SINGAPORE – When Denise Neo signed up for her first spin class in March final yr, she was excited to embark on a brand new exercise routine on high of her common working and energy workouts at house, and needed to see what spinning might supply.

Midway via the category, she began to really feel discomfort- her thigh was hurting and was dropping energy, however she managed to stay it out until the tip of the category.

Whereas Neo skilled muscle ache and soreness after the exercise, she brushed it off, pondering that it was the same old soreness after intense train. Two days later, the ache in her legs grew to become “insufferable” and “a torture”, to the purpose the place her total thigh was stiff and he or she couldn’t transfer nor bend her legs.

When she seen that her urine had darkened, she grew to become nervous and took herself to the accident and emergency division at a close-by hospital, the place the medical doctors identified her with exertional rhabdomyolysis (ER). She was hospitalised for near per week.

The 29-year-old stated: ” I can not even start to explain how painful it was. It was only a totally different form of soreness from the same old muscle aches. When stepping into the Seize (automotive) to the hospital, I might barely even stroll.”

Based on Dr Benjamin Soh, a registrar at Khoo Teck Puat Hospital’s (KTPH) Sports activities and Train Medication Centre, rhabdomyolysis happens when the muscular tissues are pushed past their restrict for a protracted interval, resulting in the muscle cells being depleted and in the end dying. The lifeless muscle cells are then damaged down and launched into the bloodstream, resulting in the assorted destructive results described.

In extreme circumstances, the situation can result in kidney failure and even demise.

He added that widespread signs embody extreme muscle aches, weak point or swelling within the affected muscular tissues, and pink or brown discolouration of the urine. Different much less widespread signs embody fever, a speedy coronary heart beat at relaxation, and nausea and vomiting.

However he insisted that rhabdomyolysis associated to strenuous exertion is pretty uncommon, with trauma, maybe in an accident, being the most typical trigger.

“Though the precise statistics usually are not accessible, most hospitals possible solely see just a few circumstances in a yr,” he stated. “A research in navy recruits present process primary coaching confirmed 22.2 circumstances per 100,000 per yr – solely about 0.02 per cent.”

All through Neo’s keep within the hospital, she was hooked as much as an intravenous (IV) saline drip.

Dr Wang Ming Chang, a guide on the Nationwide College Hospital (NUH)’s Division of Sports activities Medication Surgical procedure, defined that the first therapy for rhabdomyolysis is hydration and sustaining a excessive urine output to flush out muscle breakdown merchandise from the kidney and physique.

Sufferers usually are not launched till the degrees of an enzyme referred to as creatine kinase – which is produced by the physique when there may be muscle harm – within the bloodstream are on a downward pattern, and they’re then adopted up in an outpatient clinic till full restoration. Because the affected muscular tissues might be weaker resulting from part of the muscle dying, it might take a number of weeks to months to coach them again to their preliminary state. Restoration durations fluctuate between people.

‘Spin on one other degree’

Neo isn’t the one individual to have been identified with rhabdomyolysis after a spin class.

Spinning, a high-intensity cardiovascular exercise on a stationary bicycle, has gained a big following through the years. It’s a one-of-a-kind exercise expertise, the place people spend 45 minutes pedalling furiously in a dimly-lit room alongside to loud, pumping music starting from EDM to the most recent chart hits – considerably like clubbing.

In a research revealed within the American Journal of Medication in 2017, medical doctors famous at the very least 46 reported circumstances of rhabdomyolysis after a spin class – with 42 of them occurring after a first-ever session.


Aloysius Lee was identified with rhabdomyolysis and hospitalised for nearly per week after attending two spin lessons. PHOTOS: COURTESY OF ALOYSIUS LEE

Aloysius Lee additionally suffered rhabdomyolysis after a spin class. He admitted that he might need pushed himself past his bodily limits.

He stated: “Spin is on one other degree relating to utilizing our thigh muscular tissues. There is no such thing as a different exercise that might be as intense as the quantity of vitality you utilize in your thigh muscular tissues for spin class.”

An administrative assistant who needed to be identified solely as Ms A.L, additionally identified that the spinning sneakers, which include cleats, and the fast-paced music can also play an element in individuals getting carried away.

She stated: “As our sneakers are clipped onto the pedal, the pedal will carry on going due to the pace, so it’s laborious to know when you may have overexerted till you get off the bike.”

Hearken to your physique

Whereas bodily untrained people could also be extra vulnerable to rhabdomyolysis, Dr Wang stated that it might additionally occur to anyone, even elite athletes. Some threat components he listed embody overexertion in sizzling and humid situations, in addition to exercising while dehydrated, fatigued or in poor health. These taking sure drugs resembling statins for prime ldl cholesterol or antidepressants, particularly selective serotonin reuptake inhibitors, are additionally in danger.

He suggested learners in group train lessons to hearken to their physique and never be obliged to comply with the group. People must also begin low and go sluggish by way of rising train depth, in addition to keep nicely hydrated throughout bodily exercise particularly in sizzling and humid situations.

Dr Soh cautioned: “Being good at one sort of train doesn’t essentially imply you’ll mechanically be good at all sorts. At all times take a number of classes to familiarise your self and construct tolerance to the precise workouts you’ll be doing.”

Security first, say studios

Spin studios and instructors took pains to emphasize that the security of their riders stays of utmost significance.

Theresa Shan, basic supervisor of Absolute You Singapore – a boutique health studio that gives pilates and spin lessons – stated that the studio is among the few in Singapore that makes newbie lessons necessary for folks on trial packages, or are attempting out spin for the primary time. She identified that these lessons are vital as they’re “held at a slower tempo, orientate new customers on how you can use the bike, in addition to takes them via expectations of the category”.

She stated: “Being in a category atmosphere helps to push people to make sure that they get the very best of the exercise, however people must bear in mind their bodily skills and never push themselves too far. As those that come experience with us are all adults, they need to be capable to make accountable selections on their very own.”

Shan additionally identified that instructors within the studio do typically remind their college students to hydrate and gasoline themselves adequately.

Actress and TV host Charmian Tan, who can be an teacher at Absolute Cycle, took to her Instagram web page to handle the matter after information broke that two ladies had suffered rhabdomyolysis after attending a spin class earlier this yr.

She wrote: “No teacher ought to ever have the ultimate say over your exercise. The precise teacher will at all times encourage you to hearken to your physique and present you what you will be finished, not dictate your physique limits.

“If one thing doesn’t really feel proper, please do not ever really feel like it’s important to ‘suck it up’ as a result of everybody else appears to be nailing a routine…Figuring out ought to at all times be fulfilling and really feel achievable, if it’s all ache, it (isn’t) value it.”

Natalie Tan, spin teacher at studio Sync Cycle, echoed the identical sentiments. She stated: “There is no such thing as a stress and no judgement within the room. Benefit from the class, if you’re drained, go forward and relaxation. Simply be a part of us again on the bike each time you’re prepared.”





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