As a follow up to my long, detailed information-post on Rhabdomyolysis, I promised I would write about my own personal experience. I'm treating this post as a complete personal experience thing; this means I am just telling my story and my theories as to how everything went down. I have put three weeks of thought and research into this now and have come up with a ton of thoughts and ideas. I will also preemptively write that I may go down some theoretical rambles about how I work that some people won't relate to; just a warning. My intention here is to be forward and honest as I always am with this blog, and hope that it can help some people out there.
First things first. Not surprisingly, I have received a rather large amount of private messages from my first post about athletes who have gotten rhabdo. The main thing that popped out at me very quickly was that a good deal of these were either other coaches, or athletes who train with groups and such who admitted that it wasn't only them who got it, but a collection of people at the same time. This strengthens my theory that way, way more people get Rhabdo than we thought. Perhaps all those "scary posts" that came out a few months back were actually right!
I need to make something clear here: this does not mean you should be scared, blame CrossFit or some other "governing body" of exercise and sport. It simply means that Rhabdo truly is a common condition that a lot of people will deal with at some time or another. It probably won't kill you, hell, it probably won't even bother you all that much. But, it's better to be educated and smart, then brush it off or lie about it like an ignorant or stupid person. Just accept it, take responsibility for it, learn from it, and move on.
One more point to make (and one I will reiterate at the end of this post) is that Rhabdo is not a selective condition. It does not matter if you are male or female, experienced or a newbie, a CrossFitter or a jogger, anyone can get it. Here is how I would discribe who might get it:
If you do more than your body is prepared for, you put yourself at a very high risk of getting Rhabdo in some degree.
Please read the above sentence a few times so that you can actually understand what I am saying there. That means a person who has never exercised has around the same chance as a very experienced exerciser at getting it. And again, the line of it being very dangerous and not so dangerous is a very fine one. Actually, now that I think about it, an experienced exerciser is going to be more "comfortable" with being really sore and will be more prone to ignoring it, taking a few days off, and just moving on without actually getting that blood work. So I would argue that experienced exercisers actually get Rahbdo more than beginners. Beginners will just tend to get it diagnosed more because of how extreme the soreness feels to them. Make sense? If not, I don't know, just email me or something.
Here's my story.
I am a very experienced exerciser. I played pro baseball, ran 12 marathons, ran a 50-miler, competed in jiu-jitsu, and triathlon, and have placed pretty damn high in a lot of CrossFit events ("competitive fitness events" to use the legally correct term, but I'll use language that the majority actually understands), even getting up to the Regional level three years in a row. So, I am pretty used to pushing my limits on a very regular basis. In fact, My blog started many, many years ago as a sort of journaling of my process to find my own physical limits. It's a major curiosity of mine to see how far I can push myself. I want to challenge myself physically and mentally as much as I can so that I can grow and get better.
So, after missing out on my 4th Regionals appearance last year by 3 spots, I moved to a weightlifting and powerlifting workout program. I didn't stop doing metcon workouts or anything, just toned them back to focus on the barbell. Then about two months ago, the fire was re-lit and I started programming in those crazy CrossFit style workouts to get myself prepared for the Open. I slowly brought in high rep movements, skilled movements that I would only recommend competitive CrossFit athletes do like high rep box jumps, kipping/butterfly pull ups, kipping handstand push ups, and high rep olympic lifts. I wouldn't say I was back to my normal "CrossFit shape" but I was getting there. I was still definitely heavier than I had been while at my higher competitive levels. So I was "in progress" when I programmed a sheer volume workout for myself and my training partner. We were to do 100 each of: wall balls, pull ups, push ups, and dumbbell snatch at 75#.
It was the pull ups that did me in. I could feel my arms tighten up around rep 50. And through the push ups and DB snatch I was having a hard time straightening them out. That night at dinner my training partner and I were joking about how sore we were and how we felt like body builders walking around with our arms bent so much. The next day was much of the same. My arms and lats were swollen, and they were incredibly sore. No discolored urine at any point. I kept drinking a LOT of water, and constantly checked for this symptom. I did a very light KB and TRX mobility focus workout hoping to get the blood flowing and aid recovery, but I actually felt worse after. I then got a massage and things actually felt a little worse after that too. Thursday was the same, and I seriously thought about heading to the hospital. But I talked to a doctor on the phone and chose to hang out another day to see what would happen. Well, Friday actually felt a tad better during the day. But by the late afternoon things just got event worse. My arms were so swollen, incredibly painful, and I really started getting scared. After supporting one of my athletes at a Crossfit event on Saturday, I figured enough is enough, and went to the hospital. Sure enough (and after 6 hours of being in the emergency room dealing with some pretty, um, not smart medical staff) I was admitted with Rhabdo. My tested CPK levels were at 55,000 U/L, and my estimated levels were over 100,000 U/L (they had to dilute it three times after the original "over 25k" reading came out to get that 55k).
So, how did I get this? Well, simply put, I did more than my body could handle at that time. I found a physical limit. I would argue that this was a bit of a "perfect storm" of events that led to this. Looking back, I really don't think I made any form of bad choice in doing the workout. Yes it was a crazy one, but nothing my body wasn't used to, and nothing that actually made me nervous in any possible way. I am confident I was fueled and hydrated sufficiently, and I was more than warmed up seeing as I had just completed my programmed barbell work and was feeling really good physically. So what was wrong?
It was late (around 8:30, and I had not been pushing myself with longer, high intensity workouts all that late at night recently). I was extremely stressed and in a pretty bad mood (as was my training partner). Now, there is no research out there on cortisol levels and their effect on rate of muscle tissue breakdown, but logic tells me they are very closely related. I really would like to help get some science on this! While I had done a good bit of 15-20 minute time domain workouts, this was the first one that had me pushing at a high level, well into the mid 30 minutes. While I had begun to reintroduce the CrossFit style kipping pull ups back into my training, I had done no more than 5 at a time, and no more than 50 in one session before attempting this 100.
I think I was more tired than I thought, the stress had me moving under more tension and less efficiency than I am normally used to. The added body weight made the stress to my body greater. The rusty kipping technique had me controlling the movement more than I normally would, and the length and intensity of the workout added to the breakdown the pull ups caused.
I think that the overly controlled pull ups were the main culprit for all this. While my normal technique on the butterfly pull up allows for very minimal eccentric loading because of the efficiency of the technique, my being rusty actually increased that eccentric loading much more than normal. I would kip, pull myself over the bar, then, when I would normally let momentum and gravity just guide me through extension and back into the kipping concentric portion, I would actually tense up and control my body through the extension. This is literally the form of contraction that tends to lead to something like Rhabdo: high rep, eccentric muscle contractions. Ugh.
I've been through a good number of ups and downs with all this. I take a lot of pride in knowing my own body, and for a while I was mostly embarrassed that this sort of thing could happen to me. Yeah, I just figured that being in respectable shape, having a pretty high level of general fitness, and being healthy would mean I wouldn't be susceptible to something like Rhabdo. But it's clear to me now that it doesn't matter if you are in great shape. It doesn't matter if you feel you are not pushing yourself. It doesn't matter who you are, you are NOT immune to getting hurt or messed up. The fact of the matter is, I am lucky that I know myself well enough to have made the smart choice and went for a blood test. And that is the message I hoped to get across in the last post: if you think you might be in trouble at all, even if it's just a fleeting thought, go get a blood test.
After this will I ever do high intensity work again? Of course! I will spend the rest of my life challenging myself and pushing myself to new limits. And I'll will probably get some bumps and bruises along the way. But this is the way that I choose to live my life because hiding in my room, avoiding risk out of fear of hurting myself is in no way at all the way I want to live. And please, for the love of all that is holy, do not interpret this post or my last post as me trying to tell everyone to be scared of Rhabdo! In fact, it's the other way around! Most of you have probably already had it at one point or another and I'm sure you are mostly fine. I am simply talking about being smart. Know the risks you are getting yourself into. And if you can accept those risks, have fun! Seriously.
I recently asked the question in my gym about what is worse: avoiding things that have potential risk altogether, or, blindly doing anything with no regard for the risk?
I honestly think they are equally bad/stupid/ignorant. Don't live your life avoiding things because you might get hurt. You can literally get hurt doing ANYTHING! And don't be a jackass and just do things without having a clue as to what you are doing. Be smart, know your risks, understand what you are doing, then dive into that challenge with an open mind and open heart. You will learn so much. You will grow so much. I am not upset I got some mild case of Rhabdo, not in the least. It took me out of serious working out for two weeks. Big whoop! I learned SO much about my body, about health and fitness, about hospitals and doctors, and it all helped me grow into a better person than I was a few weeks back. And this happened because I embraced it all.
I hope this posts helps!
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