Ease into Exercise to Avoid Dangerous Side Effects

Many of us have a renewed commitment to get ourselves in better shape at the start of a new year, but not taking it slow could put you at an increased risk for a dangerous condition. Richard Figler, M.D., explains.

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CLEVELAND – Many of us find ourselves with a renewed commitment to get into better shape at the start of a new year.

But Richard Figler, M.D., a sports medicine physician at Cleveland Clinic, said it’s important to take it slow, as those who haven’t exercised in a while could be at an increased risk for a dangerous condition, known as rhabdomyolysis.

Rhabdomyolysis is typically caused by a build-up of muscle enzymes and proteins that are excreted by muscle breakdown during the course of exercise.

“Typically, when you exercise, the muscle activity leads to a subtle release of breakdown products including proteins and enzymes into your bloodstream and when it’s a reasonable amount, your body filters them out with no issues whatsoever,” said Dr. Figler. “However, when muscles are injured severely or if there’s significant change in the intensity of exercise or somebody is really pushing themselves and they have a lot of muscle pain and a lot of aches and discomfort, the muscle breaks down more and the enzymes and proteins build up so much that the body can’t process them; they just can’t filter them enough.”

Dr. Figler said muscle soreness after a workout is normal, however, muscle weakness is something to be on the lookout for.

He says typically, when we exercise, the break down and release of enzymes is normal, but when the body can’t absorb them, that’s when a problem arises.

Rhabdomyolysis can interfere with the kidneys’ ability to function, and can cause arrhythmia, cardiac events and even death.

Classic symptoms include severe muscle aches and pains as well as muscle weakness. Another warning sign is dark tea or cola-colored urine.

People who have been sedentary are at the greatest risk, however, Dr. Figler said it can even happen to a person who’s already athletic who tries to push it too far in a workout.

Typical recovery takes about two to eight weeks, depending on the severity of the injury.

Dr. Figler says it’s key to take it slow when beginning an exercise program.

“Get into an exercise program on a gradual basis so you’re not going ‘all out’ in the first couple of activities,” said Dr. Figler. “Progressively get back into exercise if you haven’t exercised in quite a while.”

He said staying well-hydrated can also help avoid any post-exercise complications.

And while rhabdomyolysis is not very common, Dr. Figler said that it can be life-threatening, so it’s important to not ignore the warning signs.

“If you are experiencing symptoms, don’t just start to take some medicine to try to make yourself feel better,” said Dr. Figler. “If you notice dark-colored urine, significant muscle soreness and weakness, get into the emergency department, have your labs checked, and they will determine if you need further treatment like IV fluids to help clear the enzymes faster.”

Dr. Figler said with proper and prompt treatment, most people will make a full recovery from rhabdomyolysis. Once a person has been cleared by a doctor, it’s essential to take a gradual approach to get back into normal activity to keep symptoms from resurfacing.

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