everyone probably equate sore muscles with a great workout.but if the pain you experience is in the first few days after a hard workout gets excruciating it could be a warning that you have a potentially fatal condition known as Rhabdomyolysis or rhabdo for short.this rare condition some times occurs after severe muscle damage and can lead to kidney failure and even heart failure if left untreated .here is some info on this .
It is well known that the muscles most prone to cramping are those that span two joints. These muscles are often contracted in a shortened position during exercise--a fact that seems to confirm the role of inner-range contractions in muscle cramping. Contraction in this state produces decreased tension in the tendons of the muscles as well as decreased Golgi-tendon activity. The best example is a calf-muscle cramp in a swimmer. During swimming, the ankle is maximally plantar flexed as the calf muscle contracts. The tension in the Achilles tendon is decreased compared with the ankle in full dorsiflexion. Golgi-tendon activity is thus decreased in plantar flexion compared with dorsiflexion, resulting in less inhibition of the gastrocnemius alpha motoneurons.
Passive stretching results in almost immediate relief of the cramp and reduction in EMG activity; stretching increases tension in the Achilles tendon and increases Golgi activity (36). This phenomenon is compatible with the hypothesis that abnormal spinal reflex activity is an important etiologic factor in EAMC, and it may account for the increase in nocturnal cramping in athletes who train heavily. Nocturnal cramps may well be due to contractions (perhaps during REM sleep) of the gastrocnemius while in the plantar flexed position.
Athletes usually manifest cramping at or near the end of a bout of intense or prolonged exercise. In the typical clinical history, prodromal muscle pain or twitching usually develops over a few minutes and is preceded by muscle fatigue and twitching (cramp-prone state). The twitching is followed by spasmodic spontaneous contractions and frank muscle cramping if activity is continued. The cramp-prone state is relieved if activity ceases or if the muscle is passively stretched (temporary relief only). Once activity ceases, cramping episodes are usually followed by cramp-free periods. Cramping episodes can be precipitated by contraction of the muscle in a shortened position (inner range).
Definition
Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents into the circulation. Some of these are toxic to the kidney and frequenty result in kidney damage.
Causes, incidence, and risk factors
Myoglobin is an oxygen-binding protein pigment found in the skeletal muscle. When the skeletal muscle is damaged, the myoglobin is released into the bloodstream. It is filtered out of the bloodstream by the kidneys. Myoglobin may occlude the structures of the kidney, causing damage such as acute tubular necrosis or kidney failure.
Myoglobin breaks down into potentially toxic compounds, which will also cause kidney failure. Necrotic (dead tissue) skeletal muscle may cause massive fluid shifts from the bloodstream into the muscle, reducing the relative fluid volume of the body and leading to shock and reduced blood flow to the kidneys.
The disorder may be caused by any condition that results in damage to skeletal muscle, especially trauma.
Risk factors include the following:
Severe exertion such as marathon running or calisthenics
Ischemia or necrosis of the muscles (as may occur with arterial occlusion, deep venous thrombosis, or other conditions)
Seizures
Use or overdose of drugs-especially cocaine, amphetamines, statins, heroin, or PCP
Trauma
Shaking chills
Heat intolerance and/or heatstroke
Alcoholism (with subsequent muscle tremors)
Low phosphate levels
Symptoms
Abnormal urine color (dark, red, or cola colored)
Muscle tenderness
Weakness of the affected muscle(s)
Generalized weakness
Muscle stiffness or aching (myalgia)
Additional symptoms that may be associated with this disease include the following:
Weight gain (unintentional)
Seizures
Joint pain
Fatigue
Signs and tests
An examination reveals tender or damaged skeletal muscles.
A urinalysis may reveal casts and be positive for hemoglobin without evidence of red blood cells on microscopic examination.
A urine myoglobin test is positive.
A serum myoglobin test is positive.
A CPK is very high.
A serum potassium may be very high (potassium is released from cells into the bloodstream when there is cell breakdown).
This disease may also alter the results of the following tests:
Urine creatinine
Serum creatinine
CPK isoenzymes
Treatment
Early and aggressive hydration may prevent complications by rapidly eliminating the myoglobin out of the kidneys. The hydration needs with muscle necrosis may approximate the massive fluid volume needs of a severely burned patient. This may involve intravenous administration of several liters of fluid until the condition stabilizes.
Diuretic medications such as mannitol or furosemide may aid in flushing the pigment out of the kidneys. If the urine output is sufficient, bicarbonate may be given to maintain an alkaline urine state. This helps to prevent the dissociation of myoglobin into toxic compounds.
Hyperkalemia should be treated if present. Kidney failure should be treated as appropriate.
Expectations (prognosis)
The outcome varies depending on the extent of kidney damage incurred.
Complications
Acute tubular necrosis
Acute renal failure
Calling your health care provider
Call your health care provider if symptoms indicate rhabdomyolysis may be present.
Prevention
After any condition that may involve damage to skeletal muscle, hydration should be adequate to dilute the urine and flush the myoglobin out of the kidney.
It is well known that the muscles most prone to cramping are those that span two joints. These muscles are often contracted in a shortened position during exercise--a fact that seems to confirm the role of inner-range contractions in muscle cramping. Contraction in this state produces decreased tension in the tendons of the muscles as well as decreased Golgi-tendon activity. The best example is a calf-muscle cramp in a swimmer. During swimming, the ankle is maximally plantar flexed as the calf muscle contracts. The tension in the Achilles tendon is decreased compared with the ankle in full dorsiflexion. Golgi-tendon activity is thus decreased in plantar flexion compared with dorsiflexion, resulting in less inhibition of the gastrocnemius alpha motoneurons.
Passive stretching results in almost immediate relief of the cramp and reduction in EMG activity; stretching increases tension in the Achilles tendon and increases Golgi activity (36). This phenomenon is compatible with the hypothesis that abnormal spinal reflex activity is an important etiologic factor in EAMC, and it may account for the increase in nocturnal cramping in athletes who train heavily. Nocturnal cramps may well be due to contractions (perhaps during REM sleep) of the gastrocnemius while in the plantar flexed position.
Athletes usually manifest cramping at or near the end of a bout of intense or prolonged exercise. In the typical clinical history, prodromal muscle pain or twitching usually develops over a few minutes and is preceded by muscle fatigue and twitching (cramp-prone state). The twitching is followed by spasmodic spontaneous contractions and frank muscle cramping if activity is continued. The cramp-prone state is relieved if activity ceases or if the muscle is passively stretched (temporary relief only). Once activity ceases, cramping episodes are usually followed by cramp-free periods. Cramping episodes can be precipitated by contraction of the muscle in a shortened position (inner range).
Definition
Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents into the circulation. Some of these are toxic to the kidney and frequenty result in kidney damage.
Causes, incidence, and risk factors
Myoglobin is an oxygen-binding protein pigment found in the skeletal muscle. When the skeletal muscle is damaged, the myoglobin is released into the bloodstream. It is filtered out of the bloodstream by the kidneys. Myoglobin may occlude the structures of the kidney, causing damage such as acute tubular necrosis or kidney failure.
Myoglobin breaks down into potentially toxic compounds, which will also cause kidney failure. Necrotic (dead tissue) skeletal muscle may cause massive fluid shifts from the bloodstream into the muscle, reducing the relative fluid volume of the body and leading to shock and reduced blood flow to the kidneys.
The disorder may be caused by any condition that results in damage to skeletal muscle, especially trauma.
Risk factors include the following:
Severe exertion such as marathon running or calisthenics
Ischemia or necrosis of the muscles (as may occur with arterial occlusion, deep venous thrombosis, or other conditions)
Seizures
Use or overdose of drugs-especially cocaine, amphetamines, statins, heroin, or PCP
Trauma
Shaking chills
Heat intolerance and/or heatstroke
Alcoholism (with subsequent muscle tremors)
Low phosphate levels
Symptoms
Abnormal urine color (dark, red, or cola colored)
Muscle tenderness
Weakness of the affected muscle(s)
Generalized weakness
Muscle stiffness or aching (myalgia)
Additional symptoms that may be associated with this disease include the following:
Weight gain (unintentional)
Seizures
Joint pain
Fatigue
Signs and tests
An examination reveals tender or damaged skeletal muscles.
A urinalysis may reveal casts and be positive for hemoglobin without evidence of red blood cells on microscopic examination.
A urine myoglobin test is positive.
A serum myoglobin test is positive.
A CPK is very high.
A serum potassium may be very high (potassium is released from cells into the bloodstream when there is cell breakdown).
This disease may also alter the results of the following tests:
Urine creatinine
Serum creatinine
CPK isoenzymes
Treatment
Early and aggressive hydration may prevent complications by rapidly eliminating the myoglobin out of the kidneys. The hydration needs with muscle necrosis may approximate the massive fluid volume needs of a severely burned patient. This may involve intravenous administration of several liters of fluid until the condition stabilizes.
Diuretic medications such as mannitol or furosemide may aid in flushing the pigment out of the kidneys. If the urine output is sufficient, bicarbonate may be given to maintain an alkaline urine state. This helps to prevent the dissociation of myoglobin into toxic compounds.
Hyperkalemia should be treated if present. Kidney failure should be treated as appropriate.
Expectations (prognosis)
The outcome varies depending on the extent of kidney damage incurred.
Complications
Acute tubular necrosis
Acute renal failure
Calling your health care provider
Call your health care provider if symptoms indicate rhabdomyolysis may be present.
Prevention
After any condition that may involve damage to skeletal muscle, hydration should be adequate to dilute the urine and flush the myoglobin out of the kidney.