3 minutes of readingI could tell something was wrong one morning in the summer of 2020 when I went to the bathroom and saw what appeared to be grainy bourbon swirling in my toilet bowl. (Sorry if I always ruined your favorite whiskey for you!) Surprising, oh yes. Come to think of it, I had been nursing sore hamstrings after a kettlebell workout a few days before. And since my pee certainly indicated that something was not working properly internally, I suspected the two were related.
Until this workout, I hadn’t picked up a kettlebell in months. It had been my primary form of exercise for six years—I even got certified to teach it—but I was starting to burn out, so I switched to a less intense Pilates practice. I was now ready to get back into the swing of things (keyword: ease).
I started with a weight of 30 pounds and did one-minute intervals of swings, squats, and presses, eventually reaching 45 pounds. I had worked with this weight before, but again, it had been a while. I limped out of the gym (oh, my hammers!) but otherwise, I’m fine.
The pain persisted but was not severe enough for me to cancel Saturday Pilates. A stretch might be a good thingI said to myself. But I woke up the next day with my unfortunate toilet spot.
Body distribution
I was vaguely aware of the condition known as rhabdomyolysisin which injured muscle tissue breaks down and releases its contents into the bloodstream, potentially damaging the kidneys. But I thought my 25-minute kettlebell session could never have been intense enough to cause this level of damage. Still, I found myself googling “that thing when you train too hard” (who remembers the word rhabdomyolysis?). One of the first symptoms I encountered: dark, brownish colored urine.
After some initial tests at urgent care, I was referred to the emergency room, where doctors measured my creatine kinase (CK), an enzyme found in your muscles that, when elevated, can indicate damage. I learned how injured I was: a healthy adult’s CK level is between 22 and 198 U/L (units per liter); mine was 90,000 U/L.
When I was told I would need to be admitted for at least a day, it was a strange pill to swallow. I didn’t have any other symptoms, like dehydration, nausea, or fainting. Still, I spent the night in the hospital with an IV bag to flush my kidneys quickly enough to prevent any damage. (Kidney failure can be one of the most serious side effects of rhabdo.)
I was told to take six weeks off from sports. When I ventured to my first hardcore class (boxing), I glanced at my pee for days afterwards, just to make sure everything looked OK. Fast forward a year later and I’m still healthy.
Give him a rest
I get it: you feel a sense of pride when you fight through painful sensations. But you’ll come back stronger if you take a day off when…
Your muscles hurt several days later.
Are you sweating on Sunday and still sore on Wednesday? It needs to be cooled.
Your fatigue is disproportionate to your training.
If you’ve been playing tennis forever but feel exhausted during a longer or hotter workout, your body may be asking for a break.
You cannot perform at your usual level.
Let’s say you trained for a race and you can’t run as fast as last week, but your diet is the same. Build more recovery time into your plan.
For your information, exercise-induced rhabdo is not very common: approximately 12,000 cases are diagnosed each year in the United States, according to a study published in BMJ Open Sports and Exercise Medicine. But Todd Cutler, MD, an internist at NewYork-Presbyterian/Weill Cornell Medical Center, says his emergency room nurses have noticed an increase in rhabdo cases that has coincided with the recent rise in popularity of high-intensity cycling classes.
It’s also usually not a beginner in exercise who gets injured; it’s often a healthy, relatively fit person who pushes themselves to the extreme the first time they try a new workout (or when they return after an absence). This makes sense, given my experience. “If you weren’t in shape, you couldn’t have done the exercise,” says Dr. Cutler. In other words, my underlying health allowed me to reach the point of overwork.
Less is more
There is a fine line between pushing yourself (which results in gains) and going too far (which results in injury). The tipping point is different for everyone, which is why it is essential to be in harmony with your body. (Hamstrings feel like they’re under a blowtorch? Cut the weight!) If you’re trying something new or returning to training after a hiatus, advise Lauren Borowski, MD, a sports medicine specialist at the NYU Langone Center for Women’s Sports Health.
My new mantra: Adapt workouts to current ability (regardless of your past experience). And… rest days are annoying. Take them. The kettlebell will still be there tomorrow.
Gn Health
