier said than done. 

"There is medical treatment for 'rhabdo,' but prevention is your responsibility," Ms. Crawford said. "Always listen to your body and progress the intensity with respect to how you responded to prior workouts. Be sure to do different exercises on the next day to allow a recovery period. Keep in mind, water should be consumed throughout the day' ideally half your body weight in ounces. It is also strongly recommended to consume a sports beverage during or after an intense workout lasting more than 60 minutes. Post-workout, refuel your body with a nourishing meal, avoiding alcohol and caffeine." 

For the still competitive-driven, an IV fluid flush to dilute the blood of excess toxins, a trip to the emergency room following by a weeklong stay and months of muscle recovery could be in their future.