NEW Year resolutions often involve weight loss and many people sign up for exercise classes at the start of the year to get in shape. But did you know that you could potentially work yourself to death with exercise?
A simple gym class, especially high-intensity ones like spin classes or CrossFit, can be dangerous if the body is pushed too hard, too quickly, or without proper preparation.
Though uncommon, a condition called rhabdomyolysis can happen to newcomers if they push themselves too much without even realising it, says Pantai Hospital Penang consultant internal medicine and nephrologist Dr Darren Lee Kian Guan.
Rhabdomyolysis is a serious and potentially life-threatening condition with different levels of severity.
It is caused by damaged muscle breaking down and releasing their substances from inside the muscle cells into the blood.
One of these important myocyte compounds, called myoglobin, when excessive, can be toxic to the kidneys and may lead to kidney failure if untreated.
"The most common cause of rhabdomyolysis is extreme physical exertion, especially when the body is unaccustomed to high-intensity or prolonged exercise.
"In many cases, rhabdomyolysis results from a combination of factors, like intense exercise in hot weather without adequate hydration, amplifying the risk," explains Dr Lee.
Beyond exercise, other frequent causes include trauma or crush injuries, which physically damage muscle tissues, and medications such as statins, which can cause muscle breakdown as a side effect.
Recognising the symptoms of rhabdomyolysis early is important as prompt treatment can prevent complications, he adds.
The classic triad of complaints is muscle pain, weakness and dark urine.
Severe muscle pain and weakness, especially in larger muscle groups like the thighs, shoulders, or back will be felt and the pain may feel intense and out of proportion to any recent physical activity.
Affected muscles may also appear swollen, tender and feel unusually firm, while dark, "cola-coloured" urine is another symptom. Other symptoms include unusual fatigue, nausea/ vomiting or reduced urination.
"If you experience any combination of these symptoms after intense physical activity, dehydration, or an injury, these are the warning signs and it is essential to seek medical attention immediately," says Dr Lee.
To diagnose rhabdomyolysis, healthcare providers typically conduct a combination of blood and urine tests.
Untreated cases can lead to complications such as kidney failure, heart issues or even life-threatening electrolyte imbalances, therefore immediate care is essential.
If you're diagnosed with rhabdomyolysis, treatment typically focuses on stopping muscle breakdown, protecting kidney function and addressing any complications.
WHO IS AT RISK?
Rhabdomyolysis can affect anyone, but certain groups are at higher risk:
• Those new to high-intensity exercises (like CrossFit, spin classes or marathon training) who push themselves too hard, especially without proper conditioning.
• Dehydration or overheating — dehydration increases the risk because it reduces blood flow to muscles and makes it harder for the kidneys to process toxins.
• Exercising in high temperatures or humidity can also increase the risk as it causes additional strain on muscles and the body.
• Trauma injury, electrical injury, burn and crush injuries which cause extensive muscle damage can lead to severe rhabdomyolysis.
• People on certain medications or illicit drugs — some medications (such as statins, antipsychotics) and illicit drugs (such as cocaine, heroin) can increase the risk of muscle breakdown.
• Infectious and inflammatory causes — certain viral or bacterial infections (such as influenza, parainfluenza and adenovirus) and diseases such as polymyositis or dermatomyositis.
• Individuals with certain health conditions, such as metabolic or genetic muscle disorders, or epilepsy (causing seizures).