Exertional rhabdomyolysis, a dangerous medical condition caused by extreme physical exertion, is on the rise as high-intensity workouts gain popularity, according to The Guardian.
The condition occurs when muscle cell contents rupture and enter the bloodstream, potentially overwhelming and damaging the kidneys.
Doctors diagnose exertional rhabdomyolysis through blood tests measuring creatine kinase (CK) levels, typically identifying the condition when levels reach at least 1,000 units per liter.
However, there is little consensus on this threshold.
"The exact number that warrants diagnosis and inpatient treatment varies, with some recent guidelines suggesting amounts as high as 10,000 units," said Dr. Barry Boden, an orthopaedic surgeon at The Orthopaedic Center in Maryland.
In extreme cases, CK counts can skyrocket, requiring aggressive treatment with intravenous (IV) fluids to help the kidneys filter toxins.
While mild cases may be managed with oral hydration at home, medical consultation is critical because mild symptoms do not always correlate with low CK elevation.
Researchers estimate that approximately 10% of patients with exertional rhabdomyolysis develop acute kidney injury (AKI) and other severe complications.
Data indicates a global rise in cases, with increased hospital records in Norway, Australia, the United States, and Canada.
Fitness experts attribute the surge to misuse of hyperintense exercise routines that combine strength and endurance without proper conditioning.
"Anybody can get it – anybody that’s pushed to an extreme, taking a big jump in their exercise level, or doing something they’re not used to doing," said Boden.
Boden authored a study estimating over 40,000 exertional rhabdomyolysis hospitalizations in the United States between 2000 and 2019, though true numbers are likely under-reported.
Under-reporting occurs because primary symptoms closely resemble delayed onset muscle soreness, leading individuals to mistake severe injury for normal post-workout ache.
Prevention Strategies and Identifying Overexertion
Medical experts emphasize that preventing muscle cellular breakdown requires varying exercises, incorporating adequate rest, and gradually building intensity.
Repetitive calisthenics and eccentric exercises, such as push-ups where muscles lengthen under tension, carry the highest statistical risk for muscle injury.
"It’s that hyperintense going from zero to 100, really intense workouts of large muscle groups, that puts people at risk," said Dr. Bryant Walrod, a sports medicine physician and head team physician for the Ohio State Buckeyes.
Sports medicine physicians advise stopping exercise immediately if unusual pain or extreme weakness occurs during a workout.
"You know your body the best, and if you feel like something isn’t right, it’s time to speak up," said Walrod.
