Exercising is important for a lot of reasons and I personally try to stay as physically active as possible. If you follow my blog or social media channels, this post is a little off topic from my usual furniture makeovers and home decor tips. But I want to share with you an experience I had that is very rare and dangerous. I think it is important for people to be aware and I want to add my voice to those who have also shared their stories and are the reason I was able to be diagnosed so quickly. If you exercise, you need to read this. If you are experiencing swelling after an intense workout, it’s possible you need to be checked for rhabdomyolysis. Here is my story.

Just Another Workout

On the morning of Monday, April 2 I completed a workout at my local CrossFit gym (this was my first day back after a three-week hiatus because #life.) Over the next couple of days I experienced intense soreness, which was not unusual. Part of that soreness was pain in the area of the tendon on the inside of my elbow joint any time I would try to straighten it. In fact, I was physically unable to straighten it without using my other hand to force it straight. This in itself was not worrisome as I expected to be intensely sore from the workout I had completed. Intense soreness was not something I was a stranger to. I actually like that feeling of knowing I worked hard and that it will hopefully equal visible results.

By Wednesday evening I noticed my right arm was slightly swollen. The only clue was that it felt a little tight when I tried to bend it. Swelling was something I had never experienced from a workout. My first thought was that I had somehow injured that tendon so badly that it was causing my arm to swell.

So Thursday morning I went to my chiropractor where they offer some therapy-type treatments in addition to your standard chiropractic services. They treated my arm for the inflammation and soreness and told me to ice it later that day. I did so and the ice seemed to help some and made it feel better for a little while. But that night as I was going to bed, I was again baffled at the amount of swelling in my arm and the fact that this had never happened before after a workout.

So I did what most people do these days (and what many will say you should never do) when they have an ailment of some sort – I googled it. I simply typed in “swollen arm after workout.” As I began to read the things that surfaced in that search I began to worry. The topic in every article/blog I read was something called rhabdomyolysis. I had never heard of this before, but everything I read described exactly what I was experiencing. Intense soreness, the inability to straighten my arms, and of course, the swelling.

The super troublesome thing about rhabdo is that it can cause kidney failure and/or death. The only treatment for it is to be admitted to the hospital for IV fluids to flush your kidneys. I debated momentarily about whether I should get out of bed and go to a 24-hour walk-in clinic or the ER right away or wait until morning. Anticipating possible hospitalization, I decided to wait and go the next morning and get one more good night’s sleep in my own bed (I don’t recommend this – I’m just sharing with you my thought process in this experience.)

Friday morning I went to the walk-in clinic first thing. The doctor I saw happened to also be a sports medicine doctor and was familiar with rhabdo. The conversation went something like this:

Doctor: Tell me what seems to be the problem.
Me: I think I might have rhabdo and I would like you to check the cpk level in my blood. (CPK stands for Creatine Phosphokinase. A high level of cpk in your blood indicates muscle injury and puts you at risk for kidney injury/failure.)
Doctor: Have you had rhabdo before?
Me: No. I had never heard of it before I googled it last night because my arm is swollen.
Doctor: Hmmm. Ok. (Imagining a thought bubble above his head that says something like, “Great, you’re one of those self-diagnosers from reading crap on the internet.”) Well, I don’t think that you have rhabdo, but I will check your cpk level to appease the situation. In the meantime, take some Ibuprofen for the inflammation and be sure to drink plenty of water. We’ll call you tomorrow (Saturday) with your blood test results.

At this time in my head I was somewhere between feeling good about having gone to get my blood checked and thinking I was probably overreacting, and still feeling like it was possible I could have rhabdo which could kill me. That same afternoon (Friday) as I’m pulling into the parking lot of my chiropractor’s office where I had already scheduled a follow-up visit for additional treatment to the arm, my phone rings. It’s the doctor from the walk-in clinic. (Remember, he had said he didn’t think I had rhabdo and that he would call the following day.)

Doctor: I was actually very surprised at the cpk level in your blood. (Trying to suppress panic mode in my head, knowing what is coming next.) You DO definitely have rhabdo and you need to go IMMEDIATELY to the nearest hospital and be admitted for IV fluids.
Me: Can you tell me what my cpk level is?
Doctor: Yes, normal level is around 150 and your cpk level is 21,913. Don’t delay. This is very serious and you need to go to a hospital right away to be treated and hopefully prevent any damage to your kidneys.

I Have Rhabdo

At that point I was calm on the outside, but inside I admit I had a full on panic moment thinking this rhabdo I have because of a workout I did is going to kill me. It’s weird the thoughts that cross your mind when you actually think about the possibility of dying. I didn’t allow myself to stay there in my mind for long, because I had to think straight enough to figure out which hospital I needed to go to that my insurance would cover, pack a bag and expect to stay for at least a couple of days (based on what I had read about rhabdo so far), and let my loved ones know what was going on all while actually getting myself to the hospital in a timely manner.

Within a few hours I was being admitted to the hospital that Friday evening with a constant stream of IV fluids in my veins. I have never pee’d so often in my life. (Which is kind of the point. The fluids flush your kidneys to ensure that the muscle proteins being broken down into your blood, which causes the cpk level to rise, don’t get stuck at your kidneys and cause them to be damaged or shut down.) I joked with friends that someone should make a t-shirt that says “EAT. SLEEP. PEE. #ISurvivedRhabdo”.

Progress

The next morning (Saturday) my cpk levels were down to 12,000. Significant progress for which I was very thankful and the doctor also seemed pleased.

By the following morning (Sunday) they were down to 7500. I’ll be honest that I expected a little better progress for that day and the doctor did too. They increased the flow of fluids coursing through my veins that day to speed up the downward trend of my cpk level. I had a sneaking suspicion of at least one reason why the number had not progressed as we all would have liked.

During the night, my IV bag was empty and my night nurse somehow failed to have another one ready to go. She said there were none available on the hospital floor I was on and that she would have to order one. (This was around like 4:30 or 5:00 in the morning so I was pretty groggy, but I remember thinking, “NO!! I NEED to have constant fluids going. That’s the ONLY reason I’m here!”) I knew it would probably take around an hour for her to get one to me if she had to order one so I waited patiently for that amount of time. I couldn’t sleep because I kept thinking I HAVE to get the fluids going again. After an hour passed, I called her to check on the IV bag she was supposed to be getting for me. I don’t know if she had forgotten me or if the bag had just arrived, but she came right away with one and reconnected it to my IV. So I lost at least an hour of fluids that night.

I don’t share that to throw my nurse under the bus, but because it is important for us to know what our treatment plan is for any ailment and to make sure it is being implemented. We are our own best advocates and should not worry about inconveniencing or annoying someone when it comes to our health.

The next day was Monday and by this time I was really hoping my cpk level had come down enough for me to be able to go home. Three days and three nights in a hospital with broken sleep is enough to make anyone wish for their own bed, even though I was so thankful to be getting the treatment I needed. The doctor came in and gave me the good news that my cpk level was now at 3000 and they were discharging me.

Maybe you wonder why they would discharge me when my cpk level is still so high above normal and I asked that question too. The doctor said the important thing at that point was not the number itself, but the downward trend. The fact that the number was decreasing steadily let them know that I was no longer in danger. Also, my kidney function was golden and THAT is the really important part.

Today is day nine post the workout that started it all and day three of being home from the hospital. I still have some swelling in my arm. The doctors say it will take some time for that to completely go away. I can’t really describe to you how tired my arm feels. Even as I type this blog, my arm feels as though I’ve just done the hardest workout of my life and yet I’m only using small motor function to type on my computer. It will definitely take some time for me to get my full strength back, which also makes painting furniture interesting. Ha!

Please note – I AM NOT A DOCTOR. You should always seek the care of your physician if you suspect something is wrong or that you may have this condition. That being said, I can tell you what I have learned from MY doctors about it.

• Females seem to be more susceptible for some reason.
• Workouts that tend to cause rhabdo are not necessarily ones that include heavy weightlifting, but more likely workouts that include a high number of reps of the same exercise (this was true in my case, the workout included 50 pull-ups in a 5 minute span, PLUS an additional workout that included several rounds of push-ups)
• A workout in itself is not bad so don’t be afraid of intense workouts. For me it was a perfect storm of 1) not having been to CrossFit for three weeks prior to that Monday, 2) a high intensity-high repetition workout, 3) dehydration. That combination is apparently a recipe for rhabdo.
• Swelling was the ONLY symptom for me. I did not feel bad in any way and the soreness did not tip me off because as I said before, I am no stranger to intense soreness after a hard workout and expected to feel intense soreness.
• Exercise after rhabdo – I have yet to jump back into exercise at this point. However, I do plan to exercise again and I even plan to go back to CrossFit. My doctors encouraged me to not be afraid to go back to CrossFit, but warned me to be smart. Drink plenty of fluids (something with electrolytes for during and after workouts is preferable). Listen to my body – if I feel tired, stop. Recovery from rhabdo is not the time to push through a workout. Recurrence is definitely possible so I have to be mindful of all the things that led to this bout and not repeat them.

Basically, don’t jump into a high intensity workout if your body is not prepared or used to that type of activity. I was fooled into thinking I was “used to it” simply because I’ve been doing CrossFit for more than two years now. HOWEVER, my body had not been subjected to that type of workout in over three weeks. Even a one-week absence would have warranted easing back in to the workouts. I simply wasn’t being smart that day.

I hope this is helpful to you if you suspect you may have rhabdo or you enjoy high intensity workouts. Please feel free to share your story or thoughts in the comments. I would love to hear from you.

I am not a doctor. Any information in this blog is not intended to diagnose or be a substitute to a doctor’s care and professional opinion. Please always seek the advice of your doctor if you suspect you have a condition that requires medical treatment.

Note: Some links in this post are affiliate links and I receive a small compensation when you purchase product via these 
links. Even though I may be compensated, all opinions are my own. Thank you for supporting my blog!

UPDATE – Saturday, April 21: Thanks to Joe Cannon for commenting on this blog post and introducing me to his book. Joe is an expert in exertion rhabdomyolysis and travels around speaking on the topic to educate personal trainers and gym coaches. I found his book especially helpful regarding recovery from rhabdo as there are so many varying reports out there regarding how to properly resume normal activities and working out. If you’d like to read his book I recommend it and it you can get it on Amazon here: Rhabdo: The Scary Side Effect Of Exercise You Need To Know About.

On Monday, April 16 (one week and three days past my diagnosis) my primary care doctor conducted a follow-up blood test and reported that my levels are now back to normal at 128. It was such a relief to hear that news! It gave me peace of mind that my health is no longer in danger and now I can just focus on getting my arm back to normal.

Today I still have some swelling in my arm. It comes and goes depending upon how much activity I try to do. As of a few days ago, I no longer wake up with it feeling as though I’ve already been lifting a ton of weight with it before I’ve even gotten out of bed. But I can feel that it is still very weak and injured. Small tasks still prove to be difficult. Things like brushing my teeth require a significant amount of effort. A few days ago I was in a hot room and went to fan my face with papers I was holding in my right hand. My body quickly reminded me that arm is not yet capable of handling such a thing that would typically be so simple. Yesterday I spent some time helping out my dear friend who just had a baby last week. I held him as needed (for maybe a total of 20 minutes, he only weighs 8 lbs) and by the end of the day my arm was throbbing and felt achy like when you have growing pains in your legs.

My primary care doctor said I can start working out again in 4-6 weeks. Same for painting. So that’s my plan for now depending upon how things progress. I’ll post an update here when I do decide to resume some more strenuous activities.

Thanks for all your comments on this post. Please feel free to share your own rhabdo story in the comments.