Two Cases of CrossFit®-Induced Rhabdomyolysis: A Rising Concern

Madhur Rathi

doi:10.5195/ijms.2014.102

Abstract

Background: The author reports the cases of two adult males who presented with severe rhabdomyolysis following identical CrossFit® workouts performed on the same day, at the same time and at the same location. Results: For both cases, symptoms of rhabdomyolysis disappeared upon discontinuation of the regime and within three days of aggressive hydration and rest. Patients made a complete recovery upon discharge. Conclusion: The rhabdomyolysis was attributed to the same excruciating workout both men underwent. Exertion rhabdomyolysis exemplified by the cases presented highlights a rising concern over the health consequences of the popular training program. CrossFit®-induced rhabdomyolysis is underrecognized and should be considered in patients presenting with signs and symptoms of rhabdomyolysis.

Highlights

Extensive information has been published about rhabdomyolysis caused by high-intensity CrossFit® training regimes, and yet the diagnosis of CrossFit®-induced rhabdomyolysis remains underrecognized in the emergency department.[1]
The causal link between rhabdomyolysis and intense workout regimens has been well documented, exercise-induced rhabdomyolysis generally go unreported as very few cases are fatal and most resolve with adequate treatment
The use of supplements among those undergoing CrossFit® training may increase their vulnerability to skeletal muscle breakdown and obscure the diagnosis of rhabdomyolysis

Summary

Introduction

Extensive information has been published about rhabdomyolysis caused by high-intensity CrossFit® training regimes, and yet the diagnosis of CrossFit®-induced rhabdomyolysis remains underrecognized in the emergency department.[1] In rhabdomyolysis, contents of injured muscle cells leak into the circulation, resulting in electrolyte abnormalities, hypovolemia, acidosis and acute renal failure.[1] An Increase in free intracellular calcium triggers activation of proteases, increased skeletal muscle cell contractility, mitochondrial dysfunction, and the production of reactive oxygen species, resulting in skeletal muscle death. Patient had some diarrhea with very dark colored urine and reported feeling nauseous but denied vomiting. Physical examination revealed a pulse rate of 114 beats/minute and a blood pressure of 137/86 mmHg. The remainder of the examination was unremarkable.

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