Tackling The Rhabdomyolysis Outbreak Before It Spins Out of Control

There are countless benefits of exercising and keeping fit. The American Heart Association’s recommendation for exercise and health is at least 150 minutes a week of moderate-intensity activity or 75 minutes per week of vigorous activity. Vigorous activities are more intense, making it difficult for you to talk without getting out of breath.  

In Singapore’s fast-paced world, spinning is a popular option for short, enjoyable, high-intensity workouts with fast calorie burn.  

Spin classes are bicycle-based workouts held in a gym setting, where loud, exciting music and enthusiastic instructors encourage participants to push themselves harder during workouts. However, despite all the benefits of such class-based exercise programs, there are also downsides and injury risks associated with spinning.

Not uncommonly, muscle sprains in the lower back and lower limbs may occur. An ill-fitted bike may also predispose to tendinitis and other tendon or joint injuries. 

However, a more concerning issue is rhabdomyolysis, where the intense workout causes significant muscle damage to the thigh muscles in particular. This muscle damage then releases muscle fibre contents into the bloodstream, which may be harmful to the kidneys and thus cause kidney damage. 

Spinning-Induced Exertional Rhabdomyolysis is increasingly being diagnosed in our emergency departments, with many patients requiring hospitalisation and intravenous fluid therapy to help flush the toxins out and protect the kidneys. Some patients may even stay in the hospital for a week!

So Who Is Prone to Developing Rhabdomyolysis?  

The majority of patients are young females under the age of 35 who attend their first spin class. This isn’t to say that young females are more prone to developing this problem, but that spin classes are more popular amongst young ladies than in older ladies or men.  

Quite commonly, men attending their first spin class with their girlfriends also end up developing rhabdomyolysis and requiring inpatient hospital treatment. 

What Are the Symptoms of Rhabdomyolysis?

Muscle pain and weakness are the most common symptoms of rhabdomyolysis. Dark-coloured urine is also suggestive of the kidneys trying to flush out the products of muscle breakdown.

I’m Thinking of Attending My First Spin Class. What Safety Measures Can I Take?

First-timers should stick to beginner’s classes, even if they are seasoned road-cyclists. Keep the resistance on your exercise-bike low, and adhere to a shorter exercise program.  

Don’t be tempted by your friends and classmates to push harder. Drink lots of fluids. If you develop severe muscle soreness, see a doctor, and don’t just take anti-inflammatory medication as this may damage your kidneys. Once you safely get through your first few classes, it should be safe to pump up the intensity of the workout!  

In summary, spinning is a great way to exercise. However, remember that it’s not always ‘No pain, no gain’! Listen to your body and build up your stamina as with all new workouts. Don’t let it spin out of control!

This article was written by Dr Bernard Lee Chee Siang. As an orthopaedic surgeon, Dr Bernard Lee, specialises in sports surgery of the shoulder, elbow, hip and knee. He has special interests in arthroscopic surgery, ligament reconstructions and complex soft tissue injuries of the knee, shoulder and elbow. He has extensive experience in multi-ligament reconstructions, revision surgery and joint preservation surgery.

For more information on Dr Bernard Lee Chee Siang:

Consultant Orthopaedic Surgeon

M.B., B.S. (Singapore),

MMed (Orthopaedics),

FRCSEd (Orthopaedics)


SportsIn Orthopaedic Clinic
Gleneagles Medical Centre 6 Napier Road, #07-07, Singapore 258499
Phone: (65) 6256 3077
Mobile: (65) 9777 2769
Fax: (65) 6256 2077
Email: shoulderelbowortho@gmail.com
Web: sportsinortho.com

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