Rhabdomyolysis after a marathon: what to know

A long race can leave muscles sore and tired. Rhabdomyolysis involves more substantial muscle-cell injury, which releases muscle contents into the blood. Warning patterns include pain that seems excessive for the effort, marked weakness, swelling, difficulty walking, nausea, or urine output that is lower than usual. The symptoms can begin during the race or develop afterward, including while ordinary soreness is expected.

Heat, dehydration, a sudden increase in training, illness, or medicines and supplements may add strain. A healthcare professional can use an examination and blood and urine tests to distinguish muscle breakdown from routine recovery and check the kidneys and body salts.

Stop running and rest in a cool place. Seek same-day medical advice if symptoms are unusual, worsening, or accompanied by weakness or swelling. Drink normally if you are alert and able to swallow, but avoid forcing fluids or taking leftover medicines. Note the race distance, weather, pace, recent training changes, and any painkillers, medicines, or supplements.

Use emergency care for severe or escalating muscle pain, inability to walk, rapidly enlarging swelling, fainting, confusion, repeated vomiting, breathing trouble, or very little urine. Dark urine is a possible clue but is not necessary. Do not try to run through these symptoms or wait for routine post-race soreness to pass.

Ask whether your symptoms fit exertional rhabdomyolysis, which tests are needed, how to monitor urine output, whether any medicine should be avoided, and what conditions should be met before you resume training.