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A little over a month ago, my brother texted me that he and his girlfriend were going to his first-ever spin class. Imagining my brother on a stationary bike among a group of (mostly) women pedal-pushing to house music was nothing short of hysterical. He’s the antithesis of a spin class–goer—a semiactive 30-year-old who can eat a family-size Jack in the Box meal with zero shame.
Afterward, he sent me a follow-up message.
“The low point was when the instructor asked ‘Who’s getting brunch after this?’ and everyone cheered. The lower point was when one of the workers offered to take my spin shoes to the box at the end because I was having trouble standing up.”
I figured he’d be a little sore after the class. I’ve only been to one spin class in my entire life and remember my backside hurting the day after from the seat being wedged up in there for the better part of an hour. I tried to go a second time post-brunch but got a little too friendly with the bottomless Bloody Marys and was in no condition to spin, let alone hop on a subway. No wonder my brother’s instructor asked who was getting brunch after the class. Rookie mistake.
What I didn’t expect, however, was just how sore he’d actually end up. As in admitted-to-the-ER sore.
When I found out he’d been in the hospital for a few days because he couldn’t walk, I was in shock. Though at first I had to laugh. Were the doctors having a field day? Young Man Sent to ER After Girlfriend Brings Him to SoulCycle—it’s an Onion article waiting to happen. But then I heard the specifics of his condition—rhabdomyolysis—and they were no laughing matter.
Given the circumstances, I wondered the likelihood of, well, anyone else coming down with this condition. To find out some answers, I spoke with Clifford Stark, DO. Keep reading to learn more about the exercise-induced condition that can be the result of any killer workout.
Meet the Expert
Clifford Stark, DO. is a dual board-certified sports and family medicine doctor in New York, New York. Stark serves as the Program Director for the Northwell Plainview Sports Medicine Fellowship and a member of the teaching faculty at NYU Langone Medical Center as well as being on the team at the US Olympic Training Center.
What Is Rhabdomyolysis?
After strenuous exercise, the skeletal muscle may tear and leak electrolytes and other proteins into the bloodstream, leading to pain, swelling, dark urine, and heightened CPK levels (creatine phosphokinase, an enzyme found in the heart, brain, and skeletal muscle). When these proteins enter the renal tubes, kidney damage can occur. This process is known as rhabdomyolysis. And, frighteningly enough, it can be life-threatening.
Who Can Develop Rhabdomyolysis?
While many people think that rhabdomyolysis only occurs to people who are out of shape, that's not always the case. “Anyone can develop rhabdomyolysis from a spin class, though an untrained individual who progresses too rapidly in his or her workout is at greater risk," Stark says. "The larger the muscle being exercised, the greater the possibility of developing rhabdomyolysis."
It’s also not just spin class that’s the culprit—boot camps and other HIIT workouts also pose a threat. “Many other forms of physical activity can cause rhabdomyolysis, especially if they involve intense, sustained exercise of larger muscle groups," Stark explains. "Spinning involves a sustained, strenuous activity that involves large muscle groups, which can, therefore, release large quantities of toxins into the bloodstream. Also, spinning is an activity that often attracts untrained individuals wanting to get in shape quickly.”
What Are the Symptoms?
NYC-based sports medicine doctor Gerardo Miranda-Comas, MD, says that the top symptoms include muscle pain, limited movement, dark urine, general malaise, feeling sluggish, tired, fatigued, or irritable. While these symptoms can be a momentary result of any workout, if they last for days on end, it could be more than just general exercise fatigue.
Meet the Expert
Gerardo Miranda-Comas, MD. is a board-certified rehabilitation and physical medicine doctor located in New York, New York. Miranda-Comas serves as the Assistant Professor at the Icahn School of Medicine at Mount Sinai and is the Director of the Sports Medicine Fellowship there. He has a sub-specialization in sports medicine.
If you find yourself immobile following a spin class (or any form of exercise), head to a doctor immediately. “One should seek urgent medical attention," Stark says. "Aggressive hydration is crucial with aggressive monitoring of fluid and electrolyte status, regularly assessing kidney function.”
How Is Rhabdomyolysis Treated?
According to Miranda-Comas, it all comes down to rest, hydration and treatment of any of the possible complications: electrolyte disturbances, renal failure, cardiac arrhythmia. Depending on the stage of your rhabdomyolysis, your doctor will be able to advise you on which method to take. Thankfully, in most cases, renal function will return to normal—only four percent of cases require dialysis.
So how do you prevent this from happening in the first place? According to Stark, slow and steady wins the race.
“Make sure to progress slowly and gradually with exercise programs and avoid rapid increases in intensity and/or duration," he explains. "It’s also best to avoid extreme temperatures, especially in association with rigorous and prolonged exercise. Staying well-hydrated is also very important—this is best accomplished by hydrating well in advance of the activity, rather than playing catch-up."
You’ll also need to be conscious of certain medications, which can be a catalyst for the condition. “Many prescription drugs may increase the risk of rhabdomyolysis, including a number of antipsychotics, lithium, SSRIs, HIV medications (like AZT), colchicine, antihistamines, decongestants (like pseudoephedrine), and several others," Stark points out. "It’s important to mention that many dietary supplements, such as those used for weight loss or as ergogenic aids, which often contain multiple ingredients, have been implicated in rhabdomyolysis, including ephedra, creatine, and large doses of caffeine. Alcohol can also increase the risk.” Uh, good thing I didn’t try to spin after those Bloody Marys.
Lastly, you can also work to improve mobility with your diet by eating frequent meals and a low-fat, high-carbohydrate diet, as well as medium-chain triglyceride supplementation, Stark shares. (We at Byrdie love this MCT oil, $28.)
The Final Takeaway
This incident was enough to scare me away from any form of spin bike in the near future, but if you’re thinking of signing up for your first class or doing any other sort of workout, just speak with a doctor first and, as Stark said, ease your way into it. As for me, for now, I’ll just take brunch—hold the strenuous exercise.
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