Rhabdomyolysis Is Systemic

I know, I know. Some of you CrossFit or lifting veterans are tired of hearing about this. But I’m having an xkcd moment (pictured below) where I need to explain something. It’s important to me. And I haven’t been able to write anything in a while anyway.


What are you crying about?

If you follow the 70′s Big Twitter you may have seen an exchange talking about a traumatic condition called Rhabdomyolysis, or “rhabdo”. I asked the lovely Shana Alverson (@ShanaAlverson) how she was feeling for CrossFit regionals, and she mentioned she had a mild case of rhabdo (seen below). I then asked a weird, inaccurate question of whether it was systemic or local. Then @TheSharkness said rhabdo was always local, which is a wrong statement, and this is why we’re here. Let’s get down to it.

What is rhabdomyolysis?

According to the A.D.A.M. Medical Encyclopedia:

Rhabdomyolysis is the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood. These substances are harmful to the kidney and often cause kidney damage.

It’s a simple definition that is quantified by the disruption of the skeletal muscle membrane — remember this sentence because it’ll be important later. CrossFit et al. has an oversimplification stating that the muscle is damaged via exertion stress, the muscle leaks myoglobin — the protein that carries oxygen in skeletal muscle — and the circulating myoglobin interferes with kidney (renal) function, and can cause acute renal failure (which can very easily lead to death). This can occur, yes, but there’s more to it.

The disruption of the membrane of the skeletal muscle means that things that are supposed to stay in the muscle cells get out, and things that are supposed to stay out get in. It’s like leaving your door open and your dogs get out while the neighborhood cats come into your house and creepily spy on you. The point is that rhabdo is defined by this breach in the membrane, and even minor cases still have this shift in contents in and out.

Why is this a systemic reaction instead of solely a local one?

I’ll try to be as simple and concise as possible for the following. The pumps on the cell membrane get damaged and they can’t function properly. Potassium leaks out of the cell into the blood stream causing a high blood serum level of potassium (hyperkalemia). Calcium increases inside the cell, which destroys the muscle fibers (necrosis). Some other stuff leaks out of the cell like phosphate, myoglobin, creatine kinase (CK) and urate, which all have an effect on their respective serum levels in the blood. My point, the catalyst argument for writing this, is that these events are systemic as opposed to local.

For example, let’s say you eat 200g of sugar. Is there a systemic response to this? Regardless of the current adaptation of the person, the answer would be yes. Serum levels of sugar increase, therefore insulin levels increase to bring the blood sugar down. Insulin, along with all hormones, has a dynamic relationship with other hormones to regulate the amount of sugar in the blood and therefore we would see arbitrary repercussions from other hormones as a result. The same goes for blood levels of anything, particularly potassium and calcium. If these levels change from homeostasis, then there is a systemic response to return to homeostasis. This is systemic, hence validating my point that rhabdomyolysis is a systemic condition, even if it’s minor.

If you’re wondering what the hell is going on, it goes like this. Muscle is damaged and stuff goes into the blood that is not supposed to. Each part of that “stuff” can do bad things if it stays there. If the total effect of all of that stuff is not enough to kill the body, then the body, AKA the system, will have a response to regulate and control it. The end.

It’s not a semantics conversation because the exact definition of rhabdomyolysis states that not only does muscle break down occur, the contents of the cell will be leaked. Simply being really sore and having damaged muscles isn’t rhabdo. It’s defined by the stuff being leaked, and it’s more than just the myoglobin. For example, the potassium and calcium being in the wrong places can cause heart arrhythmias, which can throw someone into a cardiac code and potentially kill them if treatment is not available. And, if you’re still interested, the serious cases can cause other issues like compartment syndrome, sepsis, seizures, and DIC — which are just more easy ways to die.

I’ve studied anatomy, physiology, and rhabdomyolysis itself on a personal, academic, and medical level and have been fortunate enough to talk to ER doctors and nurses, medical doctors, physician assistantants, and more about it over the years. A few people will get full blown rhabdo where they need hospitalization and help to perfuse their organs, but most of us have just been really god damn sore and sluggish for days after a physical exertion beat down. That is the systemic response of the body trying to deal with the skeletal muscle membrane disruption.

As an aside, we treat regular non-traumatic muscle damage from things like squatting, pressing, and pulling as systemic stress anyway, so I could have just ended the discussion there.

If you want to learn more about rhabdo, I’ve written an article on how to avoid giving clients, trainees, or athletes rhabdo. The message is simple: don’t do too much shit too soon with people who aren’t ready for it. Also, be aware of the continuum of symptoms since rhabdo is a systemic condition that will be debilitating to training.

Mike Interviews Powerlifter Stephen “Screamer” Manuel


Mike interviews Stephen Manuel, the silver medalist from the IPF Raw World Championship in 2013.

Mike: Tell us about yourself. How old are you, where are you from, how long have you been powerlifting, competition history, etc.?

Stephen: Hey Mike, thanks for the support. It’s always nice to know you have fans from various places and stuff so thanks for giving me another platform to communicate. I’m 25, from South Shields, England (near Newcastle in the North East of England), I’ve been Powerlifting for 8 or 9 years and started out Raw for a year, started equipped at age 18 till my final Junior year (23) and then switched back to Raw from then until present day.
I had a lot of success as an equipped lifter Nationally and a little success Internationally. I have won around 6 British Equipped Titles at Junior and Open level, finished 9th in the world as a Junior and then 4th in Europe as a Junior (I also got a gold medal for Deadlift here with a 320kg pull – that meant a lot to me because it was close to my hometown so my friends and family all got to see it).
I started Equipped lifting mainly because there was no World Championships in Raw in the IPF, but once they introduced the Classic rules I decided to switch back over as this made training for me much easier since I generally train alone and prefer to lift Raw. Since switching back to Raw lifting I have won one British title, set multiple British records and finished 2nd in the IPF World Raw Championships last year so it was a good decision to switch.

Mike: What are your best competition lifts? Any other personal bests you’d like to mention?

Stephen: My best competition lifts are a 280kg squat, 190kg bench press and a 315kg deadlift – all Raw.

Mike: You have a very unique approach to programming your training, especially your accessory work; please explain what your training template is.

Stephen: I don’t really follow much of a template really. I plan my main lifts and try to get as much volume in as possible whilst working at sub-maximal intensities of no heavier than 90%. I’ll hit the Squat and Bench Press 4 times per week and the Deadlift 1-2 times per week mainly to keep my movement patterns solid. When it comes to my accessory work, I wouldn’t go as far to say I spontaneously decide what to do but I largely listen to my body and pick what exercise I’m going to get the best out of on that particular day. For example, if my lower body is pretty beat up after squatting rather than doing a heavy loading exercise such as a Stiff Leg Deadlift, I’ll opt for a KB Swing or a BB Hip Thruster with a light load for speed or vice versa, if I’m feeling strong I’ll load up on the assistance. I started doing this around two years ago because I found that planning every final detail in my training was causing me to fall out of love with the lifting and when that happens it’s game over. So now I plan the important stuff and have fun with the other stuff. The circuit stuff I do at the end is mainly to hit areas I won’t hit through general weights stuff and also a fun way to get my weight down instead of just running at low intensities to increase my fat oxidation.

Mike: How did you develop your training philosophy?

Stephen: This is a pretty tough one to answer. It kind of feels like it just happened, mainly through trial and error. The gym I work at Underground Training Station (www.theuts.co.uk – check us out) specializes in high intensity, metabolic circuit training and teaching the average person they can train like athletes and reap the benefits of being more powerful and loading their bodies up etc. I mention on a video blog I’m currently uploading on my YouTube channel (screamermanuel) that I see myself as an athlete who decided to do Powerlifting rather than a Powerlifter who Powerlifts. You look at athletes in other sports such as sprinting, weightlifting, American Football etc. and one thing that is common between those sports and the movements they produce is they are all explosive and very powerful, and they all squat and bench like absolute beasts. So I think too much emphasis is placed on the main lifts in the typical Powerlifter and we get deep into a very “Max Strength” oriented type of training and as a result a lot of max lifts are grinded out. Now people will argue it doesn’t matter whether it takes half a second, 1 second, 5 seconds to get that squat from the hole to standing but if you ask me I’d rather get that lift done as quickly as possible!

Mike: Do you coach other lifters as well? Are they primarily powerlifters?

Stephen: I coach people from all walks of life. I do have a few people who are just getting started out in Powerlifting and have some potential to do well. I’m currently developing a few strategies and also getting some confidence to have a go at coaching people online because I’ve had a lot of positive feedback from the videos I’m putting out there so look out for that in the future.

Mike: How do you program training for other lifters? Do they focus on the squat, bench, and deadlift followed by certain accessory lifts?

Stephen: It all depends on where they’re at really. I have a lot of people who are just starting out so for me, they need to focus on the actual Powerlifts less than the accessory stuff. They need to develop the muscle mass, required to lift heavy in the powerlifts and do the main lifts purely for technical purposes, developing their connective tissues to be able to cope with the forces when the load increases and getting those motor patterns down. Then once they start hitting plateaus in the main lifts I can flip that attention on its head and get them utilizing that perfected Powerlift technique under more volume, intensity, creating more stress and developing improvements from that.

Mike: In one of your videos you analyzed an individual’s deadlift, and told him to work on his hamstring and t-spine mobility, what is your philosophy about mobility? Do you spend time working on your own, or only if you feel you have a mobility issue that has to be corrected?

Stephen: I think with mobility and Powerlifting you need to be as mobile as you need, no more no less. You don’t want to be so tight that when you’re loading up on bar weight your body is forcing you to come out of position but you also don’t want to be so flexible that you lose power, particularly at the bottom of the lifts. The amount of time I spend on mobility is usually directly related to the increase or decrease in training volume, if I train more I spend more time doing mobility work and will include it in any rest days as an active rest session. I’d like to say I spend a good 20-30 minutes daily doing it but I’d be lying! I always do 10-20 minutes before training and because I’ve been carrying an injury or two at the minute I have been doing 30 minutes after work but that is not commonplace for me. If an area needs more mobility work I will typically work overtime on that but my mobility is pretty good right now.

Mike: I see that your current goal is to win IPF Raw Worlds. Do you have any world records you also want to break? You third attempt Deadlift at Worlds last year was a World Record attempt, right?

Stephen: Yeah, I’m after that World Title for sure mate, I’ve put too much time and sacrificed too much into this to not be chasing the ultimate accolade! Last year I was only 15kg off the World Record Standard for the Squat (currently 295kg) so I hope I can achieve that but that is obviously secondary to the goal of winning the World Championships. Also, whoever wins this year is pretty much going to have to do a World Record Total because the standard of Raw lifting is only increasing since it’s largely in it’s infancy in the IPF so that would be cool to come away with two World records and a World Title!

Mike: How did you get the nickname Screamer?

Stephen: I get asked that a lot or rather “Why is your Facebook name Stephen Screamer Manuel” so I’ll tell you what I tell them…just watch one of my YouTube videos! Haha!
Feel free to add me on Instagram/Twitter/Youtube – all screamermanuel and any questions you may have for me will gladly be answered either with a video or a direct message.

70′s Big Radio – Episode 18

This was easily one of the best podcasts we’ve done. We talked about Scott Mendelson’s pec insane pec tear, sorta criticized strongman training, something Eric Cressey said, and Tony Budding’s new Pro Fitness League, and a whole lot of shit that doesn’t make much sense but made us laugh our asses off.

Topics came from Twitter, and you can send us more @70sBig or on Facebook.

Search “70′s Big” on iTunes or listen/download HERE. Subscribe with your RSS app HERE.

Life Defined By Training

I left my job, long time girlfriend, family, and friends to live in poverty and train with the best lifters and coaches in the country. Is that strange?

This was a response to Mike on FB when he asked “What was the strangest thing you’ve done to pursue your strength goals?” Mike felt compelled to find out more about Sean. Sean was kind enough to respond with his story. It’s heartfelt and motivating.

In late 2010, I was a college dropout English major, rugby player, and on the verge of tumbling into full blown alcoholism. I was able to function rather well considering and I didn’t drop out of school because I was doing poorly. In fact between a full load of courses, rugby practice, and two part time jobs I suppose I was a high functioning alcoholic. I dropped out half for monetary reasons and half for lack of purpose. Drinking had always helped writing and it’s an institution within rugby culture, but without any purpose in my life I began to allow it to take over more than anyone should. Fortunately, this did not last very long and I don’t intend to fool you into thinking I’m a sob story who overcame substance abuse or some bullshit like that.

What changed is that I found training. With only rugby left in life I decided to improve my strength and conditioning. I wanted to play at higher levels and one of the things that separated me from the next level was a lack of an off the field training program. A friend referred me to three things that were instrumental in setting me on the path.

I developed my lifting career and philosophy through these three components:
1.) CrossFit, the burgeoning fitness craze.
2.) Starting Strength, Rippetoe and Kilgore’s famous book on basic barbell training.
3.) A blog called 70s Big.

I started by trying out CrossFit workouts. I’ve always been a bigger guy, but I was athletic in my youth. Ten years of hockey taught me nothing about training except to skate more, sometimes fast, sometimes slow. Football taught me how bench shitty, squat shitty, and power clean shitty. I did not stay there long because I honestly found the game to be incredibly boring from a positional standpoint. My ADD despises running. Aside from being generally silly, running is in no way cerebrally stimulating. So CrossFit’s general lack of running, attention sustaining intensity, and endless possibility of movements was at least interesting. That was great for dropping a few pounds and keeping the lungs strong, but rugby requires an immense amount of power and physical strength. Let me tell you, you don’t want to be a soft corpse on the other side of a full stride Samoan.

This need led me to Starting Strength. I decided I should put as much effort into getting as strong as I could as fast with rugby season quickly approaching. The lungs would come back with some hours on the field. The instructions from the book were all right there. I didn’t worry about shin angles, varus vs. valgus, or am I producing torque. I showed up to the gym three days a week. I put my ass to ankles in the squat, I benched and pressed in a full range of motion, and picked shit up off the ground until I was completely erect (Get your mind out of the gutter). I drank 1-2 quarts of milk per training day. I ate meat and vegetables. I gained a significant amount of lean mass. In three months I squatted 500lbs. That’s not particularly impressive, but I do think it is a tribute to simplicity and consistency.

During this period of training, the third object of influence started to take full effect on my life. I followed and read 70s Big regularly. I found Justin’s writing entertaining, informative, and comforting (all the homo). There were so many articles I found interesting and useful and it’s been so long since I’ve read them that is hard to remember them all. The one thing that stuck with me and really changed my life was Justin’s encouragement of his readers to educate themselves. I followed suit and sought out as much knowledge as I could. I absorbed anything I could get my hands on: Zatsiorsky, Verkhoshanksy, Siff, Kilgore, Medvedyev, Roman, Yessis, Bondarchuk, Stone, Garhammer, Poliquin. Even some stuff from Simmons, Wendler, Boyle, and Cressey. Soviet Sport Manuals were my favorite and still remain a dominant part of my library.

I could take concepts I was learning and apply them to my training or that of my peers. It was something concrete, applicable, practical, a physical experience of science expressed. Training and sport science taught me to give a shit about cellular biology and physics, elements of my short lived education spent studying literature that I had happily ignored. I watched countless hours of film of lifters, gymnasts, and sprinters. For the first time in my life as a young adult I had an inkling of an idea about what I actually wanted to do with my life. I acquired many certifications. CrossFit started me on my path so I decided to get my L1. I eagerly awaited the knowledge bombs I’m told all seminar instructors possessed. Surely they had some secrets I couldn’t find in a book. While I still value practical experience over book knowledge, it quickly became evident to me that I was more educated on exercise science and had more time under the bar than most of my instructors. Even a certain famous figure in the early days of CrossFit who had university level experience and was renowned for his experience in Olympic Weightlifting was very much unable to answer my questions about snatch technique. This was an eye opening and I found it to be a reflection of the fitness industry as a whole.

Following this I got involved with a group of people who wanted to open an affiliate. Coaches were still few and far between then, especially in the market where the gym opened. I should not have been allowed, in my opinion, to coach then, though it did allow me to gain the practical experience I now have and I did simultaneously undergo an internship with a Sports Performance Coach. In my effort to become a better coach I went to acquire my USAW Level 1. Justin had posted articles about discussions with someone named Glenn Pendlay who happened to be instructing a course 5 hours away from me at a gym called California Strength. That man completely ruined my life and made me fall in love with Weightlifting. Glenn was, and continues to be, a very knowledgeable and easy person to speak to. This was the first time that I personally was able to kinesthetically understand the snatch and the revelation was life altering. Since that moment I began chasing kilos.

I made subsequent visits to California Strength, usually in week long increments to observe the lifting in person and discuss with both Coach and the lifters training ideology. In the Weightlifting community I had stumbled upon, perhaps, the most humble and hard working resource of training knowledge in all of Exercise Science. Aside from my visits to Coach, certifications, clinics, and internship I continued to be a largely self-educated coach and self-coached weightlifter. I stopped coaching at a CrossFit affiliate and after an unsuccessful attempt to open my gym I took up work coaching at a Velocity Sport Performance. This was rewarding in some aspects, and good experience with diverse populations but my heart was never really there. The one thing that stayed consistent in my life was training. As the famous Henry Rollins quote goes, “The Iron never lies to you.” I kept showing up and so did the barbell. Through knee surgery and other injuries, I kept showing up having good days and bad days. The barbell taught me consistency, diligence, and confidence. I carried myself with respect and applied the stubbornness and resourcefulness the barbell had taught me to all aspects of my life.

At the beginning of 2013 I decided to go back to school and here I am a little over a year later still going with a 4.0 so far. In early spring MuscleDriver USA announced that they were holding a tryout. They had done something similar the previous year and I decided against going as I did not think the odds were good for me to make it and there were too many elements of life which were uncertain. I regretted that decision every day thereafter. I was not going to repeat that mistake. Due to a few injuries my lifting had not progressed much from the previous year, but I began training with a distinct purpose. I was going to show up, lift weights I had never lifted before, and go 6/6. Looking back, the ferocity of my training at the time was maddening. After multiple flight delays and a mix up with my rental car reservation I made it to the tryout. I PRed in Snatch, Clean and Jerk, and Total, going 6/6. If I wasn’t going to make the cut I still wanted to go out knowing I had done everything I was capable of. After flying home, I received a call while at work the following Monday from a phone with a Texas area code. The voice on the other end was Coach Pendlay, inviting me to join Team MDUSA. “I think you’ve got potential.” It’s one of the two nicest things he’s ever said to me I think.

I packed up my car, left my long-time girlfriend, my family, my friends, my athletes, and job to drive across country into the unknown and live in poverty. I have never felt so full of purpose. Everyday I am coached and educated by two of the best coaches in American Weightlifting. My training partners and friends include National Champions and legitimate Olympic Hopefuls. I am afforded the opportunity to show up 9x a week and push my body to it’s limits and learn further lessons from the barbell. Though I have goals for certain levels of achievement in my sport, at this point it’s less about hardware and more about the journey. I am still forever chasing kilos.

You can follow me on instagram @seanmrigsby and check out heavymetalsc.com to stay up to date on projects and my perspective on Team MDUSA.

Sean tells an amazing story. I suggest you take a good hard look at yourself in the mirror, this time not hitting a front double-bi, and decide how you want to approach your life. Whether it be training, work, or a project.

QB’s Can’t Gain Weight? Bullshit.



Adam Schefter works for ESPN and is an NFL reporter who gets all the “insider” information. The above tweet is talking about the top three quarterbacks that will be going into the NFL draft this year. These stats are gleaned from the NFL Combine, which allows the NFL personnel to evaluate the talent coming from collegiate sports to the NFL. It’s a lot of mental and physical testing to try and project how well these athletes will do in professional football, yet it is often incomplete because physical stature and prowess do not always make the best football player, though it helps.

I was listening to Mike and Mike on ESPN radio this morning, and they were talking with various experts on the size of these quarterbacks, particularly Manziel and Bridgewater. The important stats for quarterbacks, from an anthropometry perspective, are height, weight, and hand size. The hand thing is apparently a good projector of success (i.e. it’s easier to hold onto a football in adverse weather), but let’s ignore that. Height is also very important — seeing over the large lineman to throw a pass is important — but we’ll ignore that too. How much a guy weighs and fills out his frame is important because football is a rough, collision-based sport, and frail guys will not have durability. Especially when there are mastodons who weigh anywhere from 250 to 350 pounds wanting to crush your soul.

The experts point out that two of the above quarterbacks weigh 207 and 214. As a “lifting and athletic population”, we know that these guys aren’t heavy. Yet we also know that it’s actually kind of simple to add mass on to a guy, especially when their frame has room to fill out (as both of those quarterbacks do).

What I find baffling is how difficult the experts think gaining weight is. And I’m not even just talking about gaining weight for the sake of gaining it, like in Starting Strength-style linear progression. I’m talking about putting a focus on retaining athleticism, agility, and speed yet increasing lean body mass. Most rookie mini-camps don’t start until the end of May. Training camp starts in July. The season actually starts in September. How long was your linear progression? I got some pretty solid fucking progress in 8 weeks by moving my three-sets-of-five from 325 to 445 while increasing my body weight from 195 to 215 (in 2009).

If the experts think it’s difficult to put five, ten, or even fifteen pounds on a guy in three to six months, then either the strength and conditioning is really shitty, there’s no athlete compliance, or they don’t even try. I’m no expert in the realm of NFL strength and conditioning, and maybe we should get John Welbourn’s thoughts, but it sounds pretty stupid to see a 21 year old’s body and think that it can’t be improved. I’ve done it over and over with athletes, so why can’t they?

Shameless plug, but this diet style would help an athlete build quality mass and aid recovery.

Shameless plug, but this diet style would help an athlete build quality mass and aid recovery.

Edit: I forgot to mention what I would do for a guy that needed to retain athleticism but increase size. I’d have him lift three days a week in conjunction with his agility, speed, and/or skill sessions. He’d squat, press, row, and do pulling movements that wouldn’t interfere much with his other training (i.e. stuff like power cleans, RDL’s, and lighter deadlifts instead of trying to push his deadlift up). A quarterback would be doing weighted pull-ups and chin-ups, possibly some barbell pullovers. I’d throw a Paleo for Lifters diet at him, which would be a quality, clean diet of meat, potatoes, fruits, veggies, and good fats with a little bit of protein powder in quantities that would help him grow. It wouldn’t be all that hard for kids that are described as “not very thick” or having a “slight build”.