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Old 02-04-2012, 08:53 PM   #1
Pär Larsson
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Rhabdo, "Cindy"

Just saw my first CrossFit-induced case of rhabdo. 25-ish female ex-college athlete, "Cindy" @ 10min with feet on the wall for supported pullups, which I'm fairly sure turned into eccentric stress. Very sore forearms, now on her second day in the hospital.
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Old 02-05-2012, 08:53 AM   #2
Jeff Metzger
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Re: Rhabdo, "Cindy"

Darn those assisted pullups, they're what did me in too.

Sounds like your friend's case was caught early. She's on an IV for hydration, right?

My Rhabdo was diagnosed four days after the culprit Josh got me and treatment, an IV drip, started soon thereafter. Six days in the hospital later and I expect full recovery with no kidney / liver damage.

All the best for your friend in her recovery,
Jeff
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Old 02-05-2012, 01:43 PM   #3
Pär Larsson
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Re: Rhabdo, "Cindy"

She's on an IV and very bored. Her numbers are coming down and everything should be allright. Nurses told her to go back to her room when she was caught walking the hall and asked her why she was up when she was in her room standing around stretching...

Just a case of too much too soon, too much intensity and not enough ramp-up time.
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Old 02-05-2012, 02:15 PM   #4
Steven Low
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Re: Rhabdo, "Cindy"

Yep, that can do it....

I always think the ex-athletes are at the most risk just because they are used to pushing themselves beyond their limits which is huge when their body is not conditioned to handle it
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Old 02-06-2012, 10:07 PM   #5
Jeff Yan
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Re: Rhabdo, "Cindy"

Steven

Just reread bits of your article on EMI.

I have students do "1/2 Cindy" as part of our on-ramp program (class #1 has Tabata squats and then Tabata push ups, class #2 later in the week has "1/2 Cindy"). I've never known myself of giving newbies rhabdo from prescribing "1/2 Cindy", but I've heard another trainer has done this to first-timers on more than one occasion.

I usually ask my students' athletic backgrounds upon introduction and I'm always keeping an eye out for anybody who's tearing through the rounds with frightening abandon.

Aside from halving the workout to 10 minutes (which wasn't enough to protect Par's colleague), we also have the typical beginner do jumping pull ups with strict emphasis on NO NEGATIVE.

Do you have any further recommendations to make this safer?

Perhaps imposing an 8 round cap in addition to the 10 minute time limit?
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Old 02-07-2012, 01:05 AM   #6
Elizabeth Ruiz
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Re: Rhabdo, "Cindy"

The only case of rhabdo I have ever seen came from a girl doing jumping pullups. She had been crossfitting for over 4 months. It's crazy how important it is to not do the "negative". She did not end up in the hospital. The doctor said she was so consistent on her water intake that it would take care of itself.
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Old 02-07-2012, 08:00 AM   #7
Steven Low
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Re: Rhabdo, "Cindy"

Quote:
Originally Posted by Jeff Yan View Post
Steven

Just reread bits of your article on EMI.

I have students do "1/2 Cindy" as part of our on-ramp program (class #1 has Tabata squats and then Tabata push ups, class #2 later in the week has "1/2 Cindy"). I've never known myself of giving newbies rhabdo from prescribing "1/2 Cindy", but I've heard another trainer has done this to first-timers on more than one occasion.

I usually ask my students' athletic backgrounds upon introduction and I'm always keeping an eye out for anybody who's tearing through the rounds with frightening abandon.

Aside from halving the workout to 10 minutes (which wasn't enough to protect Par's colleague), we also have the typical beginner do jumping pull ups with strict emphasis on NO NEGATIVE.

Do you have any further recommendations to make this safer?

Perhaps imposing an 8 round cap in addition to the 10 minute time limit?
Limiting the negatives sounds like a good idea especially if it's the first time.

As you stated, decreasing Cindy to 10 minutes may not necessarily cut all of the rhabdo risk.

I kind of like the idea of possibly just eliminating AMRAP in set amounts of time for at least the first 2-3 weeks. That should help to decrease the amount of excessive volume.

For the most part, you can still have extremely good workouts with X rounds of Y and Z movements for the first few weeks without overloading new trainees. Plus, with the X rounds you can also throw in a bit of strength work for these people beforehand which is almost an optimal scenario for them as strength is going to be key to getting better faster.

Overall though, with the X rounds of Y,Z movements you pretty much eliminate the excessive volume so you don't need to impose any cap restrictions or no eccentric portion of the exercises. That's why I think this may be better because it gives your clients less things to think about -- and it makes programming on you much easier.

I don't think there's a reason to introduce any type of chipper to these people as well.

I may have to do some revisions to the article given the new information


Okay, updated info

wfs
http://www.eatmoveimprove.com/2010/0...habdomyolysis/
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Last edited by Steven Low; 02-07-2012 at 08:21 AM..
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Old 02-07-2012, 01:12 PM   #8
Sara Lynn Miller
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Re: Rhabdo, "Cindy"

My CK(creatine kinase) levels were 69,000 when I went to the ER.

The attending doctor said he has never seen this high of a number; only in crush injuries, like if you were involved in a car accident.

It was also after doing pull ups.
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Old 02-07-2012, 03:58 PM   #9
Pär Larsson
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Re: Rhabdo, "Cindy"

Changing the jumping pullups in intro-to-Cindy to Burpees should do the trick.
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Old 02-07-2012, 07:45 PM   #10
Steven Low
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Re: Rhabdo, "Cindy"

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Originally Posted by Pär Larsson View Post
Changing the jumping pullups in intro-to-Cindy to Burpees should do the trick.
Haha, clients will hate you for because they're already kinda doing burpees with the squats and pushups
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