Rhabdo and the “5 negatives at most” rule.

by Andrew Stemler on August 7, 2012

in Articles, CFL News

The purpose of this article is to remind everyone of a possible exercise induced condition called  rhabdomyolysis .  For now I’ll use the Wikipedia definition

“Rhabdomyolysis is a condition in which damaged skeletal muscle tissue breaks down rapidly.  Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure.”

This condition effects a small amount of athletes, but can be made more likely if workouts or exercise regimes have too many negatives, or eccentric contractions.

Here are some guidelines for spotting the condition written by Amik Jones MD ( I shared my 2005 level 1 certification with him)

“1. Pain out of proportion to the amount of soreness you would expect, often coming on much faster than you would expect after a workout, and often accompanied with weakness.  And/or

2. Swelling of the body part involved, either with or without pain.  And/or

3. Decreased urine output or dark urine. This is the scary one and the one that gets you admitted to the hospital.

 
What to do

1. Get to a doctor. You can’t be sure how bad it is going to get. It may progressively get worse for days before it gets better.

2.  Drink water. The only way to protect the kidneys is to ensure they have enough fluid to handle the toxins. If it is bad enough they will be put in the hospital with a catheter in one end and an IV in the other until they recover.

3. Avoid heat. Hot tubs can greatly exacerbate the release of muscle contents and can make a case of rhabdo much worse.”

 

Rhabdo  can be associated with  negative pull ups for beginners ( read: anyone who cannot do a pull up, or perhaps has 1 or 2)

I wanted to formulate some recommendations about setting negative pull ups at Crossfit London.

First things 1st . A negative pull up ( lower down)  sort of looks like this.

http://youtu.be/sQ3pn4j-hrA.

 

As you can see,  and hear,  this takes a lot of effort.  With someone with no arm strength, they could literally drop straight through. They are excellent at building the strength to do pull ups if used in line with the following recommendations.

Currently, our risk assessment reads as follows

“12) The dangers of rhabdomyolisis must be emphasized and clients taught to watch for danger signs. Intense eccentric training in dense conditions should not be deployed”

However, like most advice on the condition, there are no actual figures given. There are several popular protocols on the internet, that I have used for years ,  that use negatives to build pull ups. None exceed 5 negatives in a session. This will now become our benchmark. No more than 5 negatives in a workout. Ideally that 5 will have 60  seconds to 2 minutes rest between each set. There should be one  days rest between sessions that use this method.

Whilst jumping  pull ups are not the central focus of this article, I might as well mention them. For years I have used jumping pull ups  as an interesting (albeit occasional) “intensifier” ( like double unders and running). As long as you simply  jump and land,  the move is safe ( its a just a glorified jump with a target). If you need to pull or lower with your arms, i say, its too risky, and  a simple jump should be used,

 

 

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