Muscle Injury - Rhabdomyolysis

Rhabdomyolysis is different from a muscle strain. A strain is essentially a stretch injury to the muscle. For more information on strains, please see the strains page.

Rhabdomyolysis is a condition where the muscle proteins enter into the blood stream. Medically, this can be a potentially serious situation that has resulted in kidney failure and has been fatal. If you believe that you have been seriously affected, the only option is to seek immediate physician medical attention.

There are many types or causes of Rhabdomyolysis including crush injuries (really bad bruises), bacterias, parasites, severe diabetes and metabolic disorders. This article is focusing on one type caused by intense muscle activity called Exertional Rhabdomyolysis.

There are 4 main signs to watch out for:

  • 1.Muscle pain. Your muscles will be painful when you work out but this pain shows up differently than normal; perhaps the pain presents earlier, lasts longer, or is more intense than youíre used to.
  • 2.Muscle weakness. If you work out often or are active, then you will generally have an idea of how strong you are and what you can handle. Be aware if you are weaker than usual or muscle fatigue sets in quicker than you expect.
  • 3.Swelling: The affected muscles will appear more swollen than normal.
  • 4.Urine colour: As strange as the topic is, the urine of an affected person will appear to be more brown-ish instead of the expected yellow. This is because of the raw muscle components being filtered out by the kidneys, which is something they are not designed to do.

If you are experiencing these symptoms, please seek immediate physician medical attention.

Because this type of muscle damage was caused by intense exertion, this can be dealt with the same way as with other overuse injuries. Whenever the body is trying to heal from being used to much the first step is rest. Whatever the activity is thatís causing the injury, thatís what needs to be reduced. Some activities cannot be completely ceased until healed, so reducing as much as possible is recommended. The general parameters for healing a muscle or tendon based overuse injury are as follows:

  • 1. Rest Ė reduce the causative activity as much as possible. In severe cases, a full week of immobilization has been found to be beneficial. The body takes 5-7 days to begin to knit back together any severed or ruptured muscle fibres. Activity during that time can increase scar tissue formation and impede full recovery.
  • 2. Hydrate Ė especially with rhabdo, increasing water intake will help to flush out damaged metabolites from the muscles and bring in fresh oxygen and proteins to help the muscle repair
  • 3. Eat Ė One possible reason why the muscles were damaged in the first place is because many people do not eat the correct mix of nutrients and/or the volume of calories that they need. Most people need more than they think they do. Improving your diet will give your body what it needs to properly repair and adapt to the tasks that youíre doing. For more info, see the diet blog post.
  • 4. Rehabilitate Ė Once an injury has healed, it is necessary to rehabilitate with a return-to-work or return-to-sport goal. It is important to understand that the healing process typically results in a weakened muscle. Exercises will be required for both strengthening and stretching of the affected muscles.
  • 5. Return to Normal Ė The only consistent message in the research appears to be to keep challenging the muscle. This means that if you cannot properly lengthen or stretch the muscle, and you canít perform your usual tasks, then you arenít ready yet. There doesnít seem to be a firm consensus in the research regarding standard timelines. This is one reason why itís important to maintain your exercises.

A 2016 study recorded that mechanical compression to injured muscles on mice increased muscle regeneration. The study compared 2 types of compression, an air filled cuff and a magnetic injected gel, against 2 types of control. What they found was that both types of compression had similar effects of increasing the rate of healing. At the end of the study period, the compressed muscle group had contractions that were over 2 times stronger with ~50% larger muscle fibers than the control group that did not receive any treatment. Itís important to note 2 key things before getting too excited:

1) the compressions were ~130g applied 1/second for 5 mins; then again 12h later, for 2 weeks straight. 130g is about the weight of 2 tennis balls or 3 golf balls.

2) The course of treatment isnít exactly plausible for humans, both in scheduling and finances.

Massage therapy can help those afflicted with muscle injuries, including Exertional Rhabomyolysis. If you need help recovering, a general treatment schedule would be 30 mins to the affected area between 1-3/wk for the first 2 weeks, depending on the severity. After the 2 weeks, we should be able to taper off from there.