I got a jump start on my New Year’s fitness goal a few years ago with a killer workout on New Year’s Eve. And when I say killer, I mean that literally.
My fitness goal for the year was a kettlebell trifecta called Iron Maiden that included a weighted pull-up with a 24 kg (about 53 pounds) kettlebell attached to a belt. That was about half my body weight, so to reach this lofty goal I’d have to push hard to increase upper body strength beyond what a couple years of powerlifting had already built.
So, freshly back from a holiday travel break, I hit the gym with a personal trainer where I did pull-ups until I couldn’t do another. Then he spotted me till I had nothing left. Then more work on machines and with dumbbells until my arms wouldn’t straighten. “What a great workout!” I thought later when I couldn’t maneuver my arms to put my coat on.
The pain struck that night, like a charlie horse in my bicep. The following day I still couldn’t move my arms, and the next day my left arm looked like a giant sausage. When I took to Facebook the following morning to describe the situation a fellow lifting friend warned me it could be rhabdo, shorthand for exercise-induced rhabdomyolysis.
Sure enough, when I got to my sports doctor shortly after this frightening warning (this was not my first sports injury so he was basically on speed dial), it was straight to the hospital after testing revealed that I indeed had rhabdo.
To failure and beyond
From one non-scientist fitness enthusiast to another, here’s what happened: In a healthy workout, muscles get micro-tears and release small amounts of a toxic protein called myoglobin that passes through your system harmlessly. Your muscles rebuild the damage during recovery and grow stronger.
“When we strength train we’re putting our body under stress but it’s calculated, and done in a systematic way,” explained physical therapist Erika Mundinger, an independent contract PT strength coach for The Movement Minneapolis.
But, in a workout that pushes too far, going beyond failure, “you are dumping toxins into the system … and your body can’t keep up with filtering,” Mundinger said. The resulting increase in the enzyme creatine kinase (CK) is too much for your kidneys and liver, and they can shut down.
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When my physician tested my CK levels the number was above 40,000 — about 400 times higher than normal. I was fit, healthy and in my 30s and he told me I faced liver damage, danger of seizing, acute renal kidney failure and heart attack.
The elevated CK is not the only danger though, because meanwhile your body is “moving stuff in to help flush the waste out,” Mundinger said. With so much “stuff pouring out of cells because they’re damaged,” fluid can’t move out of the area. That creates massive swelling which “can almost suffocate the muscles and that’s where you get necrosis,” she said. And indeed, by the time I got to my doctor the muscles in my arm were necrotic —dead.
I turned out to be lucky. Staying in a hospital bed with my arm suspended overhead reduced the swelling, and nine days of carefully calibrated intravenous fluids reduced the CK levels enough to let me return home to heal and begin a long, slow rehabilitation process. Scared straight, I dropped my ambitious fitness goal (and the trainer).