BIRMINGHAM, AL (WBRC) - Losing weight and getting into shape top the list of most popular New Year's resolutions year after year, but trying too hard, too soon, could be deadly.
"Try a class for free and you can get rhabdo for free too," cautioned Dr. Maureen Brogan in a phone interview with WBRC. Brogan, an Associate Professor of Clinical Medicine at New York Medical College, co-authored a recent study in The American Journal of Medicine on spin-class induced Rhabdomyolysis.
This rare but deadly condition occurs when a muscle begins to die and leaks toxic enzymes and proteins into a person's bloodstream. Rhabdo causes extreme muscle pain, swelling and weakness. Patients will also see a change in their urine to a dark tea or cola color as the kidneys become unable to filter the harmful chemicals and start to fail.
It is difficult to get an accurate picture of how common rhabdo is or if the number of cases are increasing because hospitals and doctors are not required to report incidents to their local health departments. There are mandatory reporting requirements for a number of other diseases, but no official numbers for rhabdo in the state of Alabama.
However, Dr. Brogan's study noted 47 cases of rhabdo linked to spinning classes alone. The United States Army estimated about 400 cases among active-duty soldiers in 2012 and also noted their research can be used to reduce injuries among firefighters. In January 2017, three University of Oregon football players were hospitalized following extreme workouts.
"You can look at the statistics and believe it's rare, but depending on the circumstances you can create a perfect storm to bring it on yourself," said Dr. Kennieth McCullough, Jr., an Assistant Professor of Sports Medicine at UAB.
McCullough encourages athletes to listen to their bodies and "start low, go slow," or work up to their fitness goals. He also cautions temperature, hydration status, and certain prescriptions can all contribute to the development of rhabdo.
The prevalence of specialty fitness studios, such as spin studios, CrossFit boxes, or heated high-intensity workouts are linked to higher incidents of rhabdo in several recent medical studies. Doctors around the world have noted the most common factor in their cases is a change in routine, or over-exertion in a new activity.
In fact, Brogan notes it is often her more physically fit patients that develop rhabdo after having only spent a short time at a new class. She encourages fitness class participants to watch out for too much repetitive motion of a muscle, or muscle group, you have not used frequently prior to class.
Consistency is one approach of a multi-faceted effort to reduce the risk of client injuries at Birmingham based Iron Tribe Fitness. In a written statement to WBRC, Kyle Sottung, Iron Tribe's Director of Product Development, noted the importance of a strong relationship between their coaches and clients.
Each Iron Tribe class is staffed with at least one coach for every ten clients. Each coach undergoes an extensive 3-week development process, during which they are trained on the causes, signs, and symptoms of rhabdo, according to Sottung. Moreover, every new client receives that same information when they enroll in an Iron Tribe program.
"Our coaches are constantly helping athletes stay on track with healthy eating habits and drinking enough fluids to allow for challenging workouts," said Sottung. "On multiple occasions, I've seen coaches put the brakes on people who are hungover, haven't eaten enough that day, are dehydrated, or just not ready to train that day - all factors that can contribute to rhabdomyolysis."
"You have to listen to your body," said Dr. McCulllough. "One way to know where you are is to wear a heart rate monitor. Know where your [heart rate is] supposed to be in relationship to your age and how fast your heart is supposed to be beating. If you're over that level, you need to back off what you're doing."
The outcomes for rhabdo patients can range from death to a full-recovery after being flushed with IV fluids. Some patients face electrolyte disorders or require dialysis until their kidneys can recover. Others have needed a surgical procedure, called fasciotomy, to open a muscle compartment, relieve pressure from swelling and allow circulation again to compromised blood vessels and nerves.
"Would you run 9 miles on your first day of jogging? No!" says Brogan. "Don't try to outdo someone else and wait a few days before taking another class if you are new at something."