It's normal to feel sore muscles when you exercise or do strenuous work. We've all experienced it. But if your muscles are swollen, you feel weak, and your urine is discolored, that's not normal. It could be a sign of a dangerous condition called rhabdomyolysis. Although the name may be a little hard to pronounce, knowing about it could save your life.
What is Rhabdomyolysis?
Simply put, rhabdomyolysis is a condition where your muscles are severely damaged and the cells in those muscles break down. Think of it like a small bag breaking open and all the stuff inside comes out. When our muscle cells break down, the stuff inside them goes straight into our bloodstream.
Among the things that accumulate in the blood in this way is a protein called myoglobin . This should normally only be found in the muscles. But in Rhabdomyolysis, a large amount of this myoglobin accumulates in the blood and goes to our kidneys, which clean the blood. When the kidneys are unable to filter such a large amount of protein, the protein gets stuck in the delicate canals of the kidneys and starts causing severe damage to the kidneys . This is the most dangerous aspect of this condition.
This is a serious condition that requires emergency medical attention, so it is very important to be aware of the symptoms.
What are the main symptoms of this condition?
Symptoms of rhabdomyolysis can sometimes start as simple muscle pain. But they are usually severe. These symptoms usually appear within a day or three of muscle damage.
| Symptom | Description |
|---|---|
| Severe muscle pain and swelling | It's a much more severe pain than the normal pain that comes after exercise. It can be so painful that you can't even touch it. The area may also feel swollen and stiff. |
| Muscle weakness | Muscles can become so weak that you can't move an arm or leg, or even walk. This isn't just fatigue. |
| Change in urine color | This is the most obvious and dangerous sign of this disease. The urine turns dark brown, tea-colored, or even cola-colored. This is because the myoglobin protein that has accumulated in the blood is excreted in the urine. |
| Other features | Some people may also experience symptoms such as dehydration, decreased urine output, nausea, and loss of consciousness. |
What are the causes of rhabdomyolysis?
There is not one single cause for this condition, but several factors can contribute to it. Basically, anything that causes severe damage to the muscles can be a cause.
| Reason | A simple explanation |
|---|---|
| Excessive exercise | Imagine that you haven't exercised in a while and suddenly lift a lot of weight or run for miles. Your body can't handle this kind of extreme exertion, which it's not used to, and your muscle cells can break down. |
| Trauma | Things like a car accident, a fall from a height, a crushing injury, severe burns, and electric shock can cause significant damage to the muscles in an instant. |
| Dehydration and high temperature | The risk of muscle cramps increases when the body is dehydrated and overheated. This risk is higher for those who work in the sun or exercise without drinking enough water. |
| Some medications | This condition can also be caused by certain statin drugs, such as those used to lower cholesterol, and some medications for mental illness. However , never stop taking the medication your doctor has prescribed. If you have any doubts, talk to your doctor about it. |
| Staying in the same position for a long time | When an elderly person falls and lies on the ground for hours or days without getting up, the muscles under the weight of the body can become damaged due to reduced blood flow. |
Who is most at risk for this condition?
Although this can happen to anyone, some people are at higher risk.
- Endurance athletes: marathon runners, high-intensity exercisers.
- People who work in hot environments: firefighters, people who work in the construction field.
- Those undergoing military training: During intensive training sessions.
- People over 65 years of age: due to the risk of falls and inability to get up.
How does a doctor diagnose and treat this?
When you go to the hospital with the symptoms mentioned above, the doctor will first ask you about your recent activities and the medications you are taking. Then, they will perform two main tests to confirm the diagnosis.
1. Blood test: This checks the level of an enzyme called creatine kinase (CK) . When muscles are damaged, this CK level becomes very high in the blood.
2. Urine test: This checks for myoglobin in the urine.
Once the disease is diagnosed, treatment begins. The main and most important treatment is to give the body large amounts of saline (IV fluids) through a vein. This is expected to wash away all the toxic substances in the blood and quickly expel them through the kidneys in the urine. This can minimize damage to the kidneys.
If the kidneys are severely damaged, you may need to undergo dialysis to clean the blood.
When should I see a doctor immediately?
This is the most important part of this article. You should be very careful about these features.
If you have unbearable muscle pain, weakness, or swelling a few days after an intense workout or other accident, especially if your urine is dark brown or tea-colored, go to a hospital emergency room (ETU) without delay. This is not a condition that can be treated at home.
How do we reduce this risk?
Although accidents cannot be prevented, there are things we can do to reduce the risk of rhabdomyolysis, especially when it occurs during exercise.
- Start slowly: If you're new to exercise, don't immediately start lifting heavy weights or running a lot. Let your body get used to it gradually.
- Drink plenty of water: Drink plenty of water before, during, and after exercising. Don't let yourself get dehydrated.
- Listen to your body: If you feel unbearable pain or fatigue while exercising, stop and rest. Don't push your body beyond its limits.
- Avoid the heat: Avoid exercising outdoors during extreme heat.
Take-Home Message
- There are two types of muscle soreness that occur after strenuous exercise: Rhabdomyolysis and severe pain, swelling, and weakness. Be aware of these symptoms.
- If your urine turns a dark tea-like color, it's a warning sign of a dangerous condition. Seek medical advice immediately.
- When starting exercise, start at a level that your body can tolerate. Don't put too much strain on your body all at once.
- Avoid dehydration by drinking plenty of water when exercising and in hot environments.
- The sooner this condition is treated, the greater the chance of preventing further damage to the kidneys and making a full recovery.
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