For endurance athletes in extreme conditions: When pushing yourself is pushing yourself too far

PHILADELPHIA (KYW Newsradio) — For her weekly conversation with KYW Newsradio Medical Editor Dr. Brian McDonough, KYW’s Michelle Durham brings a listener email about a rare but important topic: rhabdomyolysis. It's a rare situation where you get muscle injury and your muscles essentially break down. And if it's bad enough, it can be life threatening.

Michelle Durham: The listener’s son experienced this at age 17 after an intense exercise of calisthenics. So please, let's go over what this is, how it occurs, and how we can prevent it.

Dr. Brian: Rhabdomyolysis is a condition where, basically, your muscles break down. They just kind of like really break down fast, and they die. And when that happens, you get these toxic chemicals going into your body that can cause kidney damage.

Now, it is not something that happens easily. Obviously, we're all exercising all the time. We don't get rhabdomyolysis, but if you're extreme exercise, like you know, you have an exercise and then you're just going at it, if you're in a very hot environment, if you get really dehydrated — all of those things can actually cause it to happen. So, it's intense exercise, or a situation where you have some underlying condition or some strange combination of medications — it can put you in that position.

Dr. Brian and Michelle are grateful for all of the listener questions received so far. If you have a question, please e-mail askDrBrian@kywnewsradio.com .

Now, to put it in perspective, it's about 26,000 people a year in the country, so it's not something I'm saying is going to happen to you. But if it does, you have to react quickly.

The symptoms include muscle swelling, really weak muscles, they get really sore. And one of the key things is, when you urinate, it becomes tea-colored or brown, and that's another thing. You start going, ‘Wait a minute, what's going on here?’

What do you do? Well, the first thing you do, I would, in this case, is get medical care, because our best treatment is actually to start giving IV fluids and calming everything down.

So, you know, you're an endurance athlete, you're working somewhere where it's really hot. We sometimes see it in the military who are like, like, they're in boot camp, things like that. Or if you're older, all those people are at greater risk.

So we get them into a situation where we examine them, and then what we pretty much do right away is give fluids, electrolytes, IV — and that helps get those toxins out of your system. And then, once that happens, there's a recovery period, because you're weak, and your basic muscles are weak, so you have to start physical therapy. And in worst-case scenarios, you get a need for dialysis, because the kidneys have gotten that acute shock.

You and I talk about this all the time, about listening to your body, because your body generally tells you what is going on with it, and people need to listen and not ignore and say, Oh, I'm just going to take two Advil and I'll be better in the morning.

Michelle, you're right. And I think the other thing is, people who get this — think about it: You're talking about endurance athletes. So they're, let's say, like a triathlete. They're trained to push themselves at an incredible pace. And sometimes you don't listen to your body, because you think, ‘I'm just tough. I'm going to tough it out.’

It's almost like a person who ignores chest pain and they say, ‘I'm tough. I can wait.’ Sometimes that's the worst thing. So, to your point: Yes, listen to your body. There's nothing wrong with backing down because you don't want to be in that situation.

For parents of high school athletes — and you know what's going through a teenager's mind: ‘Well, if everybody else can do it, why can't I?’ Or ‘I can do it, too, and just push through.’ And I think just that guidance of ‘Some things in life, you can't push through. Some things in life you have to pay attention to.’

And it only takes a second, you know, to get some help. Talk to your coach, talk to an adult, if you're a high school athlete, you know, and say, ‘Hey, I'm not giving up on this, but something weird is happening to my body.’ No right-minded person is going to say, ‘Just get back out there.’ They need to listen and understand. And, fortunately, coaches and others now have been trained much more on those subjects, and maybe 30 years, 40 years ago, they might not have, but now they're acutely aware.