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Old 08-17-2008, 11:48 AM   #11
Peter Williams
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Re: How hard do you have to work to get Rhabdo?

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Originally Posted by Ed Haywood View Post
Does age make you more susceptible?

Just wondering, because I've seen thousands of young men intentionally driven to exhaustion and collapse in the military, but never saw "rhabdo". Now all of a sudden you do an extra 2 thrusters and people are shrieking "watch out for rhabdo". I don't mean to downplay the danger, but I wonder if the power of suggestion is making people overly sensitive to a relatively rare hazard. I'd almost call it hysteria, but that is an inflammatory term.
The military is very aware of rhabdo and tends to react well and quickly to providing appropriate and timely treatment for instances of rhabdo - perhaps that is why it isn't heard a lot about publicly. A friend of mine's son-in-law joined the Marines recently and promptly came down with rhabdo - a pretty acute case, it sounds like - and was sidelined for about 6 weeks. His trainers knew what they were dealing with and pulled him out and got him to the hospital quickly, thank God.
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Old 08-17-2008, 08:38 PM   #12
Ben Moskowitz
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Re: How hard do you have to work to get Rhabdo?

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The article states that troops struck with rhabdo are more likely to be from Army and Marine units, that cases tend to occur in the summer, and that blacks and other nonwhite service members are at a higher risk of suffering from the ailment.
http://www.marinecorpstimes.com/news...ssfit_081608w/ (WFS)
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Old 08-18-2008, 07:04 AM   #13
Christian Mason
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Re: How hard do you have to work to get Rhabdo?

I'd propose GHD situps, and jumping pullups as big risk factors.

I think a lot of people here are focusing on the wrong thing. Someone correct me if I'm wrong here, but I believe the rhabo seen in Crossfit is generally due to excessive muscle damage (i.e. grinding out failed reps, negatives, etc.. ) more so than intensity per se.


Eg.

** Doing "Fight Gone Bad" until you puke - probably lower risk. Impact is spread out over most of the body, and the exercises are fairly low weight. Failure tends to be metabolic rather than muscular. The only thing keeping this from being a REALLY bad one is that the exercises in it doesn't focus on the negatives.

** Doing "Linda" as Rxed, when not strong enough, higher risk: Grinding out endless heavy deadlifts and cleans. Stopping on failure only long enough to do one or two more.

** Doing circuits of GDH situps and back entensions:

Put my GF in the hospital on IV fluids for two days. Four months later her core musculature has STILL not recovered.

Last edited by Christian Mason : 08-18-2008 at 07:07 AM.
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Old 08-18-2008, 08:17 AM   #14
Mike Bishop
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Re: How hard do you have to work to get Rhabdo?

Here is the link to the Killer Workouts article. Pretty informative for someone who doesn't know a lot about it like myself.

http://www.crossfit.com/journal/2007...gene_alle.html
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Old 08-19-2008, 12:50 PM   #15
Sean Dunston
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Re: How hard do you have to work to get Rhabdo?

Quote:
Originally Posted by Ed Haywood View Post
Does age make you more susceptible?

Just wondering, because I've seen thousands of young men intentionally driven to exhaustion and collapse in the military, but never saw "rhabdo". Now all of a sudden you do an extra 2 thrusters and people are shrieking "watch out for rhabdo". I don't mean to downplay the danger, but I wonder if the power of suggestion is making people overly sensitive to a relatively rare hazard. I'd almost call it hysteria, but that is an inflammatory term.
I would think this is close to the truth.

At my affiliate, 2 Saturdays ago, we decided to do 2 WODs back-to-back, with exactly 10 minutes rest in between.
First WOD was Fran with chest to bar pullups, and the second WOD was Helen.
Those of us who did the WODs were all tired afterwards -- but no signs of Rhabdo.
My $0.02.

And if "age" does make people more susceptible -- what "age" are we talking about? I'll be 38 next month. But a lot of the members of the Affiliate are in their mid to late 20s. Should the "older" folks be worried, or the younger ones?

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Old 08-29-2008, 01:10 PM   #16
Adam Drake
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Re: How hard do you have to work to get Rhabdo?

As others have said, the likelihood of coming down with rhabdo is dependent on fitness levels and other conditions.

The military is well aware of this and that's why they push hydration so hard in the Marine Corps (I don't know about other branches). If you're continuously hydrating then you greatly decrease the chances of being sidelined with rhabdo although you may still technically have it.

The only really big issue with exertional rhabdo is if it is so serious as to cause hyperkalemia. If this is the case, the heart may cease to function properly and unless care is given ASAP death is certainly possible. The potassium levels in the blood will tend to peak within 12 hours of the event so if you didn't die by then, you probably wont.

The secondary issue is tubular necrosis leading to reduced kidney function and potentially failure. This is a longer-term problem and is where the hydration comes into play. By hyperhydrating you greatly reduce the likelihood that kidney damage will occur. This is the standard treatment in an ER setting although they also include certain types of diuretics and other medications to manage potassium levels. At the same time you must make sure you do not get freaked out that you might have rhabdo and start chugging water like crazy. You will get hyponatremia (low salt levels) which also causes problems with your heart. Standard treatment I've read consists of 1L/hr of fluids but that was under the supervision of ER staff.

SUMMARY:
If you don't die quickly (within 12 hours) from hyperkalemia and you hydrate adequately then you have little risk of having serious issues with rhabdo. It's not uncommon for experienced athletes to have high serum or urine CK levels after intense exercise (so technically having rhabdo) but they will usually remain asymptomatic. If you have extreme pain, swelling, or other issues you would consider out of the ordinary then seek medical attention immediately.

Last edited by Adam Drake : 08-29-2008 at 01:12 PM.
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Old 08-29-2008, 01:18 PM   #17
Sean Dunston
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Re: How hard do you have to work to get Rhabdo?

Quote:
Originally Posted by Adam Drake View Post
As others have said, the likelihood of coming down with rhabdo is dependent on fitness levels and other conditions.

The military is well aware of this and that's why they push hydration so hard in the Marine Corps (I don't know about other branches). If you're continuously hydrating then you greatly decrease the chances of being sidelined with rhabdo although you may still technically have it.

The only really big issue with exertional rhabdo is if it is so serious as to cause hyperkalemia. If this is the case, the heart may cease to function properly and unless care is given ASAP death is certainly possible. The potassium levels in the blood will tend to peak within 12 hours of the event so if you didn't die by then, you probably wont.

The secondary issue is tubular necrosis leading to reduced kidney function and potentially failure. This is a longer-term problem and is where the hydration comes into play. By hyperhydrating you greatly reduce the likelihood that kidney damage will occur. This is the standard treatment in an ER setting although they also include certain types of diuretics and other medications to manage potassium levels. At the same time you must make sure you do not get freaked out that you might have rhabdo and start chugging water like crazy. You will get hyponatremia (low salt levels) which also causes problems with your heart. Standard treatment I've read consists of 1L/hr of fluids but that was under the supervision of ER staff.

SUMMARY:
If you don't die quickly (within 12 hours) from hyperkalemia and you hydrate adequately then you have little risk of having serious issues with rhabdo. It's not uncommon for experienced athletes to have high serum or urine CK levels after intense exercise (so technically having rhabdo) but they will usually remain asymptomatic. If you have extreme pain, swelling, or other issues you would consider out of the ordinary then seek medical attention immediately.
But beware- pushing fluids TOO HARD may result in HYPONATREMIA, which may be as bad as Rhabdo.

wfs
http://www.mayoclinic.com/health/hyp...SECTION=causes
Quote:
Sodium is a key component of your body. It's an electrolyte and helps carry nerve impulses between cells. It helps maintain normal blood pressure, it's essential for your nervous system to accomplish muscle movement, and it regulates the fluids in and around your cells.

Normal blood plasma contains between 136 and 145 milliequivalents per liter (mEq/L) of sodium. Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.

When the sodium levels in your blood become too low, excess water enters your cells causing them to swell. This swelling is especially dangerous to your brain because it's confined by your skull and unable to expand.

Hyponatremia is typically the result of a medical condition that impairs the excretion of water from your body, or the excessive consumption of water.
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Old 08-29-2008, 01:27 PM   #18
Adam Drake
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Re: How hard do you have to work to get Rhabdo?

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Originally Posted by Sean Dunston View Post
But beware- pushing fluids TOO HARD may result in HYPONATREMIA, which may be as bad as Rhabdo.

wfs
http://www.mayoclinic.com/health/hyp...SECTION=causes
Sean, I mentioned that in the paragraph preceding the summary. Thanks for the link and sources though
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Old 08-31-2008, 09:44 PM   #19
Jason Hicks
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Re: How hard do you have to work to get Rhabdo?

I know this really isnt what you are talking about but I have seen a lot of rhabdo in the last few years although not exactly exercise induced. It is fairly common in elderly falls. They fall which causes trauma then struggle to get up for hours with no fluid intake for hours until somebody finds them. The combo of initial trauma, dehydration, and exertion is a recipe for it.

They usually push NS which is isotonic to help prevent the hyponatremia.

Last edited by Jason Hicks : 08-31-2008 at 09:56 PM.
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Old 09-05-2008, 06:54 PM   #20
Ben Chapman
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Re: How hard do you have to work to get Rhabdo?

A trend I've noticed is that it seems to happen a lot when people go high intensity on muscles they aren't used to using. The GHD is a good example of this because you just don't see them very often. People who rarely squat or rarely whatever can still "accomplish" the movements, but since they aren't used to them, the muscles get overworked and rhabdo etc... Just something I've noticed.

It seems to happen alot when someone hits a workout hard they they have little or no previous experience working.
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