View Full Version : On-Ramp, Rhabdo and Knowing Better, Oh My!

Ryan Kerian
05-29-2012, 11:21 AM
I'm a 32 year old 167 lb guy who used to be athletic. I ran the 2007 Chicago Marathon in blistering heat, completed the 545-mile AIDS LifeCycle from SF to LA and spent plenty of time lifting weights in years past. The most recent of these was the LifeCycle in 2009.

So I say this: feeling like an athlete and being an athlete are two different things. And, when your most recent athleticism hails back to 2009 you should probably not throw yourself into CrossFit (yes, even an On-Ramp) as if you've busting out an Ironman every few months.

Why do I say this?

I began an On-Ramp course at a local CrossFit affiliate two weeks ago. I'm imagining that we're a pretty typical On-Ramp doing pretty typical things (learning squats, deadlifts, shoulder presses, body exercises, kettlebell movements, etc.). As with most on-ramps, the class is designed to introduce you to the movements and scale up the intensity as you go along. Yet, when you are me, and you think you're still an athlete, you push yourself as hard as you can and ignore the warning signs that your weak upper body can't handle that mentality.

After the first two workouts (Tuesday: for time: 15-12-9 Dumbbell thrusters 10lbs, push-ups, run 200m; Thursday: for time, 3 rounds: 200m run, 20 goblet squats 35lb KB, 10 KB swings 35lb) I lost most of the range of motion in my triceps, couldn't touch my face, struggled to put a shirt on, and barely slept one night because my muscles hurt so badly. Delayed Onset Muscle Soreness (DOMS) I said.

When I came in for another workout the next day on Friday, I told my trainer: "You know, I've been an athlete for most of my life, and I think my arms are way too sore to work them out again today." His response "Is your pee discolored?" to which I replied "No." His response? "Then you're fine and you're working out." That was the answer I wanted to hear, so I worked out again. My muscles seemed to comply and my soreness seemed to lessen over the weekend.

Fast forward to the next week, and another workout on Tuesday and Thursday. Sore, but managing. Loving CrossFit so much that I could barely wait to get in again. Then comes Friday...

Friday morning everything is sore and I'm exhausted. My chest, my triceps, my biceps, my deltoids and my traps are all aching. Why am I so tired today, I wonder? In the afternoon I go to itch my elbow and I realize, I can't feel my elbow. Why? My right arm has swollen with fluid so much that I can barely feel my elbow joint. My left one is swelling as well. I can feel the fluid moving around. It's gross.

This is not normal. This is not good.

I go into the box, and two trainers have no idea what it is. Having read the warnings about Rhabdo I decide a trip to the emergency room to at least get my CK levels tested is probably prudent. As much as I want to work out - I skip the Friday night class to do this. Probably a good idea. I stroll into the ER thinking that I can get a quick test and make it back in time to do the workout if my CK levels are cool. I'm still in denial that I've gone too far.

Initially, the doctor has all sorts of theories as to why my arms look like this, beginning with the coincidental onset of a rare auto-immune disorder that is causing severe muscle swelling. How could it be exertional Rhabdo when he's never seen anything like this before?

Well, sure enough, the CK levels in my blood clock in at 4,800 which is around 12.9 times the maximum reference range (370) for an adult male my age. Luckily my urine was negative for muscle protein, and the CK level while disturbingly high is not high enough to endanger my kidneys. The verdict: localized Rhabdo in my arms.

So, the doctor sends me off with the order not to exercise at all, in any way (he's very adamant about this) for at least 4 weeks. He tells me that the damage I've done is "not normal" and that he's "never seen" because this is generally caused by *trauma* and not exercise. I'm to drink lots of fluids and go in for a repeat blood test a few days later.

Why am I sharing this story? For two reasons.

1) Just because your pee isn't discolored doesn't mean it's a good idea to push yourself past the breaking point by working out again. In this case I knew better and I worked out anyway. I didn't want to be embarrassed that even a on-ramp program was proving too much for my weak arm muscles. I also couldn't admit that I wasn't the athlete that I thought I was. (Note: former endurance athletes tend to push harder as if they're still endurance athletes. Don't let yourself.)

2) Just because your pee isn't discolored doesn't mean you don't have Rhabdo. Yes, once your pee is discolored you almost certainly have Rhabdo and you need to get to a hospital immediately. Yet, as with all things, there are mild cases and severe cases. And, when there are warnings signs (e.g. your muscles are filling up with fluid such that they look like they belong to an flabby 90 year old) it's best to hold back on the next workout and get checked out. No, you aren't going to be happy that you've gone too far and need to take a break. However, you've likely killed muscle in your body. You'll want to live to fight another day.

I don't blame anyone for this but myself. The trainer's view on the matter wasn't exactly nuanced -but- I went against my gut and now I'm out for at least a few weeks. I have to answer to myself first on this one because I really ought to have known better. Tonight, I get to march back into the box and tell my embarrassing tale. I feel like a moron.

Don't be me. Push it hard but listen to your body. Work your way up to a really high intensity level, especially if you're a former athlete used to pushing to extremes. Your body will thank you and you won't put your health at risk. Just my two cents. Be safe out there.

Eric Montgomery
05-29-2012, 12:33 PM
Find another gym. There's dozens of good ones in the Bay Area so there's no need to go back to one where a "trainer" continued to hammer a new client with hard workouts just because your urine wasn't brown. I know you want to take responsibility for your actions, but it's the coach's job to rein in people who want to go too hard too soon.