The Do's and Don'ts of Beginning a New Exercise Program

When I was asked to write a piece on a recent story about a man who was hospitalized and diagnosed with rhabdomyolysis, I decided to take the topic one step further. Instead of just talking about one guy and one condition, I figured this would be a great opportunity to cover a broader topic and discuss the Do's and Don'ts of beginning a new exercise program or increasing the intensity of your current program.

So first off, since I was kindly asked, let's talk about this wild story. A man named Matt Lombardi who spent many sedentary hours in front of a computer developing a business website unsurprisingly ended up gaining a lot of weight in the process. So in an attempt to quickly shed those unwanted pounds, he decided to jump off the couch and dive into the "P90X" fitness program. For those who don't know, P90X is an extreme, high-intensity exercise regimen that falls in the same category as "Insanity" and "CrossFit." Long story short – these are not for beginners. But we'll get more into that in a minute.

So after a couple grueling sessions of P90X, he began noticing some disturbing symptoms and extreme muscle soreness, and ended up checking himself into the hospital with rhabdomyolysis. Immediately upon his release from the hospital, he took to his new website posting the details of his saga with pictures of himself in his hospital bed, and subtly dropping quips about his website hitting 1 million views while he was out of commission. If this initially swayed you to believe he's using this awful situation as an avenue for free publicity for his website and the entire diagnosis is a bunch of hokum, you're probably not alone. However, regardless of your thoughts on the man and his website in particular (sorry, no I didn't include a direct link to it), rhabdomyolysis is a serious condition and this story is very real

Rhabdomyolysis. Yes, believe it or not, that's a word. It might make more sense if we break it down into parts. Rhabdo- rodlike, myo- muscle, lysis- breaks down. Okay, all together now – rodlike (skeletal) muscle breaks down. Clear as mud? Good! Rhabdomyolysis is a condition in which damaged skeletal muscle breaks down and byproducts, like the protein myoglobin, are released into the blood stream (pictured above) which may ultimately end up harming your kidneys. This can be caused by a variety of things: Genetics, drug use, a crush injury, car accident, and most commonly extreme physical exertion (Ding! Ding!). Symptoms may include muscle pains, vomiting, confusion, and dark colored urine (pictured left for your viewing pleasure), depending on the extent of damage.

Crazy stuff, right? What's even crazier is that this is real and can happen to anyone from an elite athlete to an average Joe (err...Matt). Previously, a more highly publicized event occured in January of 2011 when 13 University of Iowa football players were hospitalized after their first workout of the season. If it can happen to a Division 1 college athlete, it can happen to you. So why and how does this happen? First, it's important to differentiate this from a very common post-exercise phenomenon called Delayed Onset Muscle Soreness (DOMS). It's very common after exercising, even for those who exercise regularly, to feel sore not immediately after, but about 24-72 hours following a workout. Proper cool downs, stretching, and adequate hydration can greatly reduce the effects of DOMS. Rhabdomyolysis is an entirely different case. Yes, staying adequately hydrated before and during exercise can reduce the risk of rhabdomyolysis, but won't prevent it. However, some very simple, key tips to follow before beginning a new exercise routine or increasing the intensity of your current routine can:

1. Introduce new exercises slowly.
Never jump full speed ahead into a brand new routine or program you've never done before. Try small, short sessions to get a feel for it. For example, do jog/walk intervals of a few minutes of each before deciding to go run 3 miles one day if running isn't a regular part of your daily activity.
2. Allow the body time to recover between sessions.
Your body heals with rest. Let your muscles rest and rebuild before breaking them down again.
3. Research any new routines or regimens (i.e. P90X, CrossFit, etc.) before beginning them.
Hit the internet, visit a local gym, watch a class or DVD before performing the activity. Get all the information you need before beginning.
4. Consult a licensed professional, preferably a Physical Therapist.
PT's are the experts in evaluating proper body mechanics, exercise performance technique and form, and your individual physiological abilities and limitations.
5. Stay Hydrated.
Drink plenty of water throughout the day each day, especially if you're exercising often. If you're already feeling thirsty, you may already be dehydrated.
6. Warm Up and Cool Down.
Take 5-10 minutes before and after exercising to slowly ramp up and ramp down the intensity of your workout, including stretching.
7. Listen to your body.

No pain no gain is a way of the past. Pain is your body's signal telling you something's up. There's a difference between the soreness and burning of a good workout vs. an inflammatory process of an injury or serious muscle breakdown.

Although what happened to the man in this story is a very extreme case (no, not every person who begins a new exercise program and gets in a little over their head will automatically end up in the hospital), a valuable lesson, and the main take home point of this post, can be learned from his very preventable mistake.

It is never a good idea to jump into a completely new exercise routine without proper counseling or gradually leading up to it. If you want to start running, but have never run before, you wouldn't sign up for a marathon, would you? If you've never ran 1 mile how would you expect your body to respond to running 26.2 of them? The same goes for if you want to start lifting weights. You aren't going to slam 300 pounds on the ends of your bench press bar if you've never even seen a bench press before.

Exercise fads and new crazes can be very beneficial as new research is done on the most effective ways to get in shape; but what also comes with the package is a great room for error and responsibility on the part of the person beginning the new exercise. Not everyone will suffer the same fate as Matt, being admitted to the hospital with blood values off the chart. You may only experience tendonitis, bursitis, a muscle strain or ligament sprain, or even microfracture of a bone, but the same mantra holds true.

I love hearing people wanting to exercise and make the commitment to a beneficial lifestyle change. Whether it's swimming, jogging, weight lifting, or P90X, it's all good. And let me go on record as saying I have nothing against P90X, CrossFit, etc. They are all great ways to exercise and improve people's lives...so long as the individual is deemed medically safe for that level of exercise, all exercises are performed with proper technique and form, and adequate rest is given for muscle healing and rebuilding.

So I leave you with my final thoughts on this subject. If you're thinking about making a lifestyle change, whether it's wanting to improve cardiovascular fitness, lose a few pounds, or build some muscle, consult a professional for sound medical advice before beginning any new exercise program. If you and your Doctor, Physical Therapist, Chiropractor, etc. determine a new routine is safe, slowly ease into it little by little until you build up a greater tolerance before going "all out." Listen to what your body tells you and recognize the signs of injury and prevent them from happening. The human body thrives off of balance from muscle strength and flexibility down to the cellular level in our DNA. Enjoy your workouts, there are endless benefits to physical activity and exercise, but please, be careful out there.

If you have any questions or comments you'd like to ask or share regarding rhabdomyolysis, beginning a new exercise routine, or fitness in general, please leave us a message. We love to be a helpful resource for all of your physical activity needs.