The old Adage “No Pain, No Gain” has always been a guide for many of us in our pursuit for physical excellence. Sometimes you have to keep pushing on when every cell in your body seems to be saying “stop, please. Seriously…” This post is not a Free Pass from Kicking Ass. It is however a sober look at something that can kill you if you’re not being mindful of your body and you think vomiting is a mandatory response to an optimal workout.
Rhabdomyolysis is a condition in which muscle cells rupture. This isn’t the good kind of “Tear it down so we can rebuild it” kind of muscle breakdown that we are aiming for in the gym. This is when the cell literally rips apart and the contents of the cell dumps into the blood stream. What ends up happening is we have now spilled a bunch of Potassium into our bloodstream (remember, Potassium lives in the cell, Sodium lives outside of it, and together their fight back and forth keeps a perfect fluid balance in and outside of the cell) along with stuff called myoglobin. What then happens, is we end up with an influx of Sodium and Calcium into the muscle cells and then water naturally follows. So we have a situation where we have high potassium in the bloodstream, leading to heart issues, and we have decreased sodium in the bloodstream because it is going inside of the cells, something we don’t want.
Increased Calcium influx leads to further destruction of muscle tissue. Again, this is not cool at all.
In extreme cases, we end up with “compartment syndrome” which is where the muscle swelling caused by excess fluid, causes the intracompartmental pressure in the muscle to be greater than the capillary perfusion pressure. This is a very serious situation that involves immediate surgery to help restore fluid balance and involves slicing up meat and other stuff I don’t want to go into.
While Compartment Syndrome is a critical case that requires immediate hospitalization, I think it’s just as important to talk about the steps leading up to a severe reaction such as this. After all, if you are in a position where immediate hospitalization is needed, you’re not going to be thinking about whether you should go or not. You will feel like utter hell and will not be in a position to do much else besides vomit and ask for help.
What concerns me more is the other effects of Rhabdomyolysis and what can happen long term with a low grade version of this. Think of Myoglobin as the gunk inside of muscle cells. It should stay inside muscle cells where it belongs. When it gets into the bloodstream your kidneys have to work like hell to filter it out. In cases of high levels of Myoglobin, your kidneys will begin to fail because of tubular necrosis. The little filter units in your kidneys are dying because they can’t deal with this amount of funk. A darker colored urine, almost tea colored is what to look for in this case. But it’s tough when you pee in a toilet that has a lot of water in it, to always detect whether or not it is “dark”. Just know that if it’s anything but golden colored, and you feel crappy after working out or drinking too much or being in the heat all day, this could be a cause for concern.
The reason I bring this up is because I think the Kidneys are one of the most vital organs we have in our body, and I think they’re also one of the most abused in athletics or bodybuilding specifically. The heart is without a doubt critical, yes. The liver also takes a great deal of abuse, but it was designed for that and for the most part can rebuild itself as long as the damage hasn’t been too much. But when the kidneys go, they go, and nothing short of a transplant will keep you running optimally. Dialysis, a filtering of the blood, can extend your life, but trust me when I say you don’t want to do this the rest of your life.
So if Kidneys are important. The amount of strain we put our kidneys through can do irreversible damage to them. One of the things we can do to strain our kidneys is to release too much myoglobin in the bloodstream and we can do this by causing rhabdomyolysis. So let’s not do that, ok?
How do we avoid this?
While we still need to push ourselves, it’s important to recognize when we’re going too far. And perhaps if you’re hoping to go pro and it takes killing yourself slowly to get there, then maybe this warning isn’t all that valid. I mean this with sincerity. But if you want to live a long and healthy life while trying to look your best, then consider whether or not a workout is going too far to an extreme. Perhaps you can work up to tackling Arnold Schwarzeneger’s Chest/Back workout by building up to it over a period of time. Eccentric exercise is the biggest factor in exertional Rhabdomyolysis.
Also here is a list of drugs to watch out for. Drugs can cause rhabdomyolysis on their own. Added to an extremely high workload, this can be asking for the kind of failure we DON’T want to reach, kidney failure.
In particular, the recreational drugs, AND the statins and fibrates have my biggest attention right now.
Alot of people I know who are using anabolic steroids are attempting to control the unavoidable cholesterol side effects by using fibrates or statins. I also used to advocate using fibrates for fat loss. Now I’m not sure whether that’s such a good idea anymore, especially when there are safer and more effective alternatives out there.
The point I am trying to make here isn’t one of “the sky is falling.” It is one of awareness. Be aware that you could be pushing yourself so hard that your causing damage to your kidneys. It’s as simple as that. What you do with that realization is up to you. If you kicked ass in the gym and feel like crap afterwards, that’s just how it is. But if it takes on a whole new level of crappiness, and you feel nauseous, your heart is skipping beats and your urine is tea-colored, it’s time to make a trip down to the hospital and see if your insurance is still good.
So why don’t I have a long list of symptoms of this? Because quite frankly you might not have any dramatic outward symptoms. If you have dark colored urine then it’s time to seriously consider this as a possibility. But sometimes you just feel like shit. And sometimes it will pass, and if it happens often enough, and in conjunction with drugs that cause it on its own like cocaine, pain pills, statins, ecstacy, then you c0uld be giving yourself a slow kidney damaging ride to the operating table.