Repair After Rhabdo

A Confession - Repair After Rhabdo  - Coach Emylee Covell
- A Blog Post from May 10th 2018

I thought about keeping it a secret. Mostly because I was embarrassed. What would people say when they hear that a professional who has dedicated her life to healing, recovery practices and movement integrity has spent the last 6 days in the hospital with Rhabdo? 

Of course I was afraid of what others would think, the barrage of troll comments about “the dangers of exercise,”  and mostly I was afraid of scaring off new people curious about starting their own fitness journey for fear they can overdo it. 

But then I thought about what a lie it would be.

I thought about all the people too afraid to show anything but their highlight reel to the public. 

I thought about all the people who are too “embarrassed” to show a weakness or admit that they hurt themselves while exploring their limits.

But mostly, I thought about the missed opportunity to reach and connect with others about what it’s like to “start over” after learning the hard way about where our limits are. 

For those who haven’t heard about the ‘urban myth’ in the fitness industry, Rhabdomyolysis is condition where your muscles basically explode, release cellular contents of myoglobin into your bloodstream, and cause your kidneys to be like “What the F*ck?” and shut down, ultimately leading to kidney failure if not treated.

And if you’re disappointed in my less than anatomically sound depiction of Rhabdo, feel free to brush up with Steven Low’s thorough and informative overview...I just can’t help but break everything down to its most digestible bits. 

How did I get it you ask? Well technically I got it from 100 GHD Sit Ups (I know, I know...I don’t even let my clients do regular sit ups, let alone high rep extreme range GHD’s, and I truly believe that the only core-specific exercises we should be doing are controlled ones that focus on RESISTING movement, not flailing in extreme eccentric range a hundred times. But that’s a conversation for another post…) 

The next day I woke up and thought my abs were ripping apart (and not in the good sore kind of way). But I worked out the morning after anyway. Hours later my entire abdominal wall and back swelled to the size of 4-month pregnant belly. When I tried to eat, it felt like a whole potato was going down my throat and sitting in my stomach. I knew I fucked up. 

At the ER, I was admitted with a CPK (creatine phosphate kinase) level of 44,000 micrograms per liter (normal ranges from 10 to 120 mcg/L) and in the past 6 days I have bounced around from 14k to 34k to 20k, and at this point nobody is sure when I’ll be released. 

But I can’t really blame the workout, the reps, or the exercise. 

As the JAT journal states, “From an anecdotal standpoint, rhabdomyolysis often occurs in former athletes or those who have had a previously high fitness or strength level who are detrained. This is because their mind has had the abilities of high performance or strength before, and they are accustomed to pushing themselves. However, this is what you often have to be wary of as they can push themselves far into a state of rhabdomyolysis as they overestimate their own abilities.” 

My mind thought I was still “high performance,” but my body couldn’t keep up.

“So what have you learned from this?” Piet asked the second night in the hospital.

“Mmmm...To never do a GHD sit up, especially when deconditioned?” I scoffed. 

But he pushed further --”Emylee it’s more than that. You have been sick more times this year than I have been my entire life (gee thanks dude)...You’re burning the candle at both ends taking care of everyone and everything you can, but severely neglecting you.  You gotta figure out whatever routine you need to start operating at a higher level.”

I always hate when Piete is right, but this time it obviously struck a chord. 

You see, for about a year I have been coasting in autopilot when it comes to my own health and routine. I’ve done the bare minimum in terms of fuel, rest and training protocols and justify it with  “this is what it takes when you’re giving 100% to building this business.” A business that’s built on optimizing health, healing and performance no less! (The irony is killllling me too don’t worry) 

Undertrained, overworked, underslept, overstimulated. Sound familiar? 

I know most of you identify with this. 

You put others before yourself and your work before your rest, forever reacting to your life.

The GHD’s were just the “straw that broke the camel’s back” (or abs in this case). And as I’m sitting here in bed writhing in abdominal pain, pumped full of IV and morphine, 15 lbs heavier with poofiness and unable to even crunch myself out of bed, it’s been a chance to seriously reflect on how easy it is to lose it all and find yourself back at the ground floor.

Now what? 

Well I got nothing but recovery time on my hands--weeks of getting back to normal, months of rebuilding foundational strength and years of fine-tuning my own unique formula for long term health. 

There are tons of good reads about causation and prevention of Rhabdo, but there’s not a lot of publications about recovery and return-to-play protocols. While it’s impossible and inadvisable to create a Cookie-Cutter Game Plan for all patients, I at least wanted to find what has worked for others in terms of individualization, protocol, timeline and recurrence statistics. 

I found this study in the US National Library of Medicine (Journal of Athletic Training), in which 10 National Collegiate Athletic Association Division I football athletes were evaluated and treated for exertional rhabdomyolysis. Because of the lack of specific reports in the medical literature, the athletic trainers and physicians developed, closely tracked and published a conservative 4 Phase operation that successfully returned 10 Division I football athletes to play within 9 weeks of experiencing ER and without recurrence of symptoms. 

I’m not saying 9 weeks will be my experience...after all, these are high level athletes that have all the support in the world and it still took more than 2 months to get back. But it’s certainly great to have some more clarity and a solid resource for where to start, when and how to progress, when to scale back, and what the next few months will look like for me. 

Is it weird that there is a part of me that is excited to start from the ground floor? I was somehow blessed with the nerdiness and passion for how the human body works and I am super excited to track and measure my own healing, fine tune my own unique formula to rebuild my core and ensure my long-term health, and share it with you as I go. 

Meanwhile, I’ve been flooded with support, love and healing vibes from all directions--flowers, cards, food (and donuts), house cleaning, green smoothies and teas, magazines, soundbath healing recordings, and everything in between. 

I always tell clients that in order to facilitate healing, your body needs to have a safe environment to turn off it’s combative, inflammatory responses and allow change. 

This will be a long road to recovery for sure, but thanks to my incredibly wide support system, I have been absolutely blanketed by this kind of safe environment that will catapult my healing and fuel me to pay it forward. Thank you to everyone. 

I’ll keep you posted about when I get out of the hospital, and how I start crafting my own unique game plan for getting healthy again. 

Until the next time, 

Emylee