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Rhabdomyolysis can result from extreme muscle exertion.

Rhabdomyolysis can result from extreme muscle exertion.
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Rhabdomyolysis

2-minute read

Rhabdomyolysis happens when muscle tissue is destroyed and the muscle fibres break down or leak, releasing their contents into the bloodstream. This can lead to problems such as kidney failure. Rarely, rhabdomyolysis can cause death. However, when treated early, the chances of a recovery are high.

What is rhabdomyolysis?

Rhabdomyolysis is a serious condition caused by muscle injury.

When muscle tissue gets seriously injured, it breaks down and dies, releasing its contents, including a protein called myoglobin, into the bloodstream.

The kidneys filter out myoglobin, but since too much myoglobin is harmful to kidney cells, rhabdomyolysis can lead to kidney complications.

Causes of rhabdomyolysis

Rhabdomyolysis is caused by direct or indirect injury to muscle tissue, such as:

  • trauma or crush injuries, for example, from a car accident
  • taking illegal drugs such as cocaine, amphetamines or heroin
  • extreme muscle exertion, for example, running marathons or improper resistance training
  • a side effect of some medicines, such as cholesterol-lowering drugs (statins), although the risk is very low
  • prolonged muscle pressure, for example when someone is lying unconscious on a hard surface
  • very high body temperature (hyperthermia) or heat stroke

Rhabdomyolysis symptoms

Common rhabdomyolysis symptoms include:

  • severe muscle aching or tenderness, especially in the shoulders, thighs or lower back
  • muscle weakness or stiffness, or trouble moving arms or legs
  • confusion, dehydration or fever
  • lack of consciousness
  • dark red or brown urine, or reduced or no urine output

If not treated early, rhabdomyolysis can lead to complications, such as:

  • very high potassium levels in the blood (hyperkalaemia); this can lead to an irregular heartbeat or cardiac arrest
  • kidney failure or problems with the liver
  • compartment syndrome; this occurs when too much pressure builds up in the injured group of muscles (compartment). The extreme pressure hinders blood flow to and from the affected tissues and can cause further muscle damage and death

Rhabdomyolysis diagnosis

Rhabdomyolysis is often diagnosed in hospital. Physical examination, blood tests and urine tests are all needed. Other tests may be needed too.

Rhabdomyolysis treatment

Rhabdomyolysis is usually treated in hospital, with intravenous fluids to help you produce enough urine and prevent kidney failure.

Rarely, dialysis is needed if kidney function is poor. If you have compartment syndrome, you may need immediate surgery to avoid further muscle death or nerve damage.

Early diagnosis and treatment of rhabdomyolysis and its causes increases your chances of a full recovery.

Sources:

WebMD (rhabdomyolysis), Australian Family Physician (Resistance exercise–induced rhabdomyolysis: Need for immediate intervention and proper counselling), Mayo Clinic (Rhabdomyolysis from statins: What's the risk?), The Conversation (Explainer: what is rhabdomyolysis and what’s its connection to CrossFit?)

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Last reviewed: April 2019

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