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July 20, 2017

High-intensity workouts can cause rare, life-threatening condition, research shows

Daily Briefing

As individuals increasingly turn to more vigorous workouts, recent research highlights a rare but life-threatening condition that can be triggered by extreme exercise, Anahad O'Connor writes for the New York Times' "Well".

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According to "Well," the condition, called rhabdomyolysis, occurs when muscles die and their contents leak into the bloodstream. The condition places strain on the kidneys and can cause acute pain.

Rhabdomyolysis has long been reported among firefighters, soldiers, and others in physically demanding professions, "Well" reports. For instance, a 2012 study estimated that about 400 cases of rhabdomyolysis are diagnosed annually among active-duty soldiers.

Research highlights prevalence of rhabdomyolysis amid shift to high-intensity exercise

However, physicians say they increasingly are seeing cases of rhabdomyolysis among individuals who partake in high-intensity workouts, such as spinning.

For instance, a 2014 report published by doctors at NewYork-Presbyterian Weill Cornell Medical Center detailed two cases in which patients visited an ED shortly after taking their first spin classes and were diagnosed with rhabdomyolysis. In addition, a study published earlier this year in the American Journal of Medicine identified at least 49 cases of individuals developing rhabdomyolysis while taking spin classes that were documented in medical literature, including 42 cases in which individuals developed the condition after taking their first spin classes.

The condition is prevalent not only among spinners, "Well" reports. A 2016 study highlighted 29 ED visits for rhabdomyolysis at NewYork-Presbyterian among individuals who reported doing workouts such as CrossFit, P90X, running, and weight lifting. Todd Cutler, an internist at the hospital and the study's lead author, said, "These are people who are not unfit," but "are being pushed too hard" and develop "really bad muscle trauma."

Experts identify ways to avoid rhabdomyolysis

Patricia Deuster, a professor of military and emergency medicine at the Uniformed Services University of the Health Sciences in Maryland, said some evidence suggests certain medications—such as antipsychotic drugs, statins, and stimulants—and genetic susceptibilities might contribute to the condition. However, experts say the condition generally occurs because people do not allow their bodies enough time to adjust to new high-intensity exercise programs.

Overall, Alan Coffino, chair of medicine at Northern Westchester Hospital and a co-author of the study published in the American Journal of Medicine earlier this year, said, "I would never discourage exercise."

Eric Rawson—chair of Messiah College's department of health, nutrition, and exercise science—said it is important for individuals to begin with light to moderate exercise before progressing to high-intensity workouts. "You can be fit, and I can come up with a workout that you are unaccustomed to, and that could be what causes [rhabdomyolysis]," he said.

Individuals also should feel empowered to stop exercise programs or inform their trainers if the programs are feeling too difficult. Joe Cannon, an exercise physiologist, said, "One thing I've noticed when people tell me they've gotten [rhabdomyolysis] in the gym is that they gave up their personal power. They kept doing what the instructor told them to do because they did not want to look weak" (O'Connor, "Well," New York Times, 7/17).

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