Advertisement

Freebie Rhabdomyolysis: A Public Health Concern. Spin Class-Induced Rhabdomyolysis

Published:November 28, 2016DOI:https://doi.org/10.1016/j.amjmed.2016.11.004

      Abstract

      Background

      Rhabdomyolysis is a pathologic condition in which intracellular muscle constituents leak into the blood circulation. It is usually caused by muscle trauma. “Spinning” is an indoor form of cycling where participants use a special stationary exercise bicycle with a weighted flywheel and undergo high-intensity cycling classes focusing on endurance. There have been several case reports in the literature of exertional rhabdomyolysis following spin class.

      Methods

      Our nephrology practices have diagnosed a number of cases of symptomatic patients presenting to our emergency departments following their first spin classes, with histories and creatinine phosphokinase levels diagnostic of exertional rhabdomyolysis.

      Results

      We present 3 unusual cases of exertional rhabdomyolysis, each occurring after a first spin class. In the first case, rhabdomyolysis developed following 15 minutes of spin class. In the second case, it occurred in a young individual who exercises regularly. In the third case, the patient developed biopsy-proved acute kidney injury secondary to exertional rhabdomyolysis and required hemodialysis.

      Conclusion

      The high-intensity exercise associated with “spin class” comes with significant risks to newcomers.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Huerta-Alardín A.
        • Varon J.
        • Marik P.
        Bench-to-bedside review: rhabdomyolysis – an overview for clinicians.
        Crit Care. 2005; 9: 158-169
        • Bosch X.
        • Poch E.
        • Grau J.
        Rhabdomyolysis and acute kidney injury.
        N Engl J Med. 2009; 361: 62-72
        • Tietze D.
        • Borchers J.
        Exertional rhabdomyolysis in the athlete: a clinical review.
        Sports Health. 2014; 6: 336-339
        • Young I.
        • Thomson K.
        Spinning-induced rhabdomyolysis: a case report.
        Eur J Emerg Med. 2004; 11: 358-359
        • Ainsworth B.
        • Haskell W.
        • Whitt M.
        • et al.
        Compendium of physical activities: an update of activity codes and MET intensities.
        Med Sci Sports Exerc. 2000; 32: S498-S504
        • Hazelhurst L.
        • Claassen N.
        Gender differences in the sweat response during spinning exercise.
        J Strength Cond Res. 2006; 20: 723-724
        • Ramos-Jiménez A.
        • Hernández-Torres R.
        • Wall-Medrano A.
        • et al.
        Gender- and hydration- associated differences in the physiological response to spinning.
        Nutr Hosp. 2014; 29: 644-651
        • Battista R.
        • Foster C.
        • Andrew J.
        • Wright G.
        • Lucia A.
        • Porcari J.
        Physiologic responses during indoor cycling.
        J Strength Cond Res. 2008; 22: 1236-1241
        • Siegel A.J.
        • Silverman L.M.
        • Lopez R.E.
        Creatinine kinase elevations in marathon runners: relationship to training and competition.
        Yale J Biol Med. 1980; 53: 275-279
        • Ramme A.
        • Vira S.
        • Alaia M.
        • Van De Leuv J.
        • Rothberg R.C.
        Exertional rhabdomyolysis after spinning: case series and review of the literature.
        J Sports Med Phys Fitness. 2016; 56: 789-793
        • Kim D.
        • Ko E.
        • Cho H.
        • et al.
        Spinning-induced rhabdomyolysis: eleven case reports and review of the literature.
        Electrolyte Blood Press. 2015; 13: 58-61
        • Boni R.
        • Rabitti P.
        Spinning-induced rhabdomyolysis: importance of MRI for patient's outcome. A case report.
        Reumatismo. 2011; 63: 44-48
        • DeFilippis E.
        • Kleiman D.
        • Derman P.
        • DiFelice G.
        • Eachempati S.
        Spinning-induced rhabdomyolysis and the risk of compartment syndrome and acute kidney injury: two cases and a review of the literature.
        Sports Health. 2014; 6: 333-335
        • Elliott A.
        • Burke R.
        • Liggett N.
        No pain no gain? Two cases of spin class induced rhabdomyolysis.
        Ulster Med J. 2015; 84: 132-133
        • Bertoldo U.
        • Nicodemo A.
        • Pallavicini J.
        • Massè A.
        Acute bilateral compartment syndrome of the thigh induced by spinning training.
        Injury. 2003; 34: 791-792
        • Rankin A.
        • Maxwell J.
        Rhabdomyolysis and conservatively managed bilateral compartment syndrome of the thighs following strenuous exercise.
        Injury Extra. 2007; 38: 356-359
        • Benish M.
        • Zeitlin I.
        • Deshet D.
        • Beigel Y.
        Massive indoor cycling-induced rhabdomyolysis in a patient with hereditary neuropathy with liability to pressure palsy.
        Isr Med Assoc J. 2012; 14: 712-714
        • Parmar S.
        • Chauhan B.
        • DuBose J.
        • Blake L.
        Rhabdomyolysis after spin class?.
        J Fam Pract. 2012; 61: 584-586
        • Montero J.
        • Lovesio C.
        • Godoy M.
        • Ruiz G.
        Rhabdomyolysis caused by spinning in nine patients.
        Medicina (B Aires). 2009; 69: 153-156
        • Hernández-Contreras M.
        • Torres-Roca M.
        • Hernández-Contreras V.
        • et al.
        Rhabdomyolysis after initial session of indoor cycling: analysis of 11 patients.
        J Sports Med Phys Fitness. 2015; 55: 1371-1375
        • Thoenes M.
        Rhabdomyolysis: when exercising becomes a risk.
        J Pediatr Health Care. 2010; 24: 189-193
        • López-Miñarro P.
        • Muyor Rodríguez J.
        Heart rate and overall ratings of perceived exertion during Spinning® cycle indoor session in novice adults.
        Sci Sports. 2010; 25: 238-244
        • Yamin C.
        • Meckel Y.
        • Oliveira J.
        • et al.
        Genetic aspects of exercise and rhabdomyolysis.
        Pediatr Endocrinol Rev. 2014; 11: 400-408
        • Caria M.
        • Tangianu F.
        • Concu A.
        • Crisafulli A.
        • Mameli O.
        Quantification of Spinning bike performance during a standard 50-minute class.
        J Sports Sci. 2007; 25: 421-429