A rare and sometimes deadly muscle condition known as rhabdomyolysis is back in the headlines this week after the death of a healthy 24-year-old New York City Marathon runner.
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condition → know → runner
Rachel Apa, a Pennsylvania native and former Division One field hockey player at Bucknell University, collapsed two miles short of the race’s finish line Sunday, her father Steve Apa said.
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father → collapse → line
Doctors spent over six hours trying to save her life but were unsuccessful.
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Doctors → spend → life
Her father said her cause of death was rhabdomyolysis.
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cause → say → death
Rhabdomyolysis, often referred to as “rhabdo,” occurs when muscles break down and can poison the body.
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muscles → refer → body
It is typically triggered by overexertion, physical trauma, certain medications or an underlying health condition.
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It → trigger → overexertion
The condition is relatively uncommon with about 26,000 cases recorded in the U.S annually, according to the Cleveland Clinic.
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cases → record → Clinic
Some cases can be fatal, and Vanderbilt University research shows there are around 1,500 annual deaths.
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research → show → ?
"It's a problem, and it's very dangerous," Jacque Crockford, a college athlete turned personal trainer who suffered from rhabdo, told US News in 2017.
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who → turn → 2017
What happened to Rachel Apa?
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What → happen → Apa
Apa, who was running her first marathon, was feeling strong before she collapsed near the mile-24 marker at 1:33 p.m. EST, The New York Times reported Tuesday.
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Times → run → p.m.
She had texted her father that she had “never felt this good” earlier in the race but he told her repeatedly not to “overdo it,” Steve Apa told NBC News.
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Apa → texte → News
When she collapsed, spectators ran to help her - including two doctors - and performed CPR before emergency medical crews arrived with a defibrillator.
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crews → collapse → defibrillator
She was taken by ambulance to the Mount Sinai Medical Center at 1:50 p.m., which one spectator claimed was “was an unacceptable amount of time.”
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spectator → take → time
After continued efforts trying to resuscitate Apa, she was declared dead at 9:40 p.m. EST.
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she → continue → p.m.
“It’s unfathomable,” her father told The Times.
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father → ’ → Times
Cases of rhabdo has been widely reported in college football players.
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Cases → report → players
More than a dozen University of Iowa players were hospitalized in 2011 after a strenuous squat workout, according to The Daily Iowan.
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players → hospitalize → Iowan
In 2017, three Oregon football players were hospitalized with the condition following grueling strength and conditioning workouts.
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players → hospitalize → workouts
Other people have spoken out about developing the condition, including a Virginia man who was doing pull-ups.
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who → speak → ups
“It was just kind of a shocking thing,”Justin Urban, then 41, told The Washington Post in 2021.
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Urban → tell → 2021
“Forty pull-ups put me in the hospital for a week.”
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ups → put → week
Joseph Henson, who ran Alabama’s Mercedes Half Marathon in 2019, went into cardiac arrest after developing rhabdo.
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who → run → rhabdo
“My takeaway from all of this is it can happen to anybody, I’m pretty young for cardiac arrest and consider myself pretty fit,” Henson, then 34, told Runner’s World.
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Henson → happen → World
What happens to the body?
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What → happen → body
Rhabdo occurs when a person’s muscles break down during extreme exercise.
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muscles → occur → exercise
This breakdown releases the contents of the muscle into the bloodstream, including proteins called myoglobin and creatine kinase and the essential mineral potassium, according to the Cleveland Clinic.
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breakdown → release → Clinic
A build up of myoglobin in the body can damage the kidneys, while high levels of potassium can cause a deadly heart rhythm.
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levels → damage → rhythm
That’s how half of people with rhabdo develop a kidney injury, the clinic notes.
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clinic → ’ → injury
Other common causes of rhabdo include heat stroke, drug abuse, crush injuries and medications, such as statins and antidepressants.
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causes → include → statins
In high temperatures, muscle breaks down rapidly, and taking drugs can have a similar effect.
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taking → break → effect
The rare genetic conditions McArdle disease and Duchenne muscular dystrophy can also lead to rhabdo.
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conditions → lead → rhabdo
Both cause muscle weakness.
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Both → cause → weakness
It doesn’t matter whether you’re a weekend workout warrior or a professional athlete, you can be impacted by rhabdo.
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you → matter → rhabdo
While the likelihood of developing the condition is slim, people who drastically increase their exercise training intensity or length are at a higher risk, Dr. William Roberts wrote in Runner’s World in 2017.
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Roberts → develop → 2017
“At The Ohio State University Wexner Medical Center, we see rhabdo most associated with endurance sports, such as cycling or running,” Dr. Bryant Walrod, a family medicine physician, said.
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Walrod → see → cycling
People who work in active jobs are also at risk, including firefighters, police officers, outdoor workers and military service members, the Centers for Disease Control and Prevention says.
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Centers → work → Control
Symptoms of rhabdo can be varied and range in severity, but typically occur within 1-3 days of muscles degrading.
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muscles → occur → days
People should seek medical attention if they experience muscle pain, weakness, dark urine that looks like cola, an inability to pee, nausea or loss of consciousness.
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that → seek → consciousness
Rhabdo can be treated using IV fluids and electrolytes, though people may need dialysis if their kidneys fail.
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kidneys → treat → dialysis
…and 5 more, not listed.
The Aporia
