SHM Converge Scientific Abstract ePoster Gallery-Breaking It Down - Spin Class Induced Rhabdomyolysis in a Healthy Young Adult

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This case describes a 21-year-old healthy woman who developed spin class–induced rhabdomyolysis after a high-intensity cycling workout. She presented with 5 days of bilateral thigh pain, worsening soreness, difficulty walking, lower abdominal pain, and 1 day of dark urine. She was initially treated at urgent care for a presumed UTI after urinalysis showed blood and protein, but her symptoms worsened and she came to the emergency center.<br /><br />On exam, she was tachycardic and had tenderness over both quadriceps and the lower abdomen, but no clear signs of compartment syndrome. Labs were diagnostic for severe rhabdomyolysis: creatine kinase (CK) was 100,000 U/L, with elevated AST and ALT, but normal kidney function. Urinalysis showed blood, protein, and mild pyuria, which can occur with myoglobinuria. Ultrasound ruled out DVT and abdominal pathology.<br /><br />She was treated primarily with aggressive IV fluid resuscitation: 3 liters of normal saline followed by maintenance fluids, with a goal of urine output around 200–300 mL/hour. Her CK improved rapidly, symptoms lessened, and surgery evaluated her when leg swelling increased, but compartment syndrome was excluded. IV fluids were later stopped as CK downtrended, and she was discharged with oral hydration and follow-up. Her CK, liver enzymes, and metabolic panel normalized on outpatient testing.<br /><br />The case highlights that exercise-induced rhabdomyolysis is increasingly seen in group fitness settings like spin classes, especially among beginners without conditioning. Early recognition is important to prevent complications such as acute kidney injury, liver enzyme elevation, arrhythmias, and compartment syndrome. Patients with recurrent episodes or severe cramping should be considered for genetic or metabolic myopathy testing.

Asset Subtitle

Anna K. Young

Meta Tag

Author List Aaron Pathak, Anna K. Young, Doris Lin, Ifeanyi Anyaoha

Category Clinical Vignettes

Concept Rhabdomyolysis

Concept Exercise-Induced Muscle Breakdown

Concept Creatine Kinase

Concept Acute Kidney Injury

Concept Fluid Resuscitation

Distinguished Non-Finalist

Presenter Organization Baylor College of Medicine

Presenting Author Anna K. Young

Track Adult

Keywords

rhabdomyolysis

spin class

high-intensity exercise

creatine kinase

myoglobinuria

dark urine

quadriceps pain

intravenous fluids

acute kidney injury

compartment syndrome

Rhabdomyolysis

Exercise-Induced Muscle Breakdown

Creatine Kinase

Acute Kidney Injury

Fluid Resuscitation