Geschatte leestijd: 4 minutenSpinning classes are not entirely safe. The American Journal of Medicine published in April three cases of rhabdomyolysis and kidney problems in people who participated in a spinning class.
Spinning and Rhabdomyolysis
You will never catch me dead in one of those disco rooms with bikes. I’ve never understood it. I guess my dislike for loud dance music and house probably has something to do with it. The fact that I don’t like biking undoubtedly plays a role too. The idea that you’ve cycled your lungs out for an hour and still remain in the same place probably has something to do with it too. But that’s obviously just a personal preference. I’m all for the entertainment factor to keep people motivated during the classes.
However, there seems to be a potential danger associated with spinning classes, especially for beginners. The American Journal of Medicine published in April three cases of kidney problems in people who participated in a spinning class [1]. Rhabdomyolysis is a condition in which muscle fibers are broken down under great stress [2]. This releases breakdown products such as myoglobin and creatinine into the bloodstream, which can lead to kidney failure and be life-threatening [3,4,5]. Excessive physical exertion is one of the ways rhabdomyolysis can occur [6].
I have previously written about rhabdomyolysis in the context of crossfit and their official mascot Uncle Rhabdo because apparently they’re proud that a successful training session ends with a kidney dialysis. You might not immediately expect spinning classes to pose the risk of kidney failure. However, a previous study found that crossfit doesn’t score so ‘well’ when it comes to the number of participants sent to the emergency room with ‘rhabdo’. A hospital in New York published the figures on the number of visits to their emergency room due to rhabdo from training [8]. They counted 29 cases caused by activities such as weightlifting, crossfit, running, and P90X. However, the most common cause was attending a spinning class!
Spinning: Beginners Beware
One of the cases described in April in the American Journal of Medicine is that of Christina D’Ambrosio (33 years old) who took her first spinning class three years ago. Christina already trained regularly but had never participated in a spinning class before. She found the training tougher than expected, and her legs felt painful and wobbly after the class. The preschool teacher didn’t find that very strange; her body must still be getting used to this type of training. However, the next two days, her legs started to ache very painfully, she became nauseous, and her urine turned dark brown. She went to the hospital where she was diagnosed with rhabdomyolysis. She recovered after a two-week stay in the hospital.
In another case, only 15 minutes of spinning were done. Enough for the 33-year-old woman to step off the bike feeling dizzy and vomiting. Four days later, she was admitted with rhabdomyolysis.
The third case involved a 20-year-old man who could no longer lift his legs three days after the spinning class and had to be admitted.
46 Cases of Rhabdomyolysis after Spinning Class
The report refers to 46 other cases of people who developed rhabdomyolysis after a spinning class. For 42 of them, it was their first spinning class (and possibly the last).
An earlier publication in 2014 highlighted the case of two people who went to the emergency room shortly after their first spinning class. One of them was a 24-year-old woman whose leg had to be cut open to relieve the building pressure [7].
Rhabdomyolysis occurs relatively frequently in exhausted soldiers and firefighters, but also in cocaine users and victims of natural disasters. Additionally, it is also regularly seen in athletes who have undergone very strenuous training.
Spinning: Build Up Gradually
The reason it is now also relatively often seen after spinning classes may lie in the seemingly low threshold for a spinning class. As a participant, you may not immediately realize that it can be quite an intensive and exhausting training. As an instructor, you may not take into account enough that not everyone, let alone beginners, can immediately keep up at the same pace or for the same duration.
Everyone understands that you can’t cycle up a mountain stage of the Tour de France untrained. The intensity of a spinning class may be underestimated.
The numbers are quite clear; 42 out of the 46 cases involved new participants. We are talking about rhabdomyolysis now, but you can imagine that less severe complaints due to overtraining will occur even more frequently.
Taking into account the participant’s level could prevent a lot of problems. This may mean that you need to organize the classes differently and offer separate classes for beginners, or structure the classes themselves so that you can easily work within one group with differences in intensity. The first option may be difficult organizationally since you don’t always have enough registrations for a beginner class. The second option may be difficult because as a trainer within one group, you need to know which intensity belongs to which members.
What these publications make clear in any case is that the intensity of spinning should be taken seriously. The instructor has the responsibility to adjust the intensity to the participant. The participant themselves should listen carefully to their own body. The fact that the rest keeps on pedaling happily doesn’t mean you’re weak if you step off.
References
- Brogan, Maureen et al. Freebie Rhabdomyolysis: A Public Health Concern. Spin Class-Induced Rhabdomyolysis. The American Journal of Medicine , Volume 130 , Issue 4 , 484 – 487
- Farmer J: Rhabdomyolysis. In In Critical Care. 2nd edition. Edited by Civetta J, Taylor R, Kirby R. Philadephia, PA: Lippincott; 1997::1785-1791.
- Warren J, Blumberg P, Thompson P: Rhabdomyolysis: a review. Muscle Nerve 2002, 25:332-347.
- Huerta-Alardín AL, Varon J, Marik PE (2005). “Bench-to-bedside review: rhabdomyolysis – an overview for clinicians”. Critical Care 9 (2): 158–69. doi:10.1186/cc2978. PMC 1175909. PMID 15774072.
- Bosch X, Poch E, Grau JM (2009). “Rhabdomyolysis and acute kidney injury”. New England Journal of Medicine 361 (1): 62–72. doi:10.1056/NEJMra0801327
- Gabow P, Kaehny W, Kelleher S: The spectrum of rhabdomyolysis.Medicine 1982, 62:141-152.
- DeFilippis EM, Kleiman DA, Derman PB, DiFelice GS, Eachempati SR. Spinning-induced Rhabdomyolysis and the Risk of Compartment Syndrome and Acute Kidney Injury: Two Cases and a Review of the Literature. Sports Health. 2014 Jul;6(4):333-5. doi: 10.1177/1941738114522957. PubMed PMID: 24982706; PubMed Central PMCID: PMC4065558.
- Cutler TS, DeFilippis EM, Unterbrink ME, Evans AT. Increasing Incidence and Unique Clinical Characteristics of Spinning-Induced Rhabdomyolysis. Clin J Sport
Med. 2016 Sep;26(5):429-31. doi: 10.1097/JSM.0000000000000281. PubMed PMID:27604073.
