Be careful when exercising! Rhabdomyolysis is very painful

This is the 3338th article of Da Yi Xiao Hu

35-year-old Xiao Zhang came to the emergency department of the hospital today in a sports suit. Because he was going to have a blind date next week, Xiao Zhang was not very satisfied with his weight, so he made a "devil" weight loss plan for himself. He stayed in the gym for two days and weekends to exercise crazily, but today he felt weak in his limbs and muscle soreness during exercise. Because he had soy sauce-colored urine again, he hurried to the hospital. After the nurse asked about his condition, he immediately arranged for him to go to the emergency room. The doctor told him that this was most likely rhabdomyolysis and he had to complete the examination and treatment as soon as possible. Xiao Zhang was shocked after hearing this.

So what is rhabdomyolysis?

This is a clinical syndrome in which skeletal muscle is destroyed or disintegrated due to various reasons including excessive exercise, muscle crush injury, extreme body temperature, metabolic disorder or poisoning, and a large amount of intracellular components such as myoglobin and creatine kinase enter the extracellular fluid and blood circulation, causing the human body's internal environment to be disturbed, thus leading to acute kidney injury.

Its clinical manifestations include muscle pain, tenderness, swelling and weakness, as well as fever, general fatigue, increased white blood cell and (or) neutrophil ratio and other inflammatory response. Urine appearance: brown or red wine-colored urine. About 30% of this disease will develop acute renal failure. When the acute renal failure is severe, oliguria, anuria and other azotemia symptoms may be seen.

How is rhabdomyolysis treated?

The treatment of this disease focuses on early rehydration, restoration of blood volume, alkalinization of urine, and protection of renal function. Patients with mild symptoms can recover on their own after a few days of rest and rehydration. Patients with severe symptoms may develop acute renal failure and should undergo early blood purification and continuous renal replacement therapy, which can significantly improve survival rates.

How to avoid rhabdomyolysis while exercising?

First of all, avoid high-intensity exercise. Take it step by step, especially for those who are new to fitness. It is best to develop a fitness plan that suits you under the guidance of a professional. The difficulty of exercise increases from low to high, and the time increases from short to long. Warm up fully before exercise, and avoid high-intensity training in hot and humid weather and environment; replenish water and electrolytes in time during exercise to help the kidneys excrete metabolic waste. If you feel unwell, you need to rest immediately. If you experience muscle tenderness, swelling and weakness, and changes in urine color, go to the emergency department of a nearby hospital for medical treatment.

Author: Zheng Ting, Emergency Department, Shanghai Sixth People's Hospital