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  1. #1
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    rhabdomyolysis - horrible quad cramps after 3 days off

    Hi all,

    Wanted to post about my recent experience, hopefully to assist others in avoiding or at least recognizing symptoms. Also would love to hear how other have dealt with recovery.

    About me: avid long distance cyclist, not racer, not particularly fast, pretty fit, 45yo female.

    I'd been training pretty heavily since January to prepare for a fun summer of ride the rockies, a bunch of centuries and a week long trip to ride in the french alps. Training was mostly on trainer but starting to get outside as much as possible when weather allowed (Denver). I'm not a beginner, i've done many 500+ miles touring weeks, half IMs, have ridden tons of centuries and rode the dolomites for a week last year.

    I'd had a pretty hard training week finishing with a well deserved 3 days off to visit friend in CA. We ate and drank like french people all weekend :-) No exercise except for walking around.

    got back from the trip and my first day back at work, going down the stairs (i work on the 4th floor) at the end of the day and going out to my car, both quads cramped up so severely I was almost in tears, had to sit down and took about a half hour to hobble out to my car. This was unique since it occurred after a nice rest weekend. Granted i drank more than normal during the weekend, had more coffee and was probably a little dehydrated.

    This kept up for a couple days when went to the dr. I had done research on the web and had diagnosed myself with exercise induced rhabdomyolysis since my symptoms matched almost exactly what some other cyclists had described. it was definitely a mild case since my urine was clear but otherwise was spot on. Dr. tried not to laugh at me and said that if i had truly had rhabdomyolysis i would have brown urine. he said give it a few days and it would go away. He said to take vitamins, stretch, hydrate, drink tonic water and wait.

    5 days go by, still getting the bad cramps. Go back to doc, he has my blood tested and turns out my self-diagnosis was correct. I had ck levels of 500 nearly 12 days after original event. He said that it was probably in the thousands when it originally happened. Needless to say, he did not have much else to add about my recovery except to say continue to take supplements (b vitamins, magnesium, multi vitamins, take electrolyte sups), stretch, and drink a gallon of water + gatorade daily. He said it would take 3-5 weeks to recover and that i should start training again slowly and carefully since I would be more prone to this in the future.

    It is now 5 weeks later. I took almost 1 month off completely from exercise, no nuthin. no stairs no walking nothing. almost killed me. But the dr. said i had to let my body recover, let the kidneys flush out all the toxins and let the damages muscle repair. I've been getting massages frequently, my therapist is focusing on lymph node cleansing. Have no idea if that helps but i am getting better and it feels terrific and relaxing :-)

    Just started back to very light training this week and am feeling good. I'm terrified of doing something to bring back the cramps but at the same time i want to get back to my previous fitness and training levels.

    anyone out there experienced this? How was your recovery and what did you do?

    thanks for any input and remember - hydrate & stretch!!!

  2. #2
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    I just read your post and it was eerie how similar your circumstances were to mine. I'm wondering if you had any resolution to your Rhabdo or if you had had any reoccurrence of the problem. Would love to hear if you've figured out the issue. Here's my story:

    Was living in Germany in 2005 and had been training hard for 3 years and extra hard on the mountain bike in the winter and early spring. The weather turned good and we were excited to get on the road bikes as the weather had been pretty cold up until May. Right before Memorial Day, my buddies invited me for what was supposed to be a 2 hour ride... Well, the temperature was unseasonably warm in Germany reaching around 98F and the ride turned into a 120k 4.5 hour affair with about 2000 meters of climbing in the Odenwald. I didn't eat anything until hour 3 and then we ate and drank a ton of fluids at a german restaurant. Really felt great! Finished the ride really strong and excited..

    Went home and the next day went to France for the weekend and stayed in an un-air conditioned room and like you drank red wine and had some great french food... Finally went back to Germany and went out for a few pints with some friends... Woke up the next morning feeling great... until I got on my bike.. The cramps in my quads were UNBELIEVABLE - I got off my bike and laid down on the concrete writhing in pain. From that point on and for another week I couldn't even press the clutch in on my car without BOTH of my legs seizing. It took me 1.5 months to recover from this and my plans to do a half iron man and bike in the Pyrenees were wrecked (I had only a few more months to stay in Germany at that point). They admitted me to the hospital overnight and pumped lots of fluids through me (my urine was never anything less than clear) and put me on cyclobenzoprene...

    Its been 8 years and I've had about 2 very mild recurrences of cramping - at which point I took a break for fear of really hurting myself... I've been getting back into it slowly but did a hard ride this morning that I think may have put me over the edge again...

    Please let me know how you've fared since your incident!

  3. #3
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    Please read my reply to chronic quad cramps....
    I have just returned from a 24 year break from cycling to encounter the same muscle cramps that made me quit the sport all those years ago.I have been training for around 4 months since my return and have been religiously taking supplements but 4 days after a training ride I felt the twitches starting in my legs and when I got on my bike I had to stop after a mile as the pains were unbearable.
    I have booked an appointment with a sports physio who specialises in cycling injuries so I will post the findings here after the visit. In the meantime I have just ordered a new bike and if I'm unable to find a cure I may have to live with this chronic ailment for the rest of my cycling days, which is far from perfect.

  4. #4
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    Experiencing the same issues. Rhabdo diagnosis. Major quad cramps during ride. Had it happen once in April. Always been active and never had this type of thing happen. Confused on why it's happening now. What's triggering? I'm 42 and in good shape. I drink lot's of water and don't eat crappy. Sidelined now for a while. Legs took a couple months to feel better the first time. Used to be an avid runner and now feel hesitant to do anything too far from home for fear or recurrent cramping. Cramps don't subside right away. CK levels in the 8,000 range. IV to flush out kidneys. Any idea on triggers?

  5. #5
    just another gosling Carbonfiberboy's Avatar
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    Quote Originally Posted by APEXCYCLING View Post
    Experiencing the same issues. Rhabdo diagnosis. Major quad cramps during ride. Had it happen once in April. Always been active and never had this type of thing happen. Confused on why it's happening now. What's triggering? I'm 42 and in good shape. I drink lot's of water and don't eat crappy. Sidelined now for a while. Legs took a couple months to feel better the first time. Used to be an avid runner and now feel hesitant to do anything too far from home for fear or recurrent cramping. Cramps don't subside right away. CK levels in the 8,000 range. IV to flush out kidneys. Any idea on triggers?
    Good for you for going to the doctor! Have you researched online? If not google it, and follow with "causes" or "triggers." This seems like a pretty good reference:
    Causes of rhabdomyolysis

    which says among many other things:
    the precipitant may not be as immediately evident but is identified through a careful history and physical and laboratory evaluation

  6. #6
    Senior Member Number400's Avatar
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    I had a pretty strong case of rhabdomyolysis last year. Did not manifest in my quads but more in my arms after crossfit and kettle bell workouts stacked on top of distance running in the heat. My arms were swollen and I peed what looked like black coffee. I over did it, plain and simple. It was too hot, I was too tired but was fighting through my workouts and running with no real rest days. Dr. basically said that if I have any symptoms of it in the future, to eat tums twice a day for a few days to alkalize my urine and to hydrate and take it easy for a few days. I can work my legs very hard with no issues but when I start on the kettle bells and medicine balls and pull ups, I can cause the condition pretty quickly.


  7. #7
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    I had something similar happen. But, the docs are saying it's autoimmune hepatitis. Rabdo sounds alot easier to treat. Basically, did a really hard century ride. Hot, ton of hills, hardest ride I have ever done. Just wiped me out. That was the last ride of the season. Two weeks later, I'm in the ER checking on why I'm still peeing orange. My liver enzymes were over 1000. They admit me and for the next 4 days pump fluids. Numbers start going down, go home. Over the next 2 months till now, I am on prednizone 30mg, and doing labs every two weeks. Labs are almost to normal levels. The docs think that a virus got in me and attacked my liver. But, I'm wondering if it wasn't Rhabdo??

  8. #8
    Senior Member GeorgeBMac's Avatar
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    If it pertains to you:
    Just be aware that Rhabdomyolysis is one of the known, published and official side effects of statin, cholesterol lowering drugs. They say it is "rare" and will resolve once the statin is discontinued.

    Statins have other side affects that their manufacturers have not yet admitted to, but rhabdomyolysis is one that they do admit to...
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

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