October 01, 2005
We warned of rhabdomyolysis in a previous issue (CrossFit Journal 33, May 2005) and return to the topic this month not only to repeat our warning but to share the lessons we’ve since learned about “exertional rhabdo.”
Before the first rhabdo case was brought to our attention, we regularly warned of CrossFit’s potency wherever we had the opportunity. In the January 2005 issue of the journal, we offered the following caution for newcomers tackling the WOD (workout of the day): “Countless bad-asses from sporting and special operations communities, long regarded as bulletproof, have been burned at the stake of ego and intensity.” As it turns out, the burning is rhabdo, and we now find ourselves obligated not just to explain CrossFit’s potency but to warn of its potential lethality.
We can dispense with much medical detail with a quick and easy description of rhabdomyolysis as a potentially lethal systemic meltdown initiated by the kidneys in response to the presence of shed muscle-fiber debris and exhaust in the bloodstream. There are several causes and types of rhabdo, classified by the underlying cause of muscle breakdown. With CrossFit we are dealing with what is known as exertional rhabdomyolysis. It can disable, maim, and even kill.
To date we have seen five cases of exertional rhabdo associated with CrossFit workouts. Each case resulted in the hospitalization of the afflicted. The longest hospital stay was six days, the shortest two days. All have made full recoveries. The hardest hit was extremely sick, the least afflicted had no complaints other than soreness. All were extremely sore. Soreness doesn’t adequately explain the discomfort of rhabdo, however. The worst hit, a SWAT guy, recounts that six days of intravenous morphine drip barely touched the pain.