What is Rhabdomyolysis? Rare muscle condition linked to 24-year-old marathon runner's sudden death
A 24-year-old woman who had ‘perfect health’ died while running the New York Marathon due to a rare condition called rhabdomyolysis, her heartbroken dad has said.
Rachel Apa, from Pennsylvania, was rushed to The Mount Sinai Hospital after falling ill just two miles from the finish line on Sunday (1 November) and tragically died just hours later.
“It’s unfathomable,” Apa told the New York Times.
“Perfect health, perfect shape, 24 years old.”
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Apa said his daughter had been a lifelong athlete and lover of exercise, who had trained for months to take part in her first marathon.
Her devastated dad said he was tracking his daughter’s progress as she made her way 26.2 mile course.
Rachel also checked in with her dad via text, messaging him the single word ‘ow’ at mile 18 followed by ‘ow ow’ at mile 19.
At mile 23, Apa texted Rachel telling her she was on the ‘final stretch’ but she did not reply.
Her dad, Steve Apa, told NBC News that doctors told him his daughter had died of rhabdomyolysis - a rare but serious medical condition that causes the muscles to break down, flooding the body with proteins and electrolytes that damage organs including the kidney and heart.
Dr. Douglas Farrell, a nephrologist at Mount Sinai Hospital who was not involved in Rachel’s care told NBC that since 2022, doctors had seen a rise in rhabdomyolysis - or rhabdo - in endurance runners.
The condition has also been documented in other sports, including high-intensity fitness training and indoor cycling.
Doctor Farrell warned that warmer weather can increase the risk of muscle damage.
“If you were recently ill, or if you are even sleep-deprived, these are things that potentially all put you at risk for heat-related injury outside of just your fitness,” he said.
What is rhabdomyosis?
Rhabdomyosis ‘is a life-threatening condition that can happen after an injury or excessive exercise without rest’, the Cleveland Clinic notes.
The condition causes muscles to break down or disintegrate, which causes muscle death and the release of toxic components of the muscle fibers into the circulatory system.
This can cause sudden and life-threatening kidney failure.
It can also lead to fatal health complications.
“This dangerous muscle condition can result from overexertion, trauma, medications or an underlying health condition,” the Cleveland Clinic adds.
“Rhabdomyolysis is relatively uncommon. Every year, about 26,000 people in the United States develop this condition.”
What are the signs to look out for?
Symptoms of rhabdomyolysis include:
- Weak muscles
- Muscles swelling
- Tender or sore muscles
- Dark pee that is brown, red or ‘tea-coloured’
Dr Farrell said other warning signs can include exhaustion, dizziness, fatigue and lightheadedness.
“These are symptoms that are kind of broad that many of us who do athletics may have experienced,” he said.
“But these are also sort of symptoms that could also be related to exertional heat-related injury that may put you at risk for rhabdomyolysis.”
He added: “If you’re finding that your body feels weak or that you feel like you know you’re feeling dizzy, I think it’s probably a moment to maybe slow down or even stop and find attention.”
He also warned that symptoms can take days or even weeks to develop.
If you have any of the symptoms you should see your doctor or healthcare provider to get tested.
Claire Reid
