Workout Enthusiasts Pushing Themselves into Hospitals
In 2014, a Pleasantville, New York kindergarten teacher named Christina D’Ambrosio decided to try a spin class. Spin classes have exploded in popularity in recent years, promising both an excellent cardiovascular workout and a fun experience. During these indoor cycling classes, riders pedal quickly or at high levels of resistance while instructors shout out commands and encouragement. A single hour in a spin class can burn hundreds of calories.
Although Ms. D’Ambrosio regularly worked out, she found the spin class intense and challenging. At the end of the class, her legs were unstable and sore. She remembered, “I thought my body just wasn’t used to that kind of muscle ache because it was my first class.”
However, over the next 48 hours, Ms. D’Ambrosio’s body began to tell her that something was horribly wrong. She suffered extreme pain in her legs, and her urine transformed in color to a deep brown. She also felt queasy. When Ms. D’Ambrosio arrived at a local hospital, she was diagnosed with rhabdomyolysis. This condition, also called “rhabdo” by fitness buffs, often develops after intense exercise. When the muscles in the body are pushed too hard, they begin to die and break down. When the by-products of the dying muscles make their way into the blood stream, the kidneys are strained and the patient experiences a great deal of pain.
Ms. D’Ambrosio had to spend two weeks in the hospital while she recovered from rhabdomyolysis. The American Journal of Medicine picked up on Ms. D’Ambrosio’s story, as well as two other individuals who were diagnosed with rhabdomyolysis after taking a spin class.
In the journal’s report, the authors noted that, at that time, there were at least 46 other cases of spin class participants developing rhabdomyolysis. The vast majority—42 participants—was taking a class for the first time. The authors commented that they were not trying to discourage people from high-intensity workouts; rather, they wanted to share information about this rare, but dangerous, condition with the public. Those who start a new workout regimen should do so cautiously to avoid overworking their muscles.
Alan Coffino co-authored the study. Coffino works at Northern Westchester Hospital, where he serves as the chairman of medicine. He commented, “I would never discourage exercise, ever. Spin class is a great exercise. But it’s not an activity where you start off at full speed. And it’s important for the public to realize this and for trainers to realize this.”
In the past, most cases of rhabdomyolysis were reported in firefighters, soldiers and in others who have physically challenging careers. In one Army study from 2012, the authors estimated that around 400 cases of rhabdomyolysis are reported in active duty soldiers every year. In addition, groups of college athletes are diagnosed with rhabdomyolysis from time to time after they complete an especially demanding workout.
According to physicians, the newfound popularity of intense workouts has led to an increase in rhabdomyolysis diagnoses in their practices. Spin classes alone are hugely popular, with franchises like SoulCycle and FlyWheel booking millions of riders and millions of dollars in annual sales. High-intensity workouts extend physical, emotional, and social benefits to their participants; however, for a minority, rhabdomyolysis can develop quickly and wreak havoc on the body.
In a 2014 report, physicians from NewYork-Presbyterian/Weill Cornell Medical Center discussed two patients who found themselves at the emergency room after their first spin classes. Their diagnoses? Rhabdomyolysis. One patient was just 24 years old and arrived at the emergency room with swollen legs that felt “as tight as drums.” Emergency room physicians rushed her into an operating room, where they cut into her thighs to relieve pressure.
In a different study, emergency room visits were tracked from 2010 to 2014. That study discovered that 29 emergency room visits were due to rhabdomyolysis—and that was just at NewYork-Presbyterian. The patients reported completing workouts such as P90x, CrossFit, weight lifting, and even running. However, the most frequently cited workout was spin class. According to Dr. Todd Cutler, the primary author of the study, there are similarities among those who end up with rhabdomyolysis. He explained, “These are people who are not unfit. They are being pushed too hard, and they’re not trained to do this, and so they get really bad muscle trauma.”
Patricia Deuster, a professor at the Uniformed Services University of the Health Sciences who teaches military and emergency medicine, commented that using stimulants, statins, and antipsychotic drugs may increase the likelihood of developing rhabdomyolysis. Genetic factors might also play a role in triggering the condition.
However, in most cases, people end up with rhabdomyolysis when they try a new workout and push themselves too hard. Their muscles simply do not have enough time to adjust to the new movements or strain. Of course, small amounts of muscle damage promote growth and adaptation, but with too much stress, the muscles begin to come apart. Certain types of compounds, such as a protein called myoglobin, are released, which can harm the liver. Myoglobin causes one of the most widely recognized symptoms of rhabdomyolysis—brown urine.
Eric Rawson, who chairs the department of health, nutrition, and exercise science at Messiah College, recommends starting off with light exercise before progressing to moderate and then vigorous moves in a routine. He explained, “You can be fit, and I can come up with a workout that you are unaccustomed to, and that could be what causes rhabdo.”
Even experienced athletes develop rhabdomyolysis if the right conditions are present. Amy Purdy is famous for winning the bronze medal for snowboarding at the Paralympics. Additionally, she has performed on “Dancing with the Stars.” However, in 2016, she went to an exercise class after a three-week hiatus from training. During the class, she completed several sets of pull-ups. By the following day, Purdy could not extend her arm. She ended up enduring an eight-day hospital stay as she recovered from rhabdomyolysis. Amy shared her experience on social media, and said, “Thousands of people have reached out to me on my Instagram page who had it as well. Almost everyone was fit before, got it from pull-ups and is trying to figure out the way to get back into fitness without risking a recurrence.”
How can one avoid rhabdomyolysis? According to an exercise physiologist named Joe Cannon, there are two steps people should take. First, before beginning a new workout routine, try a milder version of it. For example, before taking a spin class, get used to riding a stationary bike. The next step is to listen to your body and know your limits. If you are finding it difficult to complete a class, it is okay to tell a trainer you cannot finish or to pack your things and leave.
In some cases, exercise studios and trainers may be held accountable when they encourage participants to push themselves too hard and overlook the risk of injury.
Were you diagnosed with rhabdomyolysis?
At Parker Waichman LLP, our Spin Class Rhabdomyolysis lawsuit attorneys believe that trainers and exercise studios that encourage dangerous levels of activity should be held accountable when participants are injured. To schedule your free consultation with our Rhabdomyolysis lawsuit lawyers, call 1-800-YOURLAWYER (1-800-968-7529) today.
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