What is “Rhabdomyolysis?”
A medical condition that might arise from breakdown of muscle tissue and release of muscle cells’ contents into the bloodstream.
What can “Rhabdomyolysis” do to the body?
Damage the kidneys and lead to renal failure or death in rare cases.
How is Rhabdomyolysis” diagnosed?
When a patient with the appropriate history has an elevated level of creatine kinase (also known as CK or CPK) - an enzyme that leaks out damaged muscle.
What is the treatment of “Rhabdomyolysis?”
IV Fluids - to flush out the myoglobin through the kidneys.
In worse cases patients might need dialysis while the kidneys recover.
How can CrossFit trainers protect athletes from “Rhabdomyolysis?”
- Follow the charter of mechanics, consistency, intensity.
- Know the movements that have a higher rate of “rhabdo” incidence (those that prolong the eccentric contraction), and be mindful of the total volume that is programmed with these exercises.
- Scale workouts for clients appropriately.
- Avoid progressive scaling.
- Educate clients on the symptoms and when it’s appropriate to seek medical attention.
- Educate against heavy drinking, esp in proximity to training.
- Educate that certain medications (eg cholesterol lowing agents) can increase risk too.
Explain how to use the “mechanics-consistency-intensity” charter when avoiding rhabdo.
- using slow and gradual increases in intensity and volume to allow the body to acclimatise to high intensity and high volume exercise.
- Treat new athletes on technique over workload, focus on long term fitness.
Name some movements that have a higher rate of incidence of rhabdo.
- Beginners should keep “negatives” to a minimum. (Although they are an effective way to build strength, beginners should not be performing high volumes of them. Look to increase gradually over time.)
- Jumping pull ups
- Full range GHD sit ups (restrict volume and range of sit up, and again increase gradually)
What is “progressively scaling?”
Continually adjusting the difficulty of the workout so that an exhausted athlete can keep moving.
Allow the athlete to stop and take rest as needed to complete the workout.
Name the typical symptoms of “rhabdo.”
- Severe generalised muscle pain
- Nausea and vomiting
- Abdominal cramping
- Dark red/cola-coloured urine (in severe cases).
If these symptoms appear following a workout, the athlete should seek medical attention immediately.
What kind of athletes are at highest risk of Rhabdo incidence?
- those with a baseline level of fitness obtained through some non-CrossFit training
- those returning to CrossFit after a layoff
- experienced CrossFit athletes who reach volume or intensity significantly outside their established “norm.”
Name some risks in the gym associated to to injury.
- Equipment condition
- Use and arrangement of equipment
- Improper spotting during movements
What can a gym owner do to minimise risk of injury in their gym when it comes to equipment?
- If inexperienced owner, please use professional assistance when building pull up rigs, hanging rings, GHD machine, etc.
- Make sure structures such as pull up bar rigs, rings and associated straps are tested at maximum loading before regular client use.
- Regularly scheduled maintenance of all equipment.
What should we think about when looking at “arrangement and use” of equipment to minimise risk of injury?
Each athlete needs enough space to perform the movements, with an additional buffer to account for wandering equipment, missed attempts and safe passage of coaches or other athletes.
What advice can a trainer give to an athlete on their grip to prevent falling?
Use a thumb grip
What does the trainer mean by having a “dry run” of the workout first?
- checking through workout space for each athlete for each proposed movement
- could simply be organising the class to rotate stations on the trainers call, and perform a quick walk-through to check spacing and arrangement.
Why is learning to “bail” important?
Trainers need to teach athletes this skill and allow them to practice it before any significant weight is lifted.
Name the 3 movements where “spotting” is recommended.
- Bench press
- Back squat
- Gymnastic movements
What is “Rhabdomyolysis?”
A rare medical condition that can arise from the breakdown of muscle tissue and release of muscle cell contents into the bloodstream.
This process can damage the kidneys and lead to renal failure or death in rare cases.
What can cause “Rhabdomyolysis” to develop?
High intensity or high volume exercise, including CrossFit or any other process that damages muscle cells.
How is “Rhabdomyolysis” diagnosed?
When a patient with the appropriate history has elevated levels of Creatine Kinase (CK or CPK).
CK is an enzyme that leaks out of damaged muscle.
What is the treatment of “Rhabdomyolysis?”
IV fluids to dilute and flush the myoglobin through the kidneys.
In worst cases, patients might need dialysis whilst their kidneys recover.
Whats are a few ways CrossFit trainers can protect athletes from “Rhabdomyolysis?”
- Follow the charter of mechanics, consistency and intensity.
- Be aware of the movements that have a higher rate of Rhabdomyolysis incidence (those that prolong the eccentric contraction), and think about the total volume that is programmed with these exercises.
- Scale workouts for clients appropriately.
- Avoid progressive scaling so that an exhausted athlete can keep moving. When they need rest, they rest.
- Educate clients on the symptoms.
Name some of the eccentric exercises that have a higher rate of “Rhabdomyolysis” incidence.
Any form of negatives should be kept to a minimum.
The 2 main CrossFit exercises are the “jumping pull up” and full range GHD sit ups.
What can increase the risks of “Rhabdomyolysis?”
Alcohol and drug use, especially along side training.
