For our writer, a single session of high-intensity exercise caused rhabdomyolysis, a dangerous breakdown of muscle tissue.
Approximately three years after I decided to change my life—to go from a sedentary sloth (whose major source of anxiety could be traced to trying to lift her overweight suitcase from the baggage carousel in public) into someone who willingly exercised—I found myself in the hospital because of it. But let’s not start there. Let’s start here instead: 12.
That was the number of times, I had calculated, that I could forgo getting changed for P.E. class, thereby waiving any expectations that I would be jogging around a track for time or getting pelted with a ball, and still get an “A” for the semester by coming in at the eleventh hour with an extra-credit report on Kristi Yamaguchi or Mia Hamm. It was 1998 and I was 10 years old, already a bit of a basement troll who preferred writing stories about my American Girl dolls on my dad’s ancient IBM or borrowing books to read from my neighbors. See, I didn’t do exercise.
Like most people, I like to blame others for my own shortcomings. I personally hold my father, along with my first-grade soccer coach and my fourth-grade karate instructor, responsible for an aversion to fitness that spanned two decades. When I was 6, my dad threw a ball at me so hard that it knocked the wind out of me and sent me flying backward as if, if memory serves, I’d been struck by a cannon. (To this day, I instinctively walk past kids playing catch with my arms in front of my face and enough adrenaline to potentially survive a raptor attack.) But get back on the horse she did, so in spite of the assault on my ribcage, I signed up for soccer through my elementary school. My first-grade soccer coach never let me play goalie—the only thing I might have excelled at, as blocking airborne balls was now my most natural reflex—during games because he confused me with another girl on the team and thought I’d already done it twice. My fourth-grade karate instructor used to punch children in the stomach or lift them up by one leg and drop them on their heads when they were late or did something wrong. By the time I was 10, I’d had enough.
My sports phobia continued until I was 24. Every plucky heroine needs a revelation, and this was mine: I was drinking second-from-the-bottom-shelf rosé on a rooftop, as 24-year-olds are wont to do. Actually, I was trying to drink on a rooftop, but I was so out of breath from climbing all of the flights of stairs to get there that I was more or less just gazing at the skyline and trying to ignore the creeping sensation that I might be about to faint. I’m in the prime of my life, I thought. I should be in better shape than this. So I joined a gym.
I went from lunging with my twiggy Bambi legs, quivering under my own body weight, to adding weights that got heavier and heavier. I walked a mile—for fun—and then I ran three, five and eventually 10 miles in one go. I took a yoga class and then I completed yoga teacher training, eventually juggling teaching four classes per week in addition to working at my full-time job.
That’s right: The girl who would have literally rather written a paper than played kickball grew up to be an adult with three different gym memberships.
The world of fitness can be personally rewarding, but it can also be socially isolating. I never went out late anymore, as I taught two classes a week at 6 a.m. I mostly skipped invitations to go out for lunch at work, as everything within walking distance was more or less a ticking time bomb of sodium and trans fats. I destroyed potential relationships, as I’d tell men that between teaching, working, working out and me time, I was available on Thursday nights from 5:30 p.m. until 8:30 p.m. and maybe Sunday afternoons and that was about it. I enjoyed my lifestyle, but I was lonely. I wanted to actually hang out with people, make some new friends. My solution? CrossFit.
Everything I ever needed to learn about CrossFit I learned on Instagram, and I learned that it was fun, sexy, vaguely dangerous, and I was going to meet a ton of new friends. At CrossFit, everyday people—your bank teller, your accountant, your barista—change out of their clothing and reveal that they could be international fitness models, but they’re actually just working out on a Tuesday night with their dearest of friends. Beside them, people who don’t look like fitness models hoist equally intimidating pounds of weights above their heads. Everyone cheers for everyone, even perfect strangers. In a way, cheering for someone in your CrossFit class isn’t really cheering for someone in your CrossFit class. It’s cheering for someone who made the same decision as you did to completely beat yourself up for the sake of beating yourself up today. It’s cheering for yourself. (In case anyone thinks I’m passing judgment here, I’d just like to say that my dog has his own Instagram. I have no room to judge anyone for anything.)
For the uninitiated, CrossFit is a fitness program and pricey trademark (memberships can range from $125 to $200 monthly) that has been adopted by approximately 13,000 gyms in more than 120 countries. It’s kind of a big deal. CrossFit workouts, known as the WOD (workout of the day), vary daily but usually involve some degree of aerobic exercise, body-weight exercise and Olympic weightlifting. Workouts are intense by design: They’re often intended to be completed as quickly as possible, or “for time.” If you feel like you want to die, proponents say, then you’re doing it right.
So, several years ago, I attended my first and only CrossFit class, on the East Coast, where I lived at the time, by accident. I went to the gym hoping to sign up for some sort of introductory class, but the coach insisted I could just stay for the WOD. We performed several rounds of exercises that ultimately added up to doing a total of 50 box jumps, 50 snatches, 100 pull-ups and 1,000 meters of rowing. There were no set breaks. I glanced at the digital clock with its bold red numbers, which seemed to have taken on a sinister glow. “This is going to be so brutal,” a girl next to me said, grinning.
“I can’t do 100 pull-ups,” I told the coach. This is where everything took a turn for the worse.
“Do this instead,” he said, putting a box underneath the pull-up bar. “Just stand on the box and jump up so your head is above the bar. Then slowly lower down so you can start building strength. It’s called a jumping pull-up.”
By the second round, my arms were shaking. I could barely breathe, true, and my face felt like it was the color of a group of lipstick swatches, yes, but these seemed to be common themes in this crowd. My thighs were on fire, but my arms felt like they weren’t even part of my body anymore. No one else seemed to be rapidly withering in the same manner that I was, and I began to wonder if I could take a fake phone call and feign an emergency, as if this was a bad date in a rom-com. I sat down to drink some water.
“No sitting!” the coach yelled, pointing at me. “Come on! You can do this. You were made for this.”
There’s this thing called the Milgram experiment. Essentially, people do very stupid things in order to be obedient when an authority figure is giving instructions. When you read about it in your Psych 101 class, you’re like, “How could anyone fall for that?” As it turns out, we all fall for it all the time in a million different ways. This was my interpretation of a tale as old as time: I dutifully got up and returned to the workout. Once I got to the pull-up part, I started doing half-jumps with just my feet, which was less of a jumping pull-up and more of just hopping on a box. The coach took one look at my pathetic movements and decided that this would be a valuable hazing moment.
“Do we half-ass the WOD here?” he yelled at the class, a large, earthworm-sized vein appearing in his neck.
“No!” the people who could breathe enough to speak yelled back.
“Start again!” the coach barked at me. He counted my reps and became something of a workout baby sitter, following me from station to station and making sure that I completed the movements. My new CrossFit friends cheered for me. Somehow, none of this was the way I had imagined it being.
“Don’t you feel awesome?” he said once I’d finished.
I did not, in fact, feel awesome. I felt like my arms were deteriorating.
If you’ve ever exercised intensely (or been tricked into “running stairs” with an alleged friend), you know and expect to be sore after a good workout. This? This was not that. I woke up the next day and frantically started rubbing my biceps with any object I could find: my thumbs, a coffee cup, a remote control. I tried to stretch. In a final effort, I slathered half a tube of Bengay on my arms. Nothing helped. The next day, 48 hours after the workout, I thought things would be better.
In fact, they got worse. I had lost the ability to fully straighten my arms, and the pain started to feel unbearable. It was as if every pressure point in my body was concentrated to my biceps and a well-fed elephant was standing on them. The bathroom mirror held perhaps the biggest surprise: My arms looked huge. Not in a glamorous Arnold Schwarzenegger way and not in a histrionic Bridezilla way, but in a way where it looked as though I had gained 15 pounds overnight and every last ounce had gone straight to my upper arms.
And there was something else: My urine was brown.
After a Googling frenzy (I’m a modern woman and, in this case, a vindicated hypochondriac) and panicked trip to the ER, I was admitted with a suspected case of rhabdomyolysis, which a blood test later confirmed. Rhabdomyolysis, or rhabdo, is a rare but serious condition in which muscle tissue breaks down and releases myoglobin—a protein that can damage the kidneys—into the bloodstream. In extreme cases, it can cause kidney failure. I was fortunate that a three-day stay in the hospital hooked up to an IV was enough to flush out the myoglobin and cure my bout of rhabdo, and I didn’t suffer from any permanent kidney damage. That isn’t always the case.
“Rhabdo can kill you,” Brandee Waite, M.D., director of Physical Medicine and Rehabilitation-Sports Medicine Fellowship at UC Davis, says. “And it can happen to anyone. It happens to men and women and people who are young as well as people who are old. It happens to very fit NFL athletes under certain conditions.”
Personal trainer Conor Foley, B.S. Kinesiology and Certified Strength and Conditioning Specialist, is also a CrossFit coach who notes that there’s a continuum of rhabdo. “It’s way more common at lower levels than people think, but there’s a threshold that it crosses and becomes a big problem,” he says. “If you go out and do a Spartan race or run a marathon or do a CrossFit ‘Murph’ workout, you’re going to have a mild case of rhabdo, but at that degree, you probably won’t need to be hospitalized for it.”
While anyone can develop rhabdo, there are usually a few telltale signs that the perfect storm is brewing. “It tends to happen more often when it’s very hot outside, or if a person is dehydrated,” Waite warns, noting that deconditioned athletes who try to attain their previous levels of fitness without properly working up to them can be especially at risk.
Specific exercises seem to spike rhabdo rates. One such exercise, Foley notes, is GHD (glute-ham developer) sit-ups. The other? Yep: jumping pull-ups. “High repetitions and eccentric movements are common causes,” Foley says. “With the jumping pull-ups, at a certain point, you’re doing so much work to help you get up with your legs and using strength that your arms just don’t have yet—but they’re still bearing the full load as you lower down.”
You might think that I blame CrossFit for what happened to me, but I don’t. Plenty of people perform workouts at CrossFit gyms all the time, and they’re fine. I’ve done CrossFit-esque workouts since then, and I’m fine. I blame myself for not stopping when I felt like I was breaking, and I also believe the particular coach I had that day should perhaps be in another line of work. Fitness professionals everywhere should take note: Tough love isn’t always the answer.
“It’s 100 percent the coach’s responsibility,” Foley says. “The coach should know your fitness level and abilities coming into the class, they should understand if the workout is appropriate for you, and they should modify accordingly.”
What should they not do? I’ll take “yell, embarrass and intimidate you into the poorly modified workout” for 500, Alex.
If you’re counting, that’s 1) getting the wind knocked out of me around the time I learned how to tie my shoes; 2) not being allowed to play goalie; 3) getting punched in the stomach for being late to class; and 4) ending up in the hospital over some pull-ups. You might think I’ve finally taken the hint that exercise isn’t for me.
Plot twist: I’m a personal trainer now.