What Is Rhabdo? How to Prevent This Type of Overtraining

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If you often find yourself working out in hot climates or high-temperature environments, it's crucial to know your limits. Exertion can lead to feeling sick and sore and, in worse case scenarios, a catastrophic event. One such health condition associated with these types of extreme fitness choices is rhabdo.

This health condition is highly complex and sometimes associated with mortality—individuals who tend to work out in tough, hot climates should be aware of the symptoms and safety requirements. At its worst, rhabdo requires a trip to the emergency room.

What is Rhabdo?

Rhabdomyolysis, also known as rhabdo, is a dangerous health condition that causes muscle cells to breakdown and release a protein into the bloodstream. Rhabdo can lead to serious health issues, including permanent disabilities, kidney failure, and sometimes fatality.

Rhabdo occurs when muscle tissue gets damaged; the body then releases proteins and electrolytes into the blood. These substances running through your bloodstream can wreak havoc on your organs, causing system failures.

Risk factors include high heat exposure, physical activity to the point of exertion (also known as exertional rhabdomyolysis), and trauma to muscles.

Signs and Symptoms

Rhabdo has three major symptoms:

  • Dark or tea-colored urine
  • Weak muscles
  • Consistent muscle pain

Causes of Rhabdo

The causes of rhabdo vary; the most common cause is muscle damage from a crushing injury. The condition is also a result of drug and medication use, infections, and overexertion of physical activity that results in electrolyte imbalances (often occurring in high-heat environments).

Statins

In 2012, the US Food and Drug Administration (FDA) issued a notice on the use of statins and the drugs' potential side effects, including muscle pain that can lead to rhabdo.

Trauma

Blunt-force trauma and crush injuries, often from car and motorcycle accidents, can cause trauma-induced rhabdo.

Exercise

Serum CK levels rise after strenuous exercise, up to 10 times the normal amount. This increase could develop into exertional rhabdomyolysis.

Heat Stroke

When the core body temperature exceeds 40.5°C (and remains high), rhabdo can occur.

Muscle Ischemia

Prolonged periods of oxygen deprivation to muscle precipitates rhabdomyolysis.

Infection

Any type of infection, both viral and bacteria, can cause rhabdo.

Treatment for Rhabdo

Rhabdo treatment should be immediate. Emergency care for rhabdo is support-based, with medical professionals centered on managing your airway, breathing, and circulation, as well as taking measures to preserve renal function and rehydrate your body with fluids containing electrolytes.

Hospital stays due to rhabdo can last a few days; if the injury was substantial, a patient could need ongoing physical therapy. After getting released, drinking plenty of fluids and resting can ease someone back to health.

When to Call a Doctor

If you notice dark-colored urine accompanied by muscle weakness, you should seek emergency medical care immediately. Rhabdo is a serious condition that, if left untreated, can lead to devastating results.

Preventing Rhabdo

Although you do not have control over injuries, you can prevent a rhabdo prognosis when working out. If you must work out outdoors in high heat, you can take the following preventative measures:

  • Break your workout up into multiple, short bursts throughout the day
  • Stay out of the sun between 10 a.m. and 3 p.m.
  • Immediately stop if you feel dizzy or nauseous
  • Try water sports, which can keep your core temperature cool
  • Stay hydrated. Rhabo is not caused by dehydration, but you can help prevent it from occurring if you drink enough water.

A Word From Verywell

Rhabdo is a serious condition caused by muscle damage. Although you cannot stop muscle injuries from occurring, you can avoid working out outdoors in high temperatures and putting yourself at risk of such a prognosis. If you or someone you know notices dark-colored urine and muscle pain, seek medical attention right away.

Frequently Asked Questions

  • Who is most at risk for rhabdomyolysis?

    Anyone can be at risk of rhabdomyolysis. You are at higher risk, however, if you work out outdoors in high heat, workout to exertion, have an infection, experience any crushing injury that causes muscle damage (such as a car or motorcycle crash) and/or take statins.

  • Can you have rhabdomyolysis without dark urine?

    You can have rhabdomyolysis without dark urine. You could have one or more of these symptoms: muscle pain, feeling weak or tired, and dark urine and have rhabdo.

  • What are the long-term effects of rhabdomyolysis?

    Most people recover from rhabdomyolysis after treatment. But some will experience ongoing muscle weakness for three to four weeks after injury, and some will even experience acute kidney injury.

7 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Rhabdomyolysis.

  2. Centers for Disease Control and Prevention. Rhabdomyolysis.

  3. Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis: pathogenesis, diagnosis, and treatmentOchsner J. 2015;15(1):58-69.

  4. Candela N, Silva S, Georges B, et al. Short- and long-term renal outcomes following severe rhabdomyolysis: a French multicenter retrospective study of 387 patientsAnn Intensive Care. 2020;10:27. doi:10.1186/s13613-020-0645-1

  5. Centers for Disease Control and Prevention. Rhabdomyolysis.

  6. Penn Medicine. 8 Tips for Working Out in the Heat.

  7. Centers for Disease Control and Prevention. Rhabdomyolysis.

Additional Reading

By Jennifer Purdie, M.Ed
Jennifer Purdie, M.Ed, is a certified personal trainer, freelance writer, and author of "Growth Mindset for Athletes, Coaches and Trainers."