Killer Workouts

By Eugene Allen

In Basics

May 01, 2005

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There is a small, yet significant possibility of catastrophic trauma from intense training, Eugene Allen writes in “Killer Workouts.” Rhabdomyolysis (Rhabdo) is a potentially fatal condition, marked by high concentrations of potassium in the blood.

Rhabdomyolysis is the breakdown of muscle cell contents, and their consequent release into the bloodstream. Muscle stress is exacerbated, and breakdown accelerates when Eccentric contractions occur simultaneously with stretching (think kipping pull up). Extra potassium is released into the blood from this process and may reach levels that can alter heart function. In extreme cases, the heart may fail completely.

Intense exercise after a recent infection raises the chance of muscle deterioration during exertion, as well as exercising when it is very hot and humid. Other rhabdo invitations are heavy alcohol consumption, cocaine usage, and the use of a cholesterol-lowering drug called Mevacor (lovastatin is the generic name).

The primary diagnostic indicator of rhabdo is elevation of serum creatine phosphokinase (CPK). Rhabdo can raise CPK levels to five times the norm. This is an advanced indicator. Post WOD warning signs may be harder to come by. Extreme weakness or fluid build up may be cause for concern. However, if you’re pissing what resembles Coca-Cola, find an emergency room STAT.

The risk of rhabdomyolysis can be reduced by vigilance and common sense. The warning label for CrossFit is a strict adherence to our charter: mechanics first, consistency with those mechanics and then intensity. Highly fit athletes are not immune to rhabdo, however increased work capacity is an excellent prophylactic measure.

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4 Comments on “Killer Workouts”

1

wrote …

Eugene,

After several 16-hour days of intense exercise, dehydration, and illness while conducting military hand-to-hand combat drills I was hospitalized for 10 days with kidney failure which led to liver failure and heart problems. Doctors pumped me full of fluids and eventually my kidneys kicked back in, however, doctors were never able to determine what I actually suffered from. Until reading your article, it had been a mystery. I have suffered from similar, though less severe symptoms since and was wondering if a person who has fallen victim to Rhabdomyolysis is more predisposed to suffering from it again?

Matt

2

wrote …

hey i read your article and found it verry interesting and i wondering if a person that works out with intensive training pretty much every day could develop this problum or is it just in people that make a large jump

3

wrote …

Hey All...

Interesting article. I guess, depending on the circumstances, pushing through one last set may not be the best!

Also very interesting about women being more "protected" from it. My wife gave birth at home (on purpose with no drugs:). I can see that women, because they give birth, biologically being more able to handle extreme exertion without causing complete system shutdown. My wife said, also, that you can choose to stop exercising anytime, but birth just keeps going. I tried to imagine doing 20 burpees every 3 minutes for 7 hours (our first homebirth was 7 hours), and then I start to maybe get a glimpse of the birth. Hmm... Women don't seem to get this... Yeah, I can see why this would be evolution-arily adventagious.

So next time I think I can't make it through another set, I'll have the internal battle of "My wife can give birth, I can do this!" vs "Dude, just quit now, don't end up like the guy in the article!" (I think, at this point, my wife will probably win)

4

wrote …

Matt,
I had a near fatal Heat Stroke while training at Ft. Benning and was found to have the same problem. I had one other later incident and looking back remember vividly both incidents. They were both due to exertional stress, hydration and heat. Since then I have been careful to hydrate and eat well, but have been able to increase my stregnth, stamina and the intensity of my activities workouts (Crossfit and Rugby being my prefered). Key is to watch for the signs, but my doctors all say that I am predisposed to it happening again if I don't pay close attention to my body.

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