We hear the stories of friends, acquaintances or fitness gurus who swear by workouts so intense practitioners vomit or can't move afterwards -- but starting an intense workout regimen could be very dangerous -- and even deadly.
Super intense workouts could lead to a condition known as rhabdomyolysis, which occurs when muscle tissue is injured and releases myoglobin into the bloodstream. That additional protein can often overwhelm the kidneys in their effort to clean out the blood, leading to kidney failure in some extreme cases.
Dr. Steven Chudik, an orthopedic surgeon and sports medicine specialist at Advocate Good Samaritan Hospital in Downers Grove, Ill., says he has seen the syndrome only a few times in his 15-year career, but called it an interesting condition because it can occur both in individuals starting an exercise program or in fit, muscular athletes alike.
"Because it occurs from muscle damage, people new to an exercise program who push themselves too hard or exercise their muscles for extended periods of time, like running a marathon, could develop rhabdomyolysis," he says. "Similarly, in conditioned athletes with large muscle mass, there is more muscle tissue and an increased potential for muscle tissue injury that can cause rhabdomyolysis."
Commonly, symptoms include muscle pain, weakness or trouble moving appendages as well as dark red or brown urine. More serious cases can include shortness of breath, nausea, confusion, dehydration, rapid heart rate, fever, lethargy or unexplained bleeding.
Dr. Chudik says early diagnosis and treatment are keys to successfully treating rhabdomyolysis, though often by the time symptoms are present, the condition requires immediate medical attention, usually including intravenous fluids.
Should patients not get the treatment they need, they can face kidney failure and even death, he says.
To put yourself in the best position to avoid the relatively rare problem, Dr. Chudik recommends drinking adequate fluids and avoiding exercising in extreme heat conditions, while sick or while using alcohol or illegal drugs.
Most of all, he suggests athletes listen to their bodies and exercise and diet in moderation.
"Everyone knows the mantra to always check with your doctor before starting any exercise program or new routine," he says. "With most things in our lives, too much of something can be harmful. Moderation is the key, and research shows it isn't necessary to push yourself to extreme limits to be physically fit. Many orthopedic injuries, overuse injuries or cases of arthritis are the direct result of high volume sports or exercise participation, overactivity and overtraining."