Rhabdomyolysis: Causes, Signs, Symptoms, Diagnosis & Treatment
In this video we explain the causes, symptoms, investigations, diagnosis and treatment of Rhabdomyolysis. We use simple explanations and diagrams that are easy to understand, aimed at helping medical students and healthcare professionals of all levels.
Timestamps:
00:21 - Causes
03:49 - Signs & Symptoms
06:07 - Investigations
07:23 - Diagnosis
09:21 - Management
10:48 - Summary
Rhabdomyolysis is a clinical syndrome where there is a sudden and excessive breakdown of muscle fibre. Causes of rhabdomyolysis can either be traumatic or non-traumatic in origin. Traumatic causes are those that cause direct muscle injury or compromise circulation. Non-traumatic causes are those that cause an inadequate energy supply or inadequate oxygenation of the muscle cell. Rhabdomyolysis can range from an asymptomatic illness to a life threatening condition. Patients may display a triad of symptoms which include muscle pain, muscle weakness and dark coloured urine. A serious complication of Rhabdomyolysis is the development of an acute kidney injury, which will further worsen symptoms. Diagnosis is made based on laboratory results, with creatine kinase levels being the most clinically useful. Treatment is aimed at managing the underlying cause, preventing an acute kidney injury, correcting fluid abnormalities and correcting electrolyte imbalances.
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Although this video is designed to provide education, it should not be used to guide clinical practice, treatment or medical decision making. These videos are designed to provide a detailed overview of each topic, and although a lot of research goes into each video errors can occur and medical practice, medical information and protocols may change over time, which is why it is important to follow local and national guidelines. These videos do not constitute medical advice, medical advice should be obtained from an appropriate healthcare provider or senior clinician.
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Hey guys. I had rhabdo back in 2019. I had obtained this job that had a fitness test as part of the onboarding. On my first day of training I had to jog up and down built in cement bleachers at a football stadium. I barely made it to the quarter mark until my legs finally gave out. I had proceeded with the other training for the next 2-3 days . On the 3rd day I was in such agony pain. I gave it my all for this job with only 3 days of intense training. At this point I couldn't hide the fact I was in a lot of pain. My manager that was training me the whole time said something about it. Right after I completed my training . With the intent to finish my physical on boarding at a later time. He tells me, “congrats man , you completed your training with us!” “ although, I do see you are in some pain stull from the other day. Im really concerned about your health. So you have to have this cleared by your doctor before you can come work with us”. At first, I was actually really proud of myself for completing the straining. But then I realized what was really going on. I knew I wasn’t going to get cleared to work by the doctor. Very discouraged. Later on that day , I remember I was driving with my buddy in the passenger. My legs hurt so bad to the point where I could not use my right leg to drive. I knew at that point I had to go to the hospital. When I had got admitted they find out I have rhabdomyelosis. Extremely puffy thighs , beyond the definition of sore. Although it wasn't until after I got to the hospital my urine turned tea color. Mind you I also have type 1 diabetes. The doctor told me if I had not come in a day later, I could have died.. Took me about a whole week to recover at the hospital. My advice is please be strategic on how you work out and please consider the amount of time you have gone without exercising. I never knew that this could potentially put your life at risk for not taking proper precautions before getting back in shape. Thanks for reading, I hope I helped someone out with my story.
@xXPhYc0t1cXx14
2 жыл бұрын
I had pk levels of 400,000 I was hooked up to a special iv fluid for the whole time .Staying hydrated with alkaline water. Stayed away from protein and sodium.
Who's here after intense workout and scared of the soreness. I literally can't fully extend my left arm due to the pain(stretching helped a bit btw)
@frenchmontana423
3 жыл бұрын
how are you feeling now???!?!?!?! also was it your biceps?? what's the update?
@takezoedits
3 жыл бұрын
@@frenchmontana423 Just as I thought, I overtrained my biceps and couldn't workout with these biceps that sore. Anyways, it was nothing. I would say avoid going too hard or gradually reduce some weight as you fail more and more on each set. Take care :)
@Helloidc
3 жыл бұрын
So it wasn’t rhabdomyolysis? I’m having the same issue and really hoping it’s not rhabdomyolysis
@takezoedits
3 жыл бұрын
@@Helloidc nop it wasn't. Just casual muscle soreness. I didn't work out much so it felt new. Just "ego"-lifted
@6ris168
3 жыл бұрын
@@Helloidc if its still like that now, its rhabdo and if you dont want to go to the hospital and spend the week there, just drink A LOTTT of water everyday like I did, about 3 gallons so you can pee out most of that liquid that destroys your kidneys. Once ur urine doesn’t look like coca cola or brown, take that 6-12 month exercise break and slowly work yourself up again with light weights and i mean light light 15 lbs.
Thank you for this. I’m educating ppl and this session was priceless to listen to. Thank you for what you do!!!!!
@AnimatedMedicine
3 жыл бұрын
Thank you for your feedback Amanda, I’m glad you’ve found the video helpful.
Just what I needed to know. Thanks. Ten years after stopping statins I still have weakness, wasting and pain in many muscles - palpitations, hand and leg cramps and spasms, extreme fatigue and breathlessness with slightest exertion. Vitamins B1 and B12 plus potassium and magnesium are helping me noticeably over the past couple of months. However, I'm still researching to see if I can get further gains. Thank you again.
@billy3650
2 жыл бұрын
How did you get off of statins?
@jennygibbons1258
2 жыл бұрын
Just stop. No tailing off - not necessary despite what people say. Join a F/Book group for statins damage if that’s helpful.
Thanks so much for the videos. Really concise but thorough !
@AnimatedMedicine
3 жыл бұрын
Hi Bec, thank you for taking the time to give some feedback, I’m glad you find them useful.
Nice explanation sir.Thank you.
These are very good please more content
@AnimatedMedicine
3 жыл бұрын
Thank you for your comment, I really appreciate your feedback.
I dont understand i have it from a young boy. Every morning I have to eat well and never skip a meal or water before activity
So I had it and spent 5 days in the hospital. How long does the soreness last?
watching this after experiencing back pain from working out (scared and a bit panicking) but yeah, drinking lots of water too
This happened to me last year couldn’t walk or move for like 3 days and my urine was dark but then went back to normals a few days after . I never went to the doctor because we don’t have insurance, but now I may have too because every time I Work out my muscles swell do you think I should still go to the doctor?
@upnext1392
3 жыл бұрын
most definitely, you should take your health seriously
@TheWeavarBrothers
3 жыл бұрын
I had this a few days ago. After a intense full body workout over 2 days, after not being in the gym of 6 years. I was is hospital for 3 days on a drip. My CK level was 260,000 (yes i said 260,000) it’s now 24,000 when it should be 300. I’m now out of hospital and they advised me to drink a lot water to flush out the CK in my system. They said to drink 3 litres of water a days and I’ve been going for blood test checkups every 3 days to see if my CK level continues to decrease. I would advise drink a lot water. 2-3 litres a day.
@TheWeavarBrothers
3 жыл бұрын
The main advise they gave me was don’t over do it the gym. Gradually build up your body to handle intense workout sessions. And if you do an intense workout session, drink a lot water 3-4 litres, before, during and after your session (the amount of water you should drink depends on your body and weight. You can learn how much you should be drinking online) They said everyones creatine kinase level raises when going to the gym, which can’t be avoided. They said you have to stay hydrated to flush out the CK as the muscle is breaking down after a workout session to avoid stressing the kidneys.
@6ris168
3 жыл бұрын
Drink a lot of water dude and I mean a lotttt, and pee a lot, then start from very low weights and work yourself up slowwwly ,it should fix it, if it doesn’t go to a doctor
I have hypokalemia or my mom does.....and I have an addiction to methamphetamines and my body is suffering from severe body odors of any and every kind....no one likes me and I feel so terrible and awful when I use...but the addiction is strong enough I have been having a hard time quitting ...why do I develope overpowering body odor to these extremes
As a paramedic in the event I have a patient that I have sizes symptoms and suspect rhabdomyolysis should I consider the possibility of transporting such a patient to a elevated trauma center as opposed to a general local emergency department? Of course follow my protocols or consulting with my local medical control to make such a request?
I’m sure this is what i have i get severe cramps in my chest and side off my body that are so painful sometimes i just want to die, I’m always tired and get swellings around the bottom off my legs am always desperate for a wee but when i go i don’t wee a lot and have a fatty Kidney. I take statin’s also Amlodipine for high blood pressure and work with health and safety clothing so my body get’s hot a lot off the time. The one thing that makes me think it might not be this is iv’e had this for quite a few years now especially the severe body cramps
Now I do 28 push-ups a day, not 140. And none of my sets are “To failure” now. Forget it! I’m not losing my kidneys over this! I’m sixty years old, by the way.
@MeeJunksEavy
Ай бұрын
Don't think a nerdly 140 push-ups will put you in a high-risk factor for rhabdo. How did you land on 28 reps 😂. No pain...
Had it back in 2016 spent 3 weeks in the hospital started off thinking that I dislocated my shoulder working out by the time that I got upstairs from the er it had already started spreading to my kidneys it sucks
Just got home from the gym, first time I've been in at least 5 years, couldn't lift my arms after, just went pee and it was pretty much black, also got a little fever, I've also been drinking cranberry and raspberry juice all day but I don't think that causes change in pee colour, should I go to hospital? It's 3 in the morning so not a lot I can do right now, Im also on the tail end of an addiction to crack heroin and alcohol and thought my kidneys were damaged anyway for many reasons, can someone let me know please who's been through it thanks
Please do the things I’m listing
High voltage or heat stroke. If you worked in a storage unit for 8 hours a day that felt like a sauna. Could that have caused Rhabdomyolysis? The other thing I did was not run for over 10 years and try to train for marathon within a week of training is when I was diagnosed. Still trying to figure it out. Seems like the doctors don't have an answer yet of why this happen or why my CK Level keeps going up!! Schedule for Bone biopsy next month 😪
Please do stemi
I'm so sad and so alone please help me understand how to fix this. Is it positive potassium ions or ???
@cherylm2C6671
2 ай бұрын
Bananas, potatoes, do nothing excessively.
@janaenae1338
2 ай бұрын
@@cherylm2C6671 ? is this real advice or is this sarcasm I'm literally unsure
Please address the new rhabdo created by covid.
I really need advice , I’ve been out the hospital for at least a month now but I still feel week in my legs and the soreness only gets bad when I lay down . Me getting this was because of drug induced . I don’t know what to do where it actually annoys me at night and not being able to walk property up and down stairs like my balance is not there . I’m ready to fall if I don’t try
@anniecrowther8423
5 ай бұрын
How are you now?
Spinal cord injury
nice vid
I ended up getting rhabdomyolosis about a year ago. And it was all because I did two and a half months in jail with covid so there was no rec center. Got out of jail, with no vehicle, and had to walk 12 miles to a hotel for the night. So two days later after the whole time my legs being extremely sore and weak. I take a shower everything's fine, I get out go to put my socks on and realize that my feet were almost one and a half times their original size. I thought no big deal it's just from walking too much it'll go away. So two more days and I start noticing I haven't urinated in over 48 hours. And I started getting kidney pain. So I go to the hospital and they do blood work. And it turns out my CK level was over 10,000. So they admitted me and I was on constant IV fluids for a little over 3 days until I can finally urinate a decent color urine. So a piece of advice to anybody that does even a month in jail where you can't move around as much because a covid. When you get out do not over exert yourself in any way. You can end up going into kidney failure like I almost did
@BigB36024
2 жыл бұрын
I apologize I forgot to mention two more symptoms that went unnoticed until I was diagnosed. I didn't realize I couldn't think straight. And I was sweating profusely Non-Stop
Pelvis and long bone fractures
Head injury - icp - causing triad
Does Rhabdomyolysis elevate AST and ALT levels?
@AnimatedMedicine
3 жыл бұрын
Hi Lann, thanks for your comment, this is an excellent question. We consider AST & ALT to be liver enzymes that are released during hepatic injury, but actually AST is found in abundance within skeletal muscle and ALT is also found in skeletal muscle but in much smaller quantities. Because of this, elevated AST levels are a common finding in Rhabdomyolysis, ALT levels may also be raised but this is a less common finding due to the small quantities that exist in skeletal muscle. When AST levels are raised without a raise in ALT levels then this would suggest that the cause is extrahepatic such as muscle breakdown. The only exception to this would be if the cause of the Rhabdomyolysis also caused hepatic injury such as the use of Statins or other hepatotoxic drugs. I hope this answers your question.
@AnimeTechs
3 жыл бұрын
@@AnimatedMedicine Thanks for your response. I’ve been researching my condition while I am undergoing treatment. Great informative video by the way
Stroke
is ACUTE KIDNEY INJURY detected by URINALYSIS?? or is there an ABNORMAL RESULT IN URINALYSIS when you have ACUTE KIDNEY INJURY?
@AnimatedMedicine
3 жыл бұрын
Hi Carlo, thank you for your question. Acute kidney injury is diagnosed if serum creatinine rises by 0.3 milligrams per decilitre or more in 48 hours or rises by at least 1 and half times its normal value in 7 days, this is because we know that creatinine levels are a direct reflection on kidney function. We can also diagnose AKI if urine output is less than 0.5 millilitres per kilogram per hour as this is not enough to remove harmful waste products. Urinalysis may show Urinary casts, which are tiny tube-shaped particles that can be found under the microscope during urinalysis. Urinary casts may be made up of white blood cells, red blood cells, kidney cells, or substances such as protein or fat and will assist in diagnosing intra-renal disease as this is where the urinary casts are formed. I hope this answers your question.
@carlojayjavier1378
3 жыл бұрын
My Urinalysis is Normal and my Creatinine is normal also but my Urine not my urine in the past that i always urinate but now only few times
@madgamerbtr7375
3 жыл бұрын
@@carlojayjavier1378 me too
Fractures
Can vitamin e help significantly reduce the risk? Vitamin e is known to be crucial in muscle health. Yet it's not fully understood why, but hypothesis goes into making cell membranes more flexible, more stable and preventing oxidation... Cell membranes have a hard time repairing when antioxidants are not present, and vitamin e is one of the few antioxidants that can fit perfectly into cell membranes. It's known that when vitamin e is present cell membranes heal rapidly after exercise, and if deficient it can cause muscle wasting diseases. Would this all be enough to reduce the risk of rhabdomyolysis significantly?
@AnimatedMedicine
3 жыл бұрын
Hi Chris, thank you for taking the time to post this excellent question. I can’t find any evidence that supports that Vitamin E reduces the risk of someone developing Rhabdomyolysis and this is likely due to the point you made, it is not well understood. I’m not sure if the role Vitamin E plays in muscle recovery after exercise would be applicable to the pathological process of cell rupture and death but this is a very interesting point and perhaps more research and evidence will be conducted. I’m sorry I couldn’t answer your question, thank you for taking the time to comment.
@Chris-dy5fy
3 жыл бұрын
@@AnimatedMedicine Vitamin E has long known as a powerful antioxidant, and now scientists have shown that without it, the plasma membrane, which essentially keeps a cell from spilling its contents and controls what moves in and out, cannot properly heal.Part of how we build muscle is a more natural tearing and repair process -- that is the no pain, no gain portion -- but if that repair doesn't occur, what you get is muscle cell death. If that occurs over a long period of time, what you get is muscle-wasting disease," said McNeil.They found vitamin E-deficient rats were generally deficient in their running ability compared with controls and made significantly more visits to a grid, despite the fact that they received a mild electric shock when they stood there. The scientists also administered a dye that could not permeate an intact plasma membrane and found it easily penetrated the muscle cells of vitamin E-deficient rats. McNeil notes that a healthy cell makes a patch within a minute and has completely restored the cell membrane within a few minutes. Later examination of the quadriceps muscle fibers under a microscope showed rats fed normal chow or chow where vitamin E had been restored were essentially the same. The large thigh muscle fibers in rats fed vitamin E-deficient chow were smaller and inflamed.-science daily
@Chris-dy5fy
3 жыл бұрын
So if the inability for a plasma membrane to heal can cause muscle cell death, vitamin e should be somewhat protective but to what degree is an interesting question. As a side note when I started working a physically demanding job I experienced muscle weakness. I heard from Dr eric berg that vitamin e helps a lot, so I started eating more nuts and seeds, and my muscle weakness disappeared. I soon not only worked this job well, but also weight lifted on top of that. I even did nucleus overload training and never got rhabdomyolysis, I didn't even get basic post workout soreness. However I've recently started going heavier on my weights, which u shouldn't do nucleus overload with, and do experience some mild soreness and do need more rest.
I recently had this and my creatine kinase level was 50'000!!
@JohnnyJayVisuals
2 жыл бұрын
Mines was 125,000
@tiradom.7918
2 жыл бұрын
Mine is 30,000
@freshtoast3879
2 жыл бұрын
@@JohnnyJayVisuals did you lose the limb?
@justincruz5057
2 жыл бұрын
Im feeling soreness in my knees and thighs what did you do to pass this phase . I’ve been out the hospital for a month or so now but still struggle to walk or go up and down stair
Well definitely I guess one of the new causes is Covid so I was diagnosed with Covid was really sick at home then when I started to feel better I was shortness of breath dizziness end up being hospitalized and find out that I have Rhabdomyolysis there’s no other reason but Covid on my end
@wastenotime27
2 жыл бұрын
How long did it take to recover?
@re9473
2 жыл бұрын
@@wastenotime27 I was in the hospital for three weeks I’m 32 years old healthy so I was so surprised I end up finding out I had Covid on 14 December and I was taking my behind for two weeks and then it was difficult for me to sleep and I was waking up as well from Being out of breath felt like I couldn’t breathe woke up like I was running track went to the hospital end up being there for two weeks still have short of breath literally have an appointment next week for more bloodwork to make sure everything is back to normal my CK level was 4500 Normal level I believe is between 30 and 300
@wastenotime27
2 жыл бұрын
@@re9473 wow. Thanks for responding 😀 I tested positive for covid-19 too. My legs felt like I been squatting for a few days. I could barely put on my shoes; it was painful evey time i reach for my toes. I came to the hospital and been hooked up to the iv for 3 days now.
@re9473
2 жыл бұрын
@@wastenotime27 wow well definitely hope you feel better I was on an IV fluid for that period of time in the hospital believe it or not being short of breath still bothers me I don’t have asthma but they prescribe me an inhaler to help just make sure when you get out the hospital get lots of blood work done and make sure everything is working like it supposed to hopefully it is and you recover soon 🙏🙏🙏🙏 But I know three other people that got Covid and it’s been affecting their kidneys did you ask them what is your CK level
Hey what’s your name ! I’m looking to cite this video in my paper
@AnimatedMedicine
3 жыл бұрын
Hi Marissa, thank you for your comment and I am glad you found the video helpful. Is there anything in particular you wish to cite? All our videos are evidence based and use a wide range of resources, so I would be more than happy to give you the original references to cite.
@marissacompolongo1262
3 жыл бұрын
@@AnimatedMedicine I’m specifically siting this video and would love to complete the citation with an author(s) name, whoever was involved with the making of this video would be deeply appreciated. Thanks !
@nccoach32
2 жыл бұрын
Where was this peer reviewed? I would like to see the sources before sharing. Great information
Yip, finally got my Rhabdo badge. Have exercised before that i know why the Trex was probably an angry dinosaur. First time having coke coloured pee. Muscle soreness weirdly is enjoyable untill you cant dress yourself or its a mission to wipe your ass. 😅