We’ve seen plenty of accidents happen at the gym—barbells to the windpipe, kettlebells to the nether regions, and whatever the hell this guy was doing on the cable machine. And every runner knows just how dangerous a stray dog or a surprise swarm of hornets can be.
But workouts need not involve flying metal or flying insects to turn deadly. No, we’re talking about when athletes push themselves—and their bodies—to the point of breaking down, whether from extreme conditions, electrolyte imbalance, or sheer exhaustion.
So we talked to the experts and got their feedback on the most potentially dangerous problems an athlete could face. Make sure you know the warning signs while you're working out—and exercise wisely, because nothing ruins #legday like a pair of failing kidneys.
Rhabdomyolysis is probably one of the most dangerous conditions, both short-term and long-term, that can result from simply working your body past the point of exhaustion. It happens most often with weightlifters and marathon runners who exhaust their muscles while also dehydrating themselves, particularly in hot conditions. Rhabdo can also be caused by drinking too much booze, and may even also be linked with taking too many creatine supplements or anabolic steroids, according to the Mayo Clinic.
With "rhabdo," as it’s known, muscle cells actually start to break down and release a protein called myoglobin into the bloodstream that can damage the kidneys. Symptoms include intense muscle pain and weakness and dark-colored urine; if someone suffering from rhabdo doesn’t get medical attention immediately, their kidneys can sustain permanent damage.
After the MMA fighter Dhafir Harris (a.k.a. Dada 5000) suffered two heart attacks during a February bout against Kimbo Slice, he blamed rhabdomyolysis. He admitted that he’d “pushed himself” to lose 40 pounds, and that his kidneys had “locked up” during the fight. “I think that my body was not used to that, because I'm not a full-time fighter,” he said on the Dan LeBatard Show. “I think that my body having so much time being off, and to push it from zero to 60, that could be something to focus on.”
Fortunately, this is a syndrome that's simple to prevent. We’re all for pushing yourself to the limit, but never go so far that your body starts to break down under the stress. If you’re new to a sport, or you’re ready to embark on a sudden, extreme new exercise technique, then do it under the eye of a trainer who knows what they’re doing—and who isn’t going to grind you into a pulp with failing kidneys.
2. Electrolyte imbalance
A hardcore workout—timed with a grueling weight-loss program and/or a sudden sugar rush—can throw your body chemistry dangerously off-track in the form of an electrolyte imbalance, which can result from either too much (hyper-) or too little (hypo-) of a given electrolyte.
“If there’s a disruption of key electrolytes like potassium, magnesium, or calcium, then that can cause electrical abnormalities in your heart,” says Dr. Michael Ackerman, M.D., a Mayo Clinic cardiologist—and, in extreme cases, result in a heart attack. “We know for sure that extremely rapid weight loss can cause major issues with swings in body electrolytes. That’s enemy number one from these weight-loss programs.”
Sudden weight loss can also be potentially deadly in the form of re-feeding syndrome, which affects people who suddenly eat or drink after conditioning their bodies to a starvation diet.
“Sometimes fighters or wrestlers will [starve themselves] to make weight, and then eat a fair amount after the weigh-in,” says Donald Hensrud, M.D., M.P.H., a Mayo Clinic doctor who specializes in nutrition, obesity, and exercise. “By feeding people too much too fast, it can actually wrench your body out of a compensated situation”—when it’s adjusted to starvation—“and suddenly create all kinds of chaos,” Hensrud says. It can even harm an athlete’s mental sharpness.
When Dada 5000 crumpled to the canvas against Kimbo Slice, it’s possible—albeit impossible to say for sure—that he was suffering from refeeding syndrome brought on by a sudden rush of sugar after a period of intense weight cutting. In turn, the electrolyte imbalance could have (again, can't say for sure) disrupted his normal cardiac rhythm.
“It’s hard to say at what point you cross the line, but in general, the degree of weight loss, the longer it goes on, and the quickness of the refeeding” all affect the severity of re-feeding syndrome,” Hensrud says.
3. Exertional heat stroke
Technically called hyperthermia, “exertional heat stroke” is a potentially deadly combination of overheating your system while working out too hard.
And while there is some evidence that training in hot weather can improve your cardio ability, it’s also true that too much heat—particularly when the body exceeds 104°F—can have a devastating impact on your body. Symptoms include confusion, nausea or vomiting, fatigue, lightheadedness, and low blood pressure, according to the Mayo Clinic. If you start feeling those symptoms, or if you notice someone at the gym who’s looking that way, make sure they stop working out and get into a cool place—even if they say they’re fine.
Even elite athletes can die from heat stroke. One famous case: Korey Stringer, a Minnesota Vikings lineman and former collegiate All-American, who died from complications related to heat stroke during a team practice in August 2001. Stringer’s sudden death—and the lawsuit brought by his widow—ultimately spurred the NFL to create a heat illness prevention program.
Hypothermia, defined as when the body’s core temperature sinks significantly below the normal 98.6°F, is typically associated with alpine sports. But hypothermia can often sneak up on everyday athletes in several other scenarios, including long-distance swimming. Swimmers in water around 48–52°F can usually tell when they’re too cold, but their judgment falters when they’re in long-distance or especially competitive races, according a British study published in 2001.
And you don’t need to be underwater or on top of a mountain to suffer from hypothermia. Say you’re on a long, sweaty run in cold weather. Once you stop running, your sweat-soaked shirt can cool off quickly, forcing your body to warm not only itself but also your gear—and puts you at risk for hypothermia. Keep a sweatshirt handy, or make sure you can change into dry clothes quickly.
You know this one. Yet dehydration can be one of the most common afflictions to strike during a workout—and, potentially, one of the most dangerous ones. Working out in hot, humid weather or a hot, humid gym? Sweating a lot? You’re at risk for dehydration, which occurs when your body loses much more water than you take in.
And while mild dehydration is usually manageable (albeit associated with significant declines in athletic performance) severe dehydration can create severe electrolyte imbalances. When the body’s supply of water starts drying up, its concentration of electrolytes increases. Just as a tablespoon of salt won’t really affect the taste of five gallons of water but have a big impact on a cup of water, serious dehydration can make it seem like your body has far more electrolytes than normal.
The easiest fix? Prevent dehydration from happening in the first place. Keep an eye out for these five signs you may be dehydrated, and make sure you follow these basic hydration rules, whether you’re running through Death Valley or sitting at your desk.
If you’re on a weight loss program, or you’re attempting an especially challenging workout where you might sweat out a lot of fluid, then make sure you’re taking steps to properly replenish all the electrolytes you’ll lose. And work out smart: If you think a workout will be too much of a shock to the system, it probably is.