Experts Warn of Rhabdomyolysis Risk as Young Adults Overexert During High-Intensity Workouts

Medical experts are warning against severe physical overexertion as hospitalisations for rhabdomyolysis rise rapidly among young adults.

The life-threatening muscle condition recently claimed the life of 24-year-old runner Rachel Apa after she collapsed during the New York City Marathon. Apa collapsed near mile 24 in Central Park before medics rushed her to Mt. Sinai Hospital, where she was pronounced dead.

Her father confirmed that she suffered from rhabdomyolysis, a rare condition triggered when damaged muscle tissue breaks down rapidly into the bloodstream.

High-Intensity Exercise Related To Severe Muscle Breakdown Cases

Rhabdomyolysis occurs when damaged skeletal muscle cells release their contents into the bloodstream, including myoglobin, potassium, phosphate and creatine kinase. Myoglobin can damage the kidneys, while electrolyte disturbances can cause potentially dangerous complications, including abnormal heart rhythms

These cellular contents filter through the kidneys, frequently causing acute kidney injury, severe swelling, or complete organ failure.

Data from the South Korea's Health Insurance Review & Assessment Service revealed a 32.3 per cent increase in rhabdomyolysis inpatients over four years.

Hospital admissions rose from 3,619 in 2021 to 4,788 last year, with total patient cases reaching 19,296 across the same timeframe.

Young adults in their 20s and 30s accounted for 50.9 per cent of all hospitalised patients last year.

Admissions for patients in their 30s surged by 76.2 per cent, while 79 per cent of young inpatients were male.

'Programs like Steel Corps and Physical: 100 have gained popularity in recent years, leading many to attempt high-intensity workouts they're unaccustomed to,' noted Professor Lee Kyung-won from South Korea's Yongin Severance Hospital, referring to a hit survival reality genre in the country.

'Consequently, more patients are visiting emergency rooms with rhabdomyolysis after overexertion.'

Key Clinical Symptoms and Life-Threatening Kidney Complications

Exertional rhabdomyolysis can develop when individuals push their muscles beyond their physical capacity, particularly during unfamiliar or excessively strenuous exercise. However, the condition can also result from infections, injuries and certain medications.

Common symptoms include acute muscle weakness, severe swelling, stiffness, nausea, and characteristic dark brown or tea-coloured urine.

Doctors typically diagnose rhabdomyolysis through blood tests measuring creatine kinase (CK), a marker of muscle damage. Additional tests may assess kidney function, electrolyte levels and myoglobin in the blood or urine. Muscle biopsies may be considered in selected cases when an underlying muscle disorder is suspected.

'If an exercised area swells severely or urine turns cola-colored, visit a hospital immediately,' advised Professor Yoo Mi-jeong from Ewha Womans University Mokdong Hospital.

Viral Infections and Physical Strain Vulnerabilities in Younger Demographics

A retrospective multicentre study involving 880 children and adolescents in South Korea found that infections accounted for 39 per cent of paediatric rhabdomyolysis cases. Neurological disorders were also common, while acute kidney injury developed in 11.3 per cent of patients. The findings highlight the range of potential causes and complications of the condition in younger populations.

While exercise causes adolescent cases, viral infections like influenza cause 39 per cent of pediatric rhabdomyolysis instances.

Severe fever-induced seizures and viral muscle damage trigger acute kidney injury in 11.3 per cent of affected children.

'Parents should seek emergency care if a child shows sudden reluctance to move or cola-colored urine after an infection like the flu,' stated Professor Kim Ji-hyun from Bundang Seoul National University Hospital.

Professor Kim also recalled a sedentary teenager who developed severe rhabdomyolysis after completing a single hour of personal weight-loss training.

Emergency Treatment Protocols and Medical Preventive Recommendations

In the United States, approximately 26,000 individuals develop rhabdomyolysis annually from exercise overexertion, trauma, or underlying conditions.

Standard medical management requires immediate intravenous fluids to flush muscle toxins from the kidneys and restore fluid balance.

Severe cases involving acute renal failure require emergency dialysis to extract blood, filter cellular waste, and prevent death.

'It's crucial to address how exercise intended for health can lead to excessive physical strain,' stated Lee Man-hee, chairperson of the National Assembly's Health and Welfare Committee. 'Systematic preventive education and early response systems are needed to reduce risks for young adults and children.'