Taking up heavy exercise without being conditioned for it may expose one to risks like rhabdo, warns Ranjita Ganesan.
Illustration: Uttam Ghosh/Rediff.com
It is not uncommon for boys in their late teens or early 20s to want to sport formidable muscles.
Several indulge in aggressive body-building, relying on a high-protein diet.
They could frequent just about any upscale building in the city for this, as most of these are equipped with a gym, Herculean trainers and big jars of supplements.
In rare cases, a combination of over-training and unprescribed diets can expose such gym rats to troubles of the kidney, says Dr Vijay Shetty, Mumbai-based orthopaedic surgeon and member of the Indian Association of Sports Medicine.
"When young, otherwise healthy boys report a kidney problem, we sometimes correlate it to their fitness habits. We cannot always prove it but theoretically we know this happens," he adds.
Another, more serious renal complication being noticed in fitness circles internationally is rhabdo, short for rhabdomyolysis.
It used to be observed mainly in elite athletes and soldiers earlier, for whom intensive training is par for the course.
As workouts like CrossFit, High Intensity Interval Training, and boot camps become popular, their followers also need to exercise caution.
In layman's language, rhabdo occurs when muscles are destroyed and release a byproduct into the blood that is dangerous for the kidney.
It is caused by over-exertion in untrained individuals, certain drugs, and during high fever, says Dr Raju Easwaran, an orthopaedic surgeon at the Max Super Speciality Hospital, Shalimar Bagh, New Delhi.
Typical symptoms are a triad of muscle pain, weakness and dark urine.
At times, this is accompanied by fever, palpitations, unconsciousness and delirium.
The effects, while treatable in younger individuals capable of fast recovery, can be long-term with a need for regular monitoring.
Taking up heavy exercise without being conditioned for it may expose one to such risks.
When Nivedita Banerjee took up spin classes after a period of no exercise, the intense workout made her feel weary rather than rejuvenated.
When the exhaustion did not appear to reduce in good time, the 30-year-old journalist had to give up training.
One way to recognise danger is that the muscle soreness should decrease as exercise becomes regular. Exceptional soreness is usually a red flag.
There are precautions fitness enthusiasts should take to ensure renal health. Experts warn against the abuse of protein shakes.
Even in the gym of the office complex where Dr Shetty's clinic is located, he has noticed trainers convincing clients to buy these products.
"The risk is usually not there if workouts are done under professional supervision and with adequate liquid intake," says Dr Raman Goel, a bariatric surgeon at Mumbai's Wockhardt Hospitals. "It is likely to happen in un-supervised settings."
Many fledgling gyms tend to have inexperienced trainers, notes Delhi-based trainer Kamal Chhikara, who runs Reebok CrossFit Yoga.
Chhikara makes it a point to learn about his client's lifestyle and habits as well as observe how they move before designing a plan for them.
His advice to those enrolling at gyms is to take a few basic tests for vitamins, active protein and testosterone levels in the body. This helps assess risks and avoid heavy-duty activity.
"Moderation is the key. Stamina and strength are built over time," agrees Payal Khanchandani, who runs the Fitness Mania Studio in Mumbai.
Awareness about rhabdomyolysis in India is very low. It is extremely uncommon, perhaps because of under-reporting or under-diagnosis, says Dr Easwaran.
One worrying aspect is how people can sometimes see pain as a natural and pride-worthy side-effect of fitness.
Common sense guides that people work out only when fit, not suffering from fever and when sufficiently hydrated, says Chhikara.
DOs and DON'Ts
- Stay hydrated.
- Get vitamin and protein levels tested.
- Consult a nutritionist.
- Don't work out if you have fever or immediately after a surgery.
- Don't work out if you are recovering from diarrhoea.
- Don't work out under the influence of alcohol.
- People with certain medical conditions like sickle cell trait are at a high risk.
- If you have a history of seizures, get checked before you join a gym.
- If you take illicit and banned drugs, don't exercise; this is high risk for rhabdo In active infection, if you are receiving antibiotics like erythromycin, you are at a high risk for rhabdo.