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Damaged muscle releasing its contents into the blood, where they can harm the kidneys. Severe muscle pain with dark, tea-coloured urine needs to be seen the same day — during opening hours, call us first, and we can arrange admission to Gleneagles Hospital if you need it.
Muscle pain or weakness after exercise, an injury or a long period lying still needs to be checked the same day if it comes with any of these:
During our opening hours, call us on +65 8849 0677. We will assess you the same day and, if you need hospital treatment, admit you directly to Gleneagles Hospital or its emergency department.
Outside opening hours, go to an emergency department. We are open Monday to Friday 9am to 5:30pm, and Saturday 9am to 1pm. If symptoms are severe or getting worse quickly, call 995. Tell the doctor what exercise, injury or medicines came before it.
Call +65 8849 0677Rhabdomyolysis — often shortened to rhabdo — is the rapid breakdown of damaged skeletal muscle. As the muscle cells break down, they release their contents into the bloodstream.
Two of those contents cause most of the danger. Myoglobin, the protein that holds oxygen in muscle, can block and damage the kidneys, and is what turns urine dark. Potassium, released in large amounts, can disturb the heart’s rhythm. With early treatment, most people recover fully, including their kidney function.
Muscles ache after hard or unfamiliar exercise, and almost always that is normal. These are the differences that matter.
| Normal soreness | Rhabdomyolysis | |
|---|---|---|
| When it comes on | 12 to 24 hours after exercise, peaking at one to three days | During or soon after, and can keep getting worse |
| How it feels | Stiff and tender; eases with gentle movement | Severe pain out of proportion, with swelling and marked weakness |
| Using the muscle | Uncomfortable but possible | Struggling to stand, climb stairs, or straighten the arms |
| Urine | Normal colour | Dark, tea- or cola-coloured; often less of it |
| What to do | Rest, gentle movement, fluids | Same-day assessment: call us in opening hours, otherwise an emergency department |
Dark urine after exercise can also come from dehydration. But dark urine together with severe muscle pain or weakness should be treated as rhabdomyolysis until a blood test shows otherwise.
Symptoms can be mild, or delayed. Some people notice little beyond sore muscles, and the classic dark urine is not always present. Where the history fits — an unaccustomed hard workout, heat, a crush injury — a blood test is what settles it.
Diagnosis is made in hospital, mainly with blood and urine tests.
Treatment happens in hospital, and starting it early is what protects the kidneys.
The main treatment: generous fluids through a drip to flush myoglobin through the kidneys, with urine output and blood tests checked closely.
High potassium is treated quickly because of its effect on the heart. Other salts are monitored and corrected as needed. Any medicine that may have contributed is reviewed.
A minority need temporary dialysis while the kidneys recover. Most regain normal kidney function.
If pressure builds dangerously inside a muscle compartment, an emergency operation (fasciotomy) releases it to save the muscle and limb.
Rhabdomyolysis is treated in hospital. During opening hours, our orthopaedic surgeons can assess a suspected case the same day and, if you need treatment, admit you directly to Gleneagles Hospital. After you have been discharged, they can also help with what follows:
Yes. It can damage the kidneys and disturb the heart’s rhythm, so severe muscle pain or weakness with dark urine needs to be seen the same day. During opening hours, call us: we can assess you and arrange admission to Gleneagles Hospital. Outside opening hours, go to an emergency department.
Yes. Intense or unfamiliar exercise is one of the commonest causes, especially in the first session of a new class, in heat, or when dehydrated. Building intensity gradually lowers the risk.
No. Dehydration can darken urine too. But dark urine together with severe muscle pain or weakness should be checked the same day.
Most people return to full activity. Wait until symptoms have settled and blood tests are normal, then build up gradually over several weeks.
Rarely. Do not stop a prescribed statin on your own, but tell your doctor promptly about unexplained muscle pain or weakness, especially with dark urine.
No. For suspected rhabdomyolysis during opening hours, call us and we will see you the same day; outside opening hours, go to an emergency department. For follow-up after hospital, bring your discharge summary and blood test results.
For suspected rhabdomyolysis, call rather than book online so we can see you the same day. For follow-up after hospital, bring your discharge summary.
