Exertional rhabdomyolysis

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Obesity, Sleep & Internal medicine
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Exertional rhabdomyolysis
Synonyms	Exercise-induced rhabdomyolysis
Pronounce	N/A
Specialty	Sports medicine, Emergency medicine
Symptoms	Muscle pain, muscle weakness, swelling, dark urine
Complications	Acute kidney injury, compartment syndrome, electrolyte imbalance
Onset	After intense physical activity
Duration	Varies, can be days to weeks
Types	N/A
Causes	Strenuous exercise, heat stress, dehydration
Risks	Dehydration, genetic predisposition, use of certain medications
Diagnosis	Blood test (elevated creatine kinase), urinalysis
Differential diagnosis	Myositis, muscle strain, heat stroke
Prevention	Adequate hydration, gradual increase in exercise intensity
Treatment	Intravenous fluids, rest, monitoring of kidney function
Medication	N/A
Prognosis	Generally good with prompt treatment
Frequency	Common in athletes and military personnel
Deaths	N/A

Exertional rhabdomyolysis is a medical condition characterized by the breakdown of muscle tissue that leads to the release of muscle fiber contents into the bloodstream. These substances are harmful to the kidney and often cause kidney damage. The condition is triggered by physical activity and is more likely to occur in individuals who engage in extreme or unfamiliar exercise, although it can also affect athletes who push their bodies beyond their limits.

Causes

Exertional rhabdomyolysis can be caused by a variety of factors, including but not limited to:

• Intense physical activity, especially in hot and humid conditions
• A sudden increase in exercise intensity or duration
• Lack of proper conditioning or acclimatization to high-intensity workouts
• Certain medications and supplements, including statins, stimulants, and caffeine
• Genetic predispositions, such as metabolic myopathies or sickle cell trait
• Electrolyte imbalances, particularly low levels of potassium or sodium

Symptoms

Symptoms of exertional rhabdomyolysis include:

• Muscle pain and stiffness
• Muscle weakness
• Dark, tea-colored urine, a result of myoglobin being released into the bloodstream and filtered by the kidneys
• Decreased urine output
• Fatigue
• Fever

Diagnosis

Diagnosis of exertional rhabdomyolysis is primarily based on the presence of clinical symptoms and is confirmed through laboratory tests, including:

• Elevated levels of creatine kinase (CK), an enzyme found in the muscles
• Presence of myoglobin in the urine
• Elevated levels of potassium, phosphorus, and creatinine in the blood
• Abnormal electrolyte levels

Treatment

Treatment for exertional rhabdomyolysis focuses on:

• Immediate cessation of exercise
• Aggressive hydration to flush out the harmful substances from the bloodstream and protect the kidneys
• Monitoring and managing electrolyte imbalances
• In severe cases, dialysis may be required to support kidney function

Prevention

Preventive measures include:

• Gradually increasing the intensity and duration of workouts
• Staying hydrated and maintaining electrolyte balance
• Avoiding exercise in extreme heat and humidity
• Listening to one's body and recognizing the signs of overexertion

Complications

If not treated promptly, exertional rhabdomyolysis can lead to serious complications, including:

• Acute kidney injury
• Electrolyte imbalances leading to cardiac arrhythmia
• Compartment syndrome, a condition where increased pressure within the muscles causes severe pain and potential muscle damage

Exertional_rhabdomyolysis gallery

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  Actin and myosin filament breakdown in rhabdomyolysis

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  Renal tubules affected by exertional rhabdomyolysis

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  Compartment syndrome in muscle

See Also

• Myopathy
• Acute kidney injury
• Electrolyte imbalance
• Compartment syndrome

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