Why Don’t We Talk More About Rhabdomyolysis Recovery?

With the rise of high-intensity workouts like CrossFit and SoulCycle, rhabdomyolysis has become newsworthy enough to get a catchier abbreviation—rhabdo. A quick internet search will turn up plenty of information about common rhabdomyolysis causes and symptoms, but there’s a lack of information about what rhabdomyolysis recovery looks like.

So we dug deep to collect advice on rhabdomyolysis treatment and what life looks like after rhabdo. Here’s what we learned.

First Things First, a Rhabdomyolysis Definition

In case you were scratching your head through that introduction wondering “What is rhabdomyolysis?” here’s a quick definition: rhabdomyolysis, often abbreviated to rhabdo, is a serious syndrome caused by direct or indirect muscle injury.

Rhabdomyolysis sets in when the death of muscle fibers sends a flood of a protein called myoglobin into your bloodstream. This can lead to serious complications, including kidney damage and even kidney failure. In the most severe cases, rhabdomyolysis can result in death. With prompt treatment, however, most people who develop rhabdomyolysis do recover.

What Causes Rhabdomyolysis?

Rhabdo causes include many kinds of traumatic and nontraumatic muscle injury, such as:

• A crush injury from a car crash, serious fall, or building collapse
• The use of illegal drugs such as heroin, cocaine, and amphetamines
• Prolonged muscle compression resulting from lying unconscious on a hard surface for a significant period of time
• Extreme muscle strain, more common in untrained athletes but more dangerous for elite athletes who have more muscle mass to break down
• Electrical shock injuries and third-degree burns
• High doses of antipsychotic and statin medications
• Heat stroke
• Seizures
• Metabolic disorders including hypothyroidism and diabetic ketoacidosis
• Diseases that affect the muscles, such as congenital muscle enzyme deficiency, McArdle’s disease, or Duchenne’s muscular dystrophy
• Viral infections like the flu, HIV, or herpes
• Bacterial infections that result in sepsis

Don’t Overlook These Rhabdomyolysis Symptoms

It can be challenging to identify rhabdo symptoms since they vary depending on the cause as well as other factors. Three symptoms form what doctors call the “classic triad:”

• Muscle pain: Particularly in the shoulders, thighs, or lower back.
• Muscle weakness: Difficulty moving arms and legs is a key indication.
• Urine changes: Decreased urination or dark red or brown urine are cause for concern.

Other signs of rhabdomyolysis include: extreme muscle swelling, abdominal pain, nausea or vomiting, fever, rapid heart rate, dehydration, and abnormal disorientation.

Andrea Wien, a writer, chef, and Certified Nutrition Expert, shared her experience with rhabdo in an article for mindbodygreen.

“My lat muscle was so swollen that it jiggled when I walked, and a few days later, my entire upper body looked like a puffy marshmallow. I Googled (of course) to see if swollen muscles were normal (they’re not) and texted a few friends to ask if they’d ever experienced anything similar (they hadn’t). Everyone told me I was likely overreacting, but I couldn’t shake the feeling that something was seriously wrong.”

Luckily, Wien honored that feeling and sought medical treatment. She ended up spending five days in the hospital on an IV drip. While she was there, she spent a lot of time researching rhabdo, which she’d never even heard of prior to her scary diagnosis.

“Though there’s a decent amount of info on the causes of rhabdo, little was written about recovery,” Wien writes. “I read plenty of horror stories about people never “bouncing back,” but articles about how to get back into the gym after rhabdo were nonexistent. What I did find was discouraging: A few sources said you should never work the injured muscle again for fear of relapse, which seemed ridiculous to me.”

What to Expect from Rhabdomyolysis Recovery

Alcohol and caffeine can increase your risk of recurrent rhabdomyolysis, so you should steer clear of both, at least in the immediate aftermath. And hydration is absolutely vital as is proper nutrition. Be sure to follow whatever instructions your physician gives you when you’re discharged.

Beyond that, there are no universal medical guidelines for rhabdomyolysis recovery, which can understandably be frustrating. But in a way, it could be a blessing in disguise. People who develop exercise-related rhabdo likely have high pain thresholds and a lot of persistence. It can be beneficial to slow down and learn how to listen to your body’s signals, especially since getting rhabdo once increases the risk that it will happen again.

There are some programs out there meant to help reintroduce physical activity, but they tend to be targeted toward high-level athletes, like Division 1 football players.

That said, these three key points come up again and again, both from fitness professionals and individuals who’ve had rhabdo and bounced back from it:

• Take a break. This can last from a couple weeks to a couple months depending on your baseline fitness level and how severe your case of rhabdo got. If you have the means to work with a professional, ideally one who has experience with rhabdo recovery, you should definitely do that.
• Ease in. When you do begin exercising again, start with low-impact activities and focus on movement integrity.
• Stop comparing yourself to others. Tune into what your body is telling you moment to moment during a workout. If something feels wrong, that’s a sign you need to slow down, pause, or even stop the workout altogether. Always respect your body’s limits.