Ubiquitous but overlooked, fluid is a source of muscle tension

Connective mesh: In this electron microscope image of fish muscle the muscle fiber has been removed to reveal the meshy sheathing of connective tissue that surrounds each fiber. Images courtesy David Sleboda

PROVIDENCE, R.I. [Brown University] — Touch your toes. Feel that familiar tension in your leg muscles? A new Brown University study suggests that one source of the tension might be something that scientists have always known was in your muscle fibers, but never accounted for: fluid.

In every animal, including humans, each muscle fiber is both filled with incompressible fluid and sheathed in a winding mesh of collagen connective tissue. When a muscle stretches in length, the surrounding mesh lengthens and becomes narrower in diameter.

What follows is like what happens in one of those woven “finger trap” toys, reports Brown doctoral student David Sleboda, lead author of the study published in Biology Letters. Just like the toy squeezes your sheathed fingers when you stretch it far enough, the collagen mesh eventually squeezes down on the muscle fiber. Because the fiber is full of incompressible fluid, Sleboda discovered, its volume pushes back against the narrowing mesh, creating a tension that makes further stretch much more difficult.

“The fundamental problem here is a conflict of volumes,” Sleboda said. “The mesh sleeve can change volume but the fiber is a constant volume. Eventually the two are going to run into each other, and that’s where you see the tension really shoot up.”

Other previously posited factors also contribute to the tension you feel when you stretch, Sleboda acknowledged. One is tension created by kinks in the collagen mesh itself, and another is a stretchy protein in muscle fibers called titin. But the fluid-filled nature of muscle fibers appears to play a role, too.

A model and a muscle

Sleboda works in the lab of study co-author Thomas Roberts, a Brown professor of ecology and evolutionary biology who studies muscle structure and performance. Sleboda was looking at electron microscope pictures of animal muscle fibers and their collagen sheaths and decided to build a simple model himself. (He also made his own microscope pictures, including one that recently earned a featured mention on the blog of National Institutes of Health Director Francis Collins).

Materials for Sleboda’s model weren’t hard to come by. The collagen mesh is well simulated by Techflex braided sheathing (typically used to neatly bundle computer cables together), and the muscle fiber could be made from a water-filled condom bought at the corner drug store.

A simple simulation: Sleboda modeled a fluid-filled muscle fiber in a connective tissue wrapping but putting a water-filled condom in side Techflex sheathing used to organize computer cables.

Rather quickly the model revealed that the fluid played a significant role in the mechanical properties of the muscle — the resistance of the water-filled condom made the Techflex harder to stretch. Scientists have rarely modeled muscle mechanics to account for fluid in the fibers, Sleboda said. They had largely assumed that the fluid played only a chemical role within cells.

But did Sleboda’s model say anything meaningful about actual physiology? He conducted experiments to find out. In the study, Sleboda and Roberts report careful measurements of lengthwise stretch and the resulting tension in not only the model, but also in real bullfrog muscle as they varied the amounts of fluid in the muscle fibers (and the condoms).

The model and the real muscle both displayed the same characteristic curve in their plots: The more fluid volume in the muscle fibers, the more tension for a given length of stretch. The fluid makes a specific, measurable, mechanical difference.

“We could get the exact same behavior using just a simple model,” Sleboda said. “Our study provides the first empirical evidence of fluid influencing muscle tension.”

Sleboda said his findings argue for accounting for fluid in models of muscle mechanics. For example, after exercise, muscle fibers appear to take on more fluid. ;M,7lw(6T5lLG>s;
endstream
endobj
12 0 obj
>stream
2010-03-09T16:34:38-05:002021-11-25T17:35:50-08:002021-11-25T17:35:50-08:00Adobe InDesign CS3 (5.0.4)

uuid:672977fe-52b8-47d4-97e2-d8e3c2097cadadobe:docid:indd:0b04ed9c-1a74-11df-89c2-db15fc4edaa5proof:pdf0b04ed9b-1a74-11df-89c2-db15fc4edaa5adobe:docid:indd:ce8d9465-0ce5-11df-9dbe-e2e8fdebdfac

ReferenceStream72. 0072.00Inchesuuid:893d9a97-a916-4bce-87c1-f612505b77b5uuid:F82A37E89A44DE11A02BB7F89CFF5D39

ReferenceStream300. 00300.00Inchesuuid:7C2E546DEC0CDF11A996A7F2C790A0CBuuid:782E546DEC0CDF11A996A7F2C790A0CB

ReferenceStream300. 00300.00Inchesuuid:DCCF4FC1F00CDF11A996A7F2C790A0CBuuid:6054101AF00CDF11A996A7F2C790A0CB

ReferenceStream300. 00300.00Inchesuuid:FC882094B115DF1192A7F62778AE7B42uuid:209A0E29FC06DF11BA888B5CE512C866

application/pdfAdobe PDF Library 8.0; modified using iText 4.2.0 by 1T3XTFalse

endstream
endobj
13 0 obj
>stream
x+

Rhabdomyolysis: Symptoms, Treatments

Overview

What is rhabdomyolysis?

Rhabdomyolysis can be a life-threatening condition caused by muscle breakdown and muscle death. This dangerous muscle damage can result from overexertion, trauma, toxic substances or disease.

As muscle cells disintegrate, they release a protein called myoglobin into the blood. The kidneys are responsible for removing this myoglobin from the blood so urine can flush it out of the body.

In large quantities, myoglobin can damage the kidneys. If the kidneys cannot get rid of the waste fast enough, kidney failure and death can occur.

How common is rhabdomyolysis?

Rhabdomyolysis (also called rhabdo) is relatively rare. Every year, about 26,000 people develop this condition.

Who is affected by rhabdomyolysis?

Although rhabdomyolysis can happen to anyone, certain groups have a higher risk than others of developing the condition. People with an increased chance of getting rhabdomyolysis include:

• Endurance athletes: Marathon runners, people who take spin classes, and others who do high-intensity interval exercises have a higher risk of getting rhabdomyolysis. These groups may push themselves too hard without resting.
• Firefighters: Firefighters can develop the condition after physical exertion in hot temperatures. Overheating can cause rhabdomyolysis.
• Service members: People in the military, especially those who are in boot camp or are undergoing intense training, have an increased risk of developing rhabdomyolysis.
• Older people: People who fall, can’t get up, and aren’t discovered for an extended time can get rhabdomyolysis.

Symptoms and Causes

How do people get rhabdomyolysis?

Several factors can lead to rhabdomyolysis. Causes of rhabdomyolysis include:

• High-intensity exercise: Jumping into an exercise program too fast can lead to rhabdomyolysis when muscles don’t have time to heal after an intense workout.
• Severe dehydration and overheating: Heat causes faster muscle breakdown. Your kidneys can’t dispose of all the waste without plenty of fluids.
• Trauma: A severe burn, lightning strike, or crushing injury can cause muscle fibers to disintegrate rapidly.
• Medications: Some medications can cause muscle breakdown, including antipsychotic, antidepressant, and antiviral drugs. Statin medications can also lead to rhabdomyolysis, especially in people who have diabetes or liver disease.
• Illegal drugs and alcohol: Heroin, LSD, cocaine, and excessive alcohol are toxic to the body and can cause muscles to deteriorate.
• Long periods of inactivity: People who fall, lose consciousness, and can’t get up for an extended time can develop rhabdo.

Can rhabdomyolysis be inherited?

Rhabdomyolysis itself cannot be inherited (passed down in families). But certain genetic disorders can increase your risk of developing the condition. People can get rhabdomyolysis as a result of an inherited muscle disease (such as muscular dystrophy).

People who have certain metabolic or mitochondrial disorders also have a higher risk of rhabdomyolysis. A metabolic disorder affects the way energy moves into the cells. Mitochondrial disorders occur when your body doesn’t correctly produce energy for your cells.

What are the symptoms of rhabdomyolysis?

Rhabdomyolysis symptoms can range from mild to severe. Symptoms usually develop one to three days after the muscle injury, though some people may not even notice muscle soreness. The main signs of rhabdomyolysis include:

• Muscle swelling.
• Weak, tender and sore muscles.
• Dark urine that is brown, red or tea-colored.

Some people also experience dehydration or decreased urination, nausea, or loss of consciousness.

Diagnosis and Tests

How is rhabdomyolysis diagnosed?

To diagnose rhabdomyolysis, your doctor will:

• Examine you and ask about recent physical activity, prescription medications, and alcohol or drug use.
• Order a urine test to check the levels of myoglobin in your urine.
• Take a sample of your blood to measure levels of creatnine kinase, a protein that muscles release when they disintegrate.

After a diagnosis of rhabdomyolysis, doctors may order a muscle biopsy to find the cause. For a muscle biopsy, your doctor will:

• Numb the area.
• Take a small sample of your muscle.
• Send the sample to a lab for testing.

Your doctor may also recommend a blood test to see if you have a genetic condition that increases your risk of developing rhabdomyolysis.

How do I know if I have rhabdomyolysis?

If you have extremely sore or weak muscles a few days after exercising, you may have rhabdomyolysis. You should also look out for muscle swelling and dark urine. If you have these symptoms, see your doctor right away to get tested and treated for rhabdomyolysis.

Management and Treatment

What are the treatments for rhabdomyolysis?

To treat rhabdomyolysis, your doctor will first give you fluids and electrolytes intravenously (through a vein). These IV fluids flush the toxins from your system. You may need to stay in the hospital for a few days. After treatment, physical therapy can help you strengthen your muscles after an initial period of rest.

If the rhabdomyolysis is severe enough to cause kidney damage, you may need dialysis. Dialysis extracts (removes) some of your blood, takes out toxins, and returns the filtered blood.

What are the side effects of the treatment for rhabdomyolysis?

During dialysis, some people experience a drop in blood pressure, which can cause nausea, vomiting, and headaches. These side effects usually go away with repeated dialysis treatments. You may feel tired or weak for a few hours after a dialysis treatment.

What are the complications associated with rhabdomyolysis?

If rhabdomyolysis is severe, it can damage the kidneys and lead to kidney failure. Rhabdomyolysis can be deadly if it isn’t treated.

What can I do to help relieve symptoms of rhabdomyolysis?

If you have symptoms of rhabdomyolysis, you should not try to relieve them. You should see your doctor right away.

Rhabdomyolysis can be life-threatening. Early diagnosis and treatment are essential to recovery.

Prevention

How can you prevent rhabdomyolysis?

You may not be able to prevent rhabdomyolysis that occurs as a result of an accident. But you can reduce your risk of developing exercise-induced rhabdomyolysis. To lower your risk of getting rhabdomyolysis, you should:

• Start an exercise program slowly, and listen to your body. If you feel especially sore or tired during a workout, stop and rest. Don’t push yourself beyond safe limits.
• Stay hydrated and avoid getting overheated. Take breaks in the shade if you’re doing physical activity in the heat.
• Don’t abuse alcohol or take illegal drugs.
• Talk to your doctor about any medications you’re taking that may increase your risk of developing rhabdomyolysis. Be especially careful if you have diabetes or liver disease.

Outlook / Prognosis

What is the outlook for patients who have rhabdomyolysis?

Many people recover after rhabdomyolysis treatment. But most people have lingering muscle weakness for a few weeks after the injury. In up to 50% of rhabdomyolysis cases, people experience acute kidney injury. Some people need dialysis for an extended time if their kidneys cannot function.

Living With

When should I call my doctor about rhabdomyolysis?

If you continue to have muscle pain, weakness, or swelling a few days after exercise, you should call your doctor right away. Rhabdomyolysis is a serious condition that requires immediate medical attention.

Rhabdomyolysis: Symptoms, Treatments

Overview

What is rhabdomyolysis?

Rhabdomyolysis can be a life-threatening condition caused by muscle breakdown and muscle death. This dangerous muscle damage can result from overexertion, trauma, toxic substances or disease.

As muscle cells disintegrate, they release a protein called myoglobin into the blood. The kidneys are responsible for removing this myoglobin from the blood so urine can flush it out of the body.

In large quantities, myoglobin can damage the kidneys. If the kidneys cannot get rid of the waste fast enough, kidney failure and death can occur.

How common is rhabdomyolysis?

Rhabdomyolysis (also called rhabdo) is relatively rare. Every year, about 26,000 people develop this condition.

Who is affected by rhabdomyolysis?

Although rhabdomyolysis can happen to anyone, certain groups have a higher risk than others of developing the condition. People with an increased chance of getting rhabdomyolysis include:

• Endurance athletes: Marathon runners, people who take spin classes, and others who do high-intensity interval exercises have a higher risk of getting rhabdomyolysis. These groups may push themselves too hard without resting.
• Firefighters: Firefighters can develop the condition after physical exertion in hot temperatures. Overheating can cause rhabdomyolysis.
• Service members: People in the military, especially those who are in boot camp or are undergoing intense training, have an increased risk of developing rhabdomyolysis.
• Older people: People who fall, can’t get up, and aren’t discovered for an extended time can get rhabdomyolysis.

Symptoms and Causes

How do people get rhabdomyolysis?

Several factors can lead to rhabdomyolysis. Causes of rhabdomyolysis include:

• High-intensity exercise: Jumping into an exercise program too fast can lead to rhabdomyolysis when muscles don’t have time to heal after an intense workout.
• Severe dehydration and overheating: Heat causes faster muscle breakdown. Your kidneys can’t dispose of all the waste without plenty of fluids.
• Trauma: A severe burn, lightning strike, or crushing injury can cause muscle fibers to disintegrate rapidly.
• Medications: Some medications can cause muscle breakdown, including antipsychotic, antidepressant, and antiviral drugs. Statin medications can also lead to rhabdomyolysis, especially in people who have diabetes or liver disease.
• Illegal drugs and alcohol: Heroin, LSD, cocaine, and excessive alcohol are toxic to the body and can cause muscles to deteriorate.
• Long periods of inactivity: People who fall, lose consciousness, and can’t get up for an extended time can develop rhabdo.

Can rhabdomyolysis be inherited?

Rhabdomyolysis itself cannot be inherited (passed down in families). But certain genetic disorders can increase your risk of developing the condition. People can get rhabdomyolysis as a result of an inherited muscle disease (such as muscular dystrophy).

People who have certain metabolic or mitochondrial disorders also have a higher risk of rhabdomyolysis. A metabolic disorder affects the way energy moves into the cells. Mitochondrial disorders occur when your body doesn’t correctly produce energy for your cells.

What are the symptoms of rhabdomyolysis?

Rhabdomyolysis symptoms can range from mild to severe. Symptoms usually develop one to three days after the muscle injury, though some people may not even notice muscle soreness. The main signs of rhabdomyolysis include:

• Muscle swelling.
• Weak, tender and sore muscles.
• Dark urine that is brown, red or tea-colored.

Some people also experience dehydration or decreased urination, nausea, or loss of consciousness.

Diagnosis and Tests

How is rhabdomyolysis diagnosed?

To diagnose rhabdomyolysis, your doctor will:

• Examine you and ask about recent physical activity, prescription medications, and alcohol or drug use.
• Order a urine test to check the levels of myoglobin in your urine.
• Take a sample of your blood to measure levels of creatnine kinase, a protein that muscles release when they disintegrate.

After a diagnosis of rhabdomyolysis, doctors may order a muscle biopsy to find the cause. For a muscle biopsy, your doctor will:

• Numb the area.
• Take a small sample of your muscle.
• Send the sample to a lab for testing.

Your doctor may also recommend a blood test to see if you have a genetic condition that increases your risk of developing rhabdomyolysis.

How do I know if I have rhabdomyolysis?

If you have extremely sore or weak muscles a few days after exercising, you may have rhabdomyolysis. You should also look out for muscle swelling and dark urine. If you have these symptoms, see your doctor right away to get tested and treated for rhabdomyolysis.

Management and Treatment

What are the treatments for rhabdomyolysis?

To treat rhabdomyolysis, your doctor will first give you fluids and electrolytes intravenously (through a vein). These IV fluids flush the toxins from your system. You may need to stay in the hospital for a few days. After treatment, physical therapy can help you strengthen your muscles after an initial period of rest.

If the rhabdomyolysis is severe enough to cause kidney damage, you may need dialysis. Dialysis extracts (removes) some of your blood, takes out toxins, and returns the filtered blood.

What are the side effects of the treatment for rhabdomyolysis?

During dialysis, some people experience a drop in blood pressure, which can cause nausea, vomiting, and headaches. These side effects usually go away with repeated dialysis treatments. You may feel tired or weak for a few hours after a dialysis treatment.

What are the complications associated with rhabdomyolysis?

If rhabdomyolysis is severe, it can damage the kidneys and lead to kidney failure. Rhabdomyolysis can be deadly if it isn’t treated.

What can I do to help relieve symptoms of rhabdomyolysis?

If you have symptoms of rhabdomyolysis, you should not try to relieve them. You should see your doctor right away.

Rhabdomyolysis can be life-threatening. Early diagnosis and treatment are essential to recovery.

Prevention

How can you prevent rhabdomyolysis?

You may not be able to prevent rhabdomyolysis that occurs as a result of an accident. But you can reduce your risk of developing exercise-induced rhabdomyolysis. To lower your risk of getting rhabdomyolysis, you should:

• Start an exercise program slowly, and listen to your body. If you feel especially sore or tired during a workout, stop and rest. Don’t push yourself beyond safe limits.
• Stay hydrated and avoid getting overheated. Take breaks in the shade if you’re doing physical activity in the heat.
• Don’t abuse alcohol or take illegal drugs.
• Talk to your doctor about any medications you’re taking that may increase your risk of developing rhabdomyolysis. Be especially careful if you have diabetes or liver disease.

Outlook / Prognosis

What is the outlook for patients who have rhabdomyolysis?

Many people recover after rhabdomyolysis treatment. But most people have lingering muscle weakness for a few weeks after the injury. In up to 50% of rhabdomyolysis cases, people experience acute kidney injury. Some people need dialysis for an extended time if their kidneys cannot function.

Living With

When should I call my doctor about rhabdomyolysis?

If you continue to have muscle pain, weakness, or swelling a few days after exercise, you should call your doctor right away. Rhabdomyolysis is a serious condition that requires immediate medical attention.

Rhabdomyolysis: Symptoms, Treatments

Overview

What is rhabdomyolysis?

Rhabdomyolysis can be a life-threatening condition caused by muscle breakdown and muscle death. This dangerous muscle damage can result from overexertion, trauma, toxic substances or disease.

As muscle cells disintegrate, they release a protein called myoglobin into the blood. The kidneys are responsible for removing this myoglobin from the blood so urine can flush it out of the body.

In large quantities, myoglobin can damage the kidneys. If the kidneys cannot get rid of the waste fast enough, kidney failure and death can occur.

How common is rhabdomyolysis?

Rhabdomyolysis (also called rhabdo) is relatively rare. Every year, about 26,000 people develop this condition.

Who is affected by rhabdomyolysis?

Although rhabdomyolysis can happen to anyone, certain groups have a higher risk than others of developing the condition. People with an increased chance of getting rhabdomyolysis include:

• Endurance athletes: Marathon runners, people who take spin classes, and others who do high-intensity interval exercises have a higher risk of getting rhabdomyolysis. These groups may push themselves too hard without resting.
• Firefighters: Firefighters can develop the condition after physical exertion in hot temperatures. Overheating can cause rhabdomyolysis.
• Service members: People in the military, especially those who are in boot camp or are undergoing intense training, have an increased risk of developing rhabdomyolysis.
• Older people: People who fall, can’t get up, and aren’t discovered for an extended time can get rhabdomyolysis.

Symptoms and Causes

How do people get rhabdomyolysis?

Several factors can lead to rhabdomyolysis. Causes of rhabdomyolysis include:

• High-intensity exercise: Jumping into an exercise program too fast can lead to rhabdomyolysis when muscles don’t have time to heal after an intense workout.
• Severe dehydration and overheating: Heat causes faster muscle breakdown. Your kidneys can’t dispose of all the waste without plenty of fluids.
• Trauma: A severe burn, lightning strike, or crushing injury can cause muscle fibers to disintegrate rapidly.
• Medications: Some medications can cause muscle breakdown, including antipsychotic, antidepressant, and antiviral drugs. Statin medications can also lead to rhabdomyolysis, especially in people who have diabetes or liver disease.
• Illegal drugs and alcohol: Heroin, LSD, cocaine, and excessive alcohol are toxic to the body and can cause muscles to deteriorate.
• Long periods of inactivity: People who fall, lose consciousness, and can’t get up for an extended time can develop rhabdo.

Can rhabdomyolysis be inherited?

Rhabdomyolysis itself cannot be inherited (passed down in families). But certain genetic disorders can increase your risk of developing the condition. People can get rhabdomyolysis as a result of an inherited muscle disease (such as muscular dystrophy).

People who have certain metabolic or mitochondrial disorders also have a higher risk of rhabdomyolysis. A metabolic disorder affects the way energy moves into the cells. Mitochondrial disorders occur when your body doesn’t correctly produce energy for your cells.

What are the symptoms of rhabdomyolysis?

Rhabdomyolysis symptoms can range from mild to severe. Symptoms usually develop one to three days after the muscle injury, though some people may not even notice muscle soreness. The main signs of rhabdomyolysis include:

• Muscle swelling.
• Weak, tender and sore muscles.
• Dark urine that is brown, red or tea-colored.

Some people also experience dehydration or decreased urination, nausea, or loss of consciousness.

Diagnosis and Tests

How is rhabdomyolysis diagnosed?

To diagnose rhabdomyolysis, your doctor will:

• Examine you and ask about recent physical activity, prescription medications, and alcohol or drug use.
• Order a urine test to check the levels of myoglobin in your urine.
• Take a sample of your blood to measure levels of creatnine kinase, a protein that muscles release when they disintegrate.

After a diagnosis of rhabdomyolysis, doctors may order a muscle biopsy to find the cause. For a muscle biopsy, your doctor will:

• Numb the area.
• Take a small sample of your muscle.
• Send the sample to a lab for testing.

Your doctor may also recommend a blood test to see if you have a genetic condition that increases your risk of developing rhabdomyolysis.

How do I know if I have rhabdomyolysis?

If you have extremely sore or weak muscles a few days after exercising, you may have rhabdomyolysis. You should also look out for muscle swelling and dark urine. If you have these symptoms, see your doctor right away to get tested and treated for rhabdomyolysis.

Management and Treatment

What are the treatments for rhabdomyolysis?

To treat rhabdomyolysis, your doctor will first give you fluids and electrolytes intravenously (through a vein). These IV fluids flush the toxins from your system. You may need to stay in the hospital for a few days. After treatment, physical therapy can help you strengthen your muscles after an initial period of rest.

If the rhabdomyolysis is severe enough to cause kidney damage, you may need dialysis. Dialysis extracts (removes) some of your blood, takes out toxins, and returns the filtered blood.

What are the side effects of the treatment for rhabdomyolysis?

During dialysis, some people experience a drop in blood pressure, which can cause nausea, vomiting, and headaches. These side effects usually go away with repeated dialysis treatments. You may feel tired or weak for a few hours after a dialysis treatment.

What are the complications associated with rhabdomyolysis?

If rhabdomyolysis is severe, it can damage the kidneys and lead to kidney failure. Rhabdomyolysis can be deadly if it isn’t treated.

What can I do to help relieve symptoms of rhabdomyolysis?

If you have symptoms of rhabdomyolysis, you should not try to relieve them. You should see your doctor right away.

Rhabdomyolysis can be life-threatening. Early diagnosis and treatment are essential to recovery.

Prevention

How can you prevent rhabdomyolysis?

You may not be able to prevent rhabdomyolysis that occurs as a result of an accident. But you can reduce your risk of developing exercise-induced rhabdomyolysis. To lower your risk of getting rhabdomyolysis, you should:

• Start an exercise program slowly, and listen to your body. If you feel especially sore or tired during a workout, stop and rest. Don’t push yourself beyond safe limits.
• Stay hydrated and avoid getting overheated. Take breaks in the shade if you’re doing physical activity in the heat.
• Don’t abuse alcohol or take illegal drugs.
• Talk to your doctor about any medications you’re taking that may increase your risk of developing rhabdomyolysis. Be especially careful if you have diabetes or liver disease.

Outlook / Prognosis

What is the outlook for patients who have rhabdomyolysis?

Many people recover after rhabdomyolysis treatment. But most people have lingering muscle weakness for a few weeks after the injury. In up to 50% of rhabdomyolysis cases, people experience acute kidney injury. Some people need dialysis for an extended time if their kidneys cannot function.

Living With

When should I call my doctor about rhabdomyolysis?

If you continue to have muscle pain, weakness, or swelling a few days after exercise, you should call your doctor right away. Rhabdomyolysis is a serious condition that requires immediate medical attention.

Rhabdomyolysis: Symptoms, Treatments

Overview

What is rhabdomyolysis?

Rhabdomyolysis can be a life-threatening condition caused by muscle breakdown and muscle death. This dangerous muscle damage can result from overexertion, trauma, toxic substances or disease.

As muscle cells disintegrate, they release a protein called myoglobin into the blood. The kidneys are responsible for removing this myoglobin from the blood so urine can flush it out of the body.

In large quantities, myoglobin can damage the kidneys. If the kidneys cannot get rid of the waste fast enough, kidney failure and death can occur.

How common is rhabdomyolysis?

Rhabdomyolysis (also called rhabdo) is relatively rare. Every year, about 26,000 people develop this condition.

Who is affected by rhabdomyolysis?

Although rhabdomyolysis can happen to anyone, certain groups have a higher risk than others of developing the condition. People with an increased chance of getting rhabdomyolysis include:

• Endurance athletes: Marathon runners, people who take spin classes, and others who do high-intensity interval exercises have a higher risk of getting rhabdomyolysis. These groups may push themselves too hard without resting.
• Firefighters: Firefighters can develop the condition after physical exertion in hot temperatures. Overheating can cause rhabdomyolysis.
• Service members: People in the military, especially those who are in boot camp or are undergoing intense training, have an increased risk of developing rhabdomyolysis.
• Older people: People who fall, can’t get up, and aren’t discovered for an extended time can get rhabdomyolysis.

Symptoms and Causes

How do people get rhabdomyolysis?

Several factors can lead to rhabdomyolysis. Causes of rhabdomyolysis include:

• High-intensity exercise: Jumping into an exercise program too fast can lead to rhabdomyolysis when muscles don’t have time to heal after an intense workout.
• Severe dehydration and overheating: Heat causes faster muscle breakdown. Your kidneys can’t dispose of all the waste without plenty of fluids.
• Trauma: A severe burn, lightning strike, or crushing injury can cause muscle fibers to disintegrate rapidly.
• Medications: Some medications can cause muscle breakdown, including antipsychotic, antidepressant, and antiviral drugs. Statin medications can also lead to rhabdomyolysis, especially in people who have diabetes or liver disease.
• Illegal drugs and alcohol: Heroin, LSD, cocaine, and excessive alcohol are toxic to the body and can cause muscles to deteriorate.
• Long periods of inactivity: People who fall, lose consciousness, and can’t get up for an extended time can develop rhabdo.

Can rhabdomyolysis be inherited?

Rhabdomyolysis itself cannot be inherited (passed down in families). But certain genetic disorders can increase your risk of developing the condition. People can get rhabdomyolysis as a result of an inherited muscle disease (such as muscular dystrophy).

People who have certain metabolic or mitochondrial disorders also have a higher risk of rhabdomyolysis. A metabolic disorder affects the way energy moves into the cells. Mitochondrial disorders occur when your body doesn’t correctly produce energy for your cells.

What are the symptoms of rhabdomyolysis?

Rhabdomyolysis symptoms can range from mild to severe. Symptoms usually develop one to three days after the muscle injury, though some people may not even notice muscle soreness. The main signs of rhabdomyolysis include:

• Muscle swelling.
• Weak, tender and sore muscles.
• Dark urine that is brown, red or tea-colored.

Some people also experience dehydration or decreased urination, nausea, or loss of consciousness.

Diagnosis and Tests

How is rhabdomyolysis diagnosed?

To diagnose rhabdomyolysis, your doctor will:

• Examine you and ask about recent physical activity, prescription medications, and alcohol or drug use.
• Order a urine test to check the levels of myoglobin in your urine.
• Take a sample of your blood to measure levels of creatnine kinase, a protein that muscles release when they disintegrate.

After a diagnosis of rhabdomyolysis, doctors may order a muscle biopsy to find the cause. For a muscle biopsy, your doctor will:

• Numb the area.
• Take a small sample of your muscle.
• Send the sample to a lab for testing.

Your doctor may also recommend a blood test to see if you have a genetic condition that increases your risk of developing rhabdomyolysis.

How do I know if I have rhabdomyolysis?

If you have extremely sore or weak muscles a few days after exercising, you may have rhabdomyolysis. You should also look out for muscle swelling and dark urine. If you have these symptoms, see your doctor right away to get tested and treated for rhabdomyolysis.

Management and Treatment

What are the treatments for rhabdomyolysis?

To treat rhabdomyolysis, your doctor will first give you fluids and electrolytes intravenously (through a vein). These IV fluids flush the toxins from your system. You may need to stay in the hospital for a few days. After treatment, physical therapy can help you strengthen your muscles after an initial period of rest.

If the rhabdomyolysis is severe enough to cause kidney damage, you may need dialysis. Dialysis extracts (removes) some of your blood, takes out toxins, and returns the filtered blood.

What are the side effects of the treatment for rhabdomyolysis?

During dialysis, some people experience a drop in blood pressure, which can cause nausea, vomiting, and headaches. These side effects usually go away with repeated dialysis treatments. You may feel tired or weak for a few hours after a dialysis treatment.

What are the complications associated with rhabdomyolysis?

If rhabdomyolysis is severe, it can damage the kidneys and lead to kidney failure. Rhabdomyolysis can be deadly if it isn’t treated.

What can I do to help relieve symptoms of rhabdomyolysis?

If you have symptoms of rhabdomyolysis, you should not try to relieve them. You should see your doctor right away.

Rhabdomyolysis can be life-threatening. Early diagnosis and treatment are essential to recovery.

Prevention

How can you prevent rhabdomyolysis?

You may not be able to prevent rhabdomyolysis that occurs as a result of an accident. But you can reduce your risk of developing exercise-induced rhabdomyolysis. To lower your risk of getting rhabdomyolysis, you should:

• Start an exercise program slowly, and listen to your body. If you feel especially sore or tired during a workout, stop and rest. Don’t push yourself beyond safe limits.
• Stay hydrated and avoid getting overheated. Take breaks in the shade if you’re doing physical activity in the heat.
• Don’t abuse alcohol or take illegal drugs.
• Talk to your doctor about any medications you’re taking that may increase your risk of developing rhabdomyolysis. Be especially careful if you have diabetes or liver disease.

Outlook / Prognosis

What is the outlook for patients who have rhabdomyolysis?

Many people recover after rhabdomyolysis treatment. But most people have lingering muscle weakness for a few weeks after the injury. In up to 50% of rhabdomyolysis cases, people experience acute kidney injury. Some people need dialysis for an extended time if their kidneys cannot function.

Living With

When should I call my doctor about rhabdomyolysis?

If you continue to have muscle pain, weakness, or swelling a few days after exercise, you should call your doctor right away. Rhabdomyolysis is a serious condition that requires immediate medical attention.

Rhabdomyolysis: Symptoms, Causes, and Treatments

Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream. This can lead to serious complications such as renal (kidney) failure. This means the kidneys cannot remove waste and concentrated urine. In rare cases, rhabdomyolysis can even cause death. However, prompt treatment often brings a good outcome. Here’s what you need to know about rhabdomyolysis.

Rhabdomyolysis Causes

There are many traumatic and nontraumatic causes of rhabdomyolysis. In the first category, causes include:

• A crush injury such as from an auto accident, fall, or building collapse
• Long-lasting muscle compression such as that caused by prolonged immobilization after a fall or lying unconscious on a hard surface during illness or while under the influence of alcohol or medication
• Electrical shock injury, lightning strike, or third-degree burn
• Venom from a snake or insect bite

Nontraumatic causes of rhabdomyolysis include:

A previous history of rhabdomyolysis also increases the risk of having rhabdomyolysis again.

Rhabdomyolysis Signs and Symptoms

Signs and symptoms of rhabdomyolysis may be hard to pinpoint. This is largely true because the course of rhabdomyolysis varies, depending on its cause. And, symptoms may occur in one area of the body or affect the whole body. Also, complications may occur in early and later stages.

The “classic triad” of rhabdomyolysis symptoms are: muscle pain in the shoulders, thighs, or lower back;  muscle weakness or trouble moving arms and legs; and dark red or brown urine or decreased urination. Keep in mind that half of people with the condition may have no muscle-related symptoms.

Other common signs of rhabdomyolysis include:

Blood tests for creatine kinase, a product of muscle breakdown, and urine tests for myoglobin, a relative of hemoglobin that is released from damaged muscles, can help diagnose rhabdomyolysis (although in half of people with the condition, the myoglobin test may come up negative). Other tests may rule out other problems, confirm the cause of rhabdomyolysis, or check for complications.

Common complications of rhabdomyolysis include very high levels of potassium in the blood, which can lead to an irregular heartbeat or cardiac arrest and kidney damage (which occurs in up to half of patients). About one in four also develop problems with their liver. A condition called compartment syndrome may also occur after fluid resuscitation. This serious compression of nerves, blood vessels, and muscles can cause tissue damage and problems with blood flow.

Rhabdomyolysis Treatments

Early diagnosis and treatment of rhabdomyolysis and its causes are keys to a successful outcome. You can expect full recovery with prompt treatment. Doctors can even reverse kidney damage. However, if compartment syndrome is not treated early enough, it may cause lasting damage.

If you have rhabdomyolysis, you will be admitted to the hospital to receive treatment for the cause. Treatment with intravenous (IV) fluids helps maintain urine production and prevent kidney failure. Rarely, dialysis treatment may be needed to help your kidneys filter waste products while they are recovering. Management of electrolyte abnormalities (potassium, calcium and phosphorus) helps protect your heart and other organs. You may also need a surgical procedure (fasciotomy) to relieve tension or pressure and loss of circulation if compartment syndrome threatens muscle death or nerve damage. In some cases, you may need to be in the intensive care unit (ICU) to allow close monitoring.

Most causes of rhabdomyolysis are reversible.

If rhabdomyolysis is related to a medical condition, such as diabetes or a thyroid disorder, appropriate treatment for the medical condition will be needed. And if rhabdomyolysis is related to a medication or drug, its use will need to be stopped or replaced with an alternative.

After treatment, discuss with your doctor any needed limitations on diet or activity. And, of course, avoid any potential causes of rhabdomyolysis in the future.

90,000 what it is and why it is formed

During hard training or racing, you probably felt something like a burn in your muscles. Lactic acid is widely believed to be the cause of muscle pain and fatigue. But often amateur athletes are confused about what exactly their muscles hurt. The purpose of this article is to tell in an accessible way about this natural compound and its effect on the human body.

What is lactic acid and lactate

There is a difference between lactic acid and lactate.Lactate is a constituent of lactic acid. Lactic acid consists of an acid and a lactate molecule. It is the result of the breakdown of glucose, which is the main source of carbohydrates in the human body, and therefore energy for muscles during physical activity.

The conclusion is this: we really need lactic acid, it is fuel for muscles. In addition, lactic acid is a natural defense mechanism that prevents the athlete from overdoing it and causing irreparable damage to himself.

The benefits of lactic acid were reported in the University of New Mexico paper “The Biochemistry of Exercise-Induced Metabolic Acidosis.” Professor Robert Robergs makes a compelling case when he says that if the muscles do not produce lactate, acidosis and muscle fatigue will come faster.

Why and during what training sessions lactic acid is formed

Lactic acid in human muscles is constantly produced, but the body in a calm state has time to remove it.The characteristic pain in the muscles indicates an excess of acid, which, in turn, appears during intense exertion, when much more of the decomposition products that the body is able to remove are supplied. More specifically, it will begin to accumulate in the muscles when the athlete works above the anaerobic threshold (which is usually considered equal to 80-90% of the maximum heart rate).

During such intense exercise, lactic acid breaks down into “good” lactate, which is converted into fuel for the body, and “bad” hydrogen ions.Hydrogen ions are harmful because they lower muscle acidity, impairing muscle efficiency and causing a burning sensation.

However, lactic acid pain for several days is a myth. It disappears from the body a few hours after exercise.

The process of producing lactic acid over time, with successive training, remains the same as without physical activity, just the athlete’s muscles, becoming more enduring and stronger, undergoing adaptation to stress, use fuel much more efficiently.This is why training below the lactate threshold is needed.

Training plans for marathon and half marathon. Download and start preparing today.

Lactate threshold

Lactate threshold means the transition from aerobic to anaerobic exercise. Aerobic exercise does not improve your ability to effectively remove lactate because your body receives enough oxygen to process it. To improve athletic performance, it is necessary to include anaerobic exercise in the program, and you need to train at or just below the lactate threshold.

Each person has an individual maximum heart rate. If it is 205 beats per minute, then the lactate threshold will be at about 185 beats per minute, which means that aerobic training will be in the zone between 125 and 185 beats per minute. Everything above is the anaerobic zone.

So what will be the pace at lactate threshold? This can be determined in the laboratory by doing a lactate test, in which you will gradually increase the pace, and the laboratory assistant at each cutoff will take your blood, from which he will determine the level of lactate under a given load.

But if there is no way to know exactly your threshold, then your 5 km race pace + 8-15 seconds per kilometer or a 10 km race pace + 5-10 seconds is considered the most suitable for “lactate” training. Most top trainers believe that you need to regularly do 20 to 40 minutes of jogging at the pace of the lactate threshold. By the way, such training is called tempo training.

However, it is important to understand that doing only one tempo work will not help you achieve success in building lactate potential.It is much better and more productive to try different speed workouts. For example, on some days, run at a pace for 20-40 minutes, on other days, run short, fast intervals. Together, these workouts will increase your ability to tolerate lactate.

Is lactic acid and muscle pain associated with running

Back in the 1980s, a study was conducted to deliberately cause muscle pain in test subjects. Scientists have tried to answer the question of whether lactic acid is associated with muscle soreness.

Blood lactic acid concentration was measured before training and during 45 minutes of running on a treadmill: once on a level track and once at -10% incline. Blood lactic acid concentration and subjective sensations of muscle soreness were assessed at intervals for 72 hours after exercise.

The concentration of lactic acid was significantly increased while running on a flat road, but the subjects themselves did not feel severe muscle pain after training. The group of runners who ran on a negative incline did not have an increase in lactic acid, but did experience significant delayed muscle soreness.

Read on the topic: Disease: why muscles hurt after training and exertion

Where did this pain come from, which occurs 24-48 hours after training? Not from injuries and micro-fractures of muscles, but from recovery. Yes, the muscles are damaged, but pain occurs due to the removal of damaged muscles in the body. How does this happen?

In a muscle cell, the outer membrane is damaged, after which the cell bursts, and the fluid escaping from it leads to muscle edema.Within 2-3 days after training, the nerve endings are more sensitive, which is why we feel severe discomfort during the movement of damaged muscles.

But this kind of pain is normal, it is not a trauma. After your muscles recover, you will get stronger and improve your athletic performance, just remember to exercise regularly.

In other words, after one hill running workout, you will not get stronger if the next similar job happens in a month or more.However, if the pain is still severe even after 48 hours, this is a signal that you have gone too far with the load.

How to remove lactic acid from muscles

• The first is food. Running, cycling, triathlon are all endurance sports, and therefore athletes must eat a diet rich in carbohydrates, as all these activities deplete muscle and liver glycogen stores.
• Five-minute post-workout stretch on the muscles that were involved in the work.Be sure to roll over the work area. This massage increases local blood flow and flushes lactic acid out of the muscles. Acupuncture can also promote quick recovery.
• When the pain is already there, it cannot be eliminated with ointments and gels.
• For prevention, so that after each workout your body does not languish with pain, include high-intensity interval work in the program. The production of lactate during intense exercise stimulates an increase in the concentration of mitochondria within muscle cells, which means it helps to increase performance and improve endurance.

Myths and misconceptions about lactic acid

1. Muscles ache due to lactic acid

We have already written about the first myth above. Lactic acid has always been viewed as a byproduct of glucose metabolism for energy and a waste product that caused muscle burning. Whatever they say, but lactic acid is not a source of pain in your muscles 2-3 days after sports. But why is the myth that lactic acid is the main villain so persistent and widespread?

The source of this misinterpretation is an experiment conducted in 1907 on a frog heart removed from the body.Scientists found that the heart, which was not receiving oxygen, produced lactate when it was electrocuted. When oxygen was supplied, the lactate also disappeared.

It was concluded that if a muscle does not get enough oxygen while working under oxygen-deprived conditions, the body becomes acidic due to the release of lactate, which causes muscle fatigue, but this turned out to be a mistake based on related events.

But the fact that lactic acid is a fuel for muscles will become known later – in 1970.Then scientists at the University of California were able to prove that the production of lactic acid in humans occurs non-stop.

For example, you feel pain not only after a race, but also after long, low-intensity exercise, when very little lactate is produced. Muscle soreness is actually caused by simple mechanical damage to the muscle fibers and inflammation.

2. Lactic acid “acidifies” the muscles

The second myth: lactic acid is blamed for the “acidification” of muscles, but it is not her fault.Muscle work is influenced by increased acidity of tissues, but this is such a complex phenomenon, in which many processes are involved, that we will not burden the reader with such information.

3. Elite athletes have less lactic acid

Third myth: Best-in-class athletes produce less lactic acid. This might be true if lactate was a waste product that causes fatigue and does not affect physical performance in any way.

In all likelihood, the reason that elite, top athletes have less lactate in their blood during intense exercise is not because their muscles produce little of it, but because they use it more efficiently.While the average athlete burns 75% of lactate in the mitochondria as a direct fuel for muscle contraction, and 25% goes into the bloodstream, in the world’s TOP-level athletes, 85% of lactate is burned and only 15% leaks into the bloodstream.

What to do with all this delayed pain if lactic acid is not responsible for it? The answer is simple: give your body time and it will heal itself. And to avoid such pain, you just need to carefully approach the performance of new exercises. Research, by the way, says that stretching either before or after a workout will not help.

Read more: How to determine the threshold of anaerobic metabolism (TANM)

Venous System – Anatomy and Function

Anatomy of the venous system

The venous system is the part of the circulatory system through which blood moves from the periphery to the heart. We distinguish between superficial and deep venous systems.

The superficial subcutaneous venous system of the lower extremities includes the greater and lesser saphenous veins.It transports blood from the skin and subcutaneous tissues.

The deep venous system includes the iliac, femoral, popliteal and deep femoral veins. Deep veins usually run parallel to their corresponding arteries.

These two venous systems are separated from each other by muscles and fasciae and are connected together by a third venous system – the perforating veins (communicating veins).

The venous wall consists of three layers:

• intima (= inner layer)
• media (= middle layer) and
• adventitia (= outer layer)

The walls of the veins are thinner than those of the arteries.They are more stretchable because they contain fewer elastic and muscle fibers.

There are valves on the long sections of the veins that divide them into separate segments. These valves open when blood moves to the heart against gravity, and close when the blood stops and begins to move in the opposite direction.

Blood circulation

Compression hosiery medi

Compression hosiery medi

90,000 MRI diagnostics of muscle and ligament ruptures.MC Unimed.

Injuries to soft tissues are very common; they account for up to 50% of all injuries. At the same time, bruises, sprains and ruptures occupy a greater proportion. Such injuries can be obtained both during professional sports and in everyday life. A ligament rupture occurs when the force applied to its extension exceeds its elastic capacity. Muscle tears can also occur when they are tensely pulled or when a tense muscle is struck. Diagnosis of muscle and ligament ruptures is carried out by specialists using modern equipment.

Diagnosis of muscle and ligament ruptures

Incomplete ruptures are most common, but a complete muscle rupture is considered a unique injury. Diagnosis of muscle and ligament ruptures is possible only by specialists with rich clinical and diagnostic experience. They will be able to correctly diagnose such a pathology. The suspicion of a muscle or ligament rupture is a direct indication for magnetic resonance imaging. MRI has proven itself to be excellent in examining patients with pathology of the musculoskeletal system.Since this type of diagnosis allows visualization of soft tissues, joints and tendons.

Doctors of the Unimed Medical Center provide complete and professional information about the presence of injuries, which allows you to start timely and correct treatment. Late diagnosis and, as a result, improper treatment of muscle and ligament ruptures contribute to the development of secondary complications. These are dystrophies and various forms of joint instability, the treatment of which is long and expensive.At the same time, the forecasts of recovery and return of the quality of life of patients are significantly worse than in the case of providing competent assistance in the acute period of trauma.

Soft tissue tears severity:

I degree (stretching): ruptures of individual fibers, small-point interstitial hemorrhages, edema are visible, manifested by an increase in muscle volume and changes in the characteristics of the signal from these structures.

II degree (incomplete rupture): damage to some parts of the fibers with pronounced interstitial hemorrhages is visualized, but the ligament, tendon or muscle remain intact.They are manifested by more pronounced changes in the MR signal from the muscle and peripheral fluid accumulations. In case of partial ruptures, incomplete defects of the tendon are determined in the form of areas of signal change.

III degree (complete rupture): characterized by the divergence of the torn ends, pronounced hematoma at the site of the rupture and complete dysfunction.
In case of complete ruptures, complete defects of ligaments and tendons are revealed with a discrepancy of the ends by 1-3 cm and fluid at the site of the rupture.

Diagnosis of muscle and ligament ruptures.Characteristics 90 140 90 141

On a series of images, soft tissue ruptures are manifested by characteristic features:

• an increase in volume and a violation of the normal structure of the muscles;
• hematoma and diffuse edema at the site of injury;
• accumulation of fluid in deep intermuscular spaces.

Thus, the high sensitivity of modern equipment makes MRI the most valuable method for diagnosing traumatic injuries of ligaments and muscles.

90,000 Rules of healthy eating when doing fitness

Preparation
In a normal way of life, the body consumes 2-3 liters of water daily. With intense physical exertion, more fluid is required; lack of proper attention to this feature can lead to dehydration. Therefore, before training, it is useful to drink 0.5-0.6 liters of water (without gas) in 1-2 hours. It is also advisable to take water with you to training. Additional liquid allows you to more efficiently remove toxins and metabolic products, the production of which becomes more intensive due to the acceleration of metabolism.In addition, it is useful to enrich your meals on workout days with foods containing catechins: berries, fruits, green tea, cocoa beans. Catechins help fight off excess calories by regulating blood sugar levels, having antioxidant activity and helping to increase energy expenditure and speed up metabolism.

Meals on the day of training, if it is planned for the early hours, should be light: it is good to eat muesli with yogurt or drink tea with honey. During the day, you can eat in 2-3 hours, including legumes or cereals in the meal (the content of complex carbohydrates should be approximately 50-100 g) and 100-150 g of seafood or lean chicken.Do not completely neglect food: fasting lowers sugar levels and also slows down metabolism, this negatively affects the effectiveness of training.

During training
Intense physical exercise is an additional burden for the body. Already during the warm-up, he begins to readjust to active activity, while resources are mobilized.

1. The energy source for muscles is glycogen. It is consumed intensively during training.In addition, as a result of the activation of metabolic processes, lactic acid accumulates in the muscles, which interferes with their contraction and creates painful sensations after exercise. Need: remove acid from the body
2. To obtain energy, the body first of all begins to use carbohydrates, then fats. It is at this moment of training that the feeling of hunger appears.
   Do: refrain from any food intake for at least an hour after finishing your workout.
3. Actively working muscles require additional oxygen and nutrition.
   It is necessary: ​​to provide the muscles with the substances in the required amount.
4. Intense sweating leads to thickening of the blood.
   It is necessary: ​​to prevent the possible appearance of blood clots.

While exercising, pay close attention to possible signs of dehydration: headache, dizziness, dry mouth. In the future, this can go to general weakness, increased fatigue, loss of activity. Therefore, when the first symptoms of dehydration appear, you should immediately start drinking water.Interrupt this workout until the condition returns to normal. Approximate volume of water for a person weighing 60-75 kg: 100-150 ml, calculated for 10-15 minutes. More intense loads require more fluid, it is also useful to use not pure water, but special isotonic drinks, which contain vitamins, trace elements and carbohydrates. In contrast, nutrition during exercise is undesirable. Only if the duration of the workout is more than 2 hours, you should refuel a little with dried fruits.

After training

The main tasks of this period are to restore the normal rhythm of the heartbeat and as quickly as possible to remove from the body the accumulated toxins formed as a result of muscle activity. This requires an additional amount of liquid. In addition, you need to “return” to the body useful trace elements and vitamins that came out along with sweat during training. Drinking a glass of freshly squeezed apple or carrot juice half an hour after class will also help restore energy.
An hour after class, it is time to eat. What are the best things to eat after exercise? In the morning, for those who want to lose weight, green salad and boiled salmon are suitable, and for those who are working on gaining muscle mass, grilled chicken breast and 100 g of rice are suitable. In the afternoon, you can limit yourself to 100-150 g of low-fat cottage cheese or 1-2 glasses of low-fat kefir.
Other recovery methods
Walking. In order to calm the pulse and bring it to 60-80 beats, it is useful to walk a little calmly, preferably in the fresh air.This allows you to prolong the breakdown of fats, as well as provide the body with additional oxygen. When walking, the muscles return to normal operation within 10 minutes. The total recommended walking time is 30-40 minutes.
Pool. Promotes the restoration of the thermoregulatory system and muscle tissue, the elimination of lactic acid, creates an additional aerobic load. It’s good to swim for 15-20 minutes right after your workout.
Bath. Helps to strengthen the immune system, improve the condition of the ligaments and joints.On the other hand, the bath creates additional stress on the thermoregulatory system and the heart, it should be used with caution, especially after an intense workout. Recommended regimen: 2-3 sessions, from 5 to 15 minutes each, after high loads it is better to limit yourself to one 5-minute session.

I WANT TO LOSE IN 30 days

Fitness Menu
Strength Training

The main task is to provide the body with a sufficient amount of essential substances.The intake of protein should be at least 1.2-1.6 g per 1 kg of body weight, carbohydrates – 3-4 g, fats – 0.7-0.8 g. The recommended amount of calories is 34-36 kcal per 1 kg of body weight. It is best to avoid fried foods, saturated fats, and simple carbohydrates on the day of your workout. For those who want to lose weight, you can eat a salad of fresh vegetables (200 g), for those who build muscle mass – lean pork or chicken (200 g).

Cardio

A significant increase in the volume of carbohydrates and a decrease in the volume of proteins are required.Carbohydrates should be up to 5-6 g per 1 kg of body weight, proteins – 0.8-1 g. Directly during classes, be sure to use water, preferably an isotonic drink. For those who want to lose weight, you can use the ratio of fats, proteins and carbohydrates the same as in the case of strength training, but at the same time lower the calorie content of food to 26-30 kcal. Ideal food before cardio is cereals with low-calorie kefir. Another option is stewed vegetables and rice, 100g each.

Yoga and Pilates

The diet should be balanced: for each gram of protein – 0.8 g of fat, 4 g of carbohydrates.Energy value: 30-34 kcal. Foods containing fibrous carbohydrates such as vegetables and herbs are recommended. Smoked meats, fatty meats, fish are best excluded. A vegetable stew, tomato soup with spinach and rice, a salad of fresh vegetables, or a glass of low-fat milk will give you a good mood for class.

DETRIMAX ACTIVE 30ML LIQUID FLAC WITH PUMP-PUMP

necessary for human body activity 9000 -MUSCULAR SYSTEM.Participates in the regulation of phosphorus-calcium metabolism: helps to absorb calcium in the intestine, maintains the necessary levels of calcium and phosphorus in the blood, activates bone metabolism. Promotes bone strength and reduces the risk of rickets and osteomalacia111. Maintaining normal vitamin D levels is critical at any age, but especially in the elderly, when the risk of falls and bone fractures is increased. Vitamin D strengthens teeth by activating the production of dentin, the main constituent of dental hard tissue.Adequate vitamin D levels in the body reduce the risk of tooth decay. ‘ Helps maintain muscle strength and neuromuscular conduction1. Vitamin D deficiency is associated with muscle weakness, which, especially in the elderly, may have difficulty walking.