This is the third part on a series about hiking and rhabdomyolysis that I’ve been doing. To sum things up so far, rhabdomyolysis, or rhabdo for short, is a life threatening condition that can happen to hikers. It’s essentially caused by overexertion that causes muscles to become damaged. The damaged muscle cells can lead to kidney damage and even death if left untreated.

Summing Up Rhabdomyolysis

In my first post on rhabdomyolysis I broke done what hikers essentially need to know about rhabdo. Like I mentioned, rhabdo is the breakdown of muscle cells inside your body. Broken down muscle cells can be toxic to your body and can cause kidney failure and even death. Signs that a person might have rhabdo are coke colored urine, generalized weakness, not having any urine output, confusion, and extremity swelling to name just a few. For a more detailed description on rhabdo and it’s signs and symptoms, please check out the post, What Hikers Need To Know About Rhabdomyolysis.

My second post focused specifically on risk factors for rhabdomyolysis. Knowing factors that put a person at risk can help to prevent hikers from developing rhabdo. A few things that rhabdomyolysis can be prevented by are:

  • Not hiking above your physical ability level.
  • Knowing your climates and weather.
  • Dressing appropriately.
  • Hydrating enough.
  • Getting adequate nutrition.

For a full detailed list for things that you as a hiker can do to prevent rhabdomyolysis, please check out my post, How Hikers Can Prevent Rhabdomyolysis.

What Hikers Need To Know About Rhabdomyolysis Treatment

If you’re one of the unfortunate hikers out there to be diagnosed with rhabdomyolysis, chances are you’ve been in an emergency room or even admitted to the hospital for treatment. A general workup will include blood work and a urine sample. Sometimes an ultrasound will be ordered to take a look at your kidneys.

IV fluid is the gold standard of treatment to help flush out your kidneys. The IV fluid will help protect your kidneys from being damaged by the broken down muscle cells and also for rehydration. Rehydration is key in rhabdomyolysis. If your blood work shows any electrolyte abnormalities those will be replaced through IV fluids or medications. The amount of IV fluid given varies per person. Essentially IV fluid is given until the doctors suspect and see that your lab work is improving and your urine output is normal.

Sometimes rhabdomyolysis can temporarily cause your kidneys to stop working. When the kidneys aren’t functioning properly your body can become acidic. A medication called sodium bicarbonate is usually given for those whose labs show too much acidity.

Rhabdomyolysis Worst Case Scenarios

Most of the time this diagnosis will just need a little blood work, some IV fluid, and a little close monitoring. However, there are cases where rhabdo can become life threatening or will be treated as a medical emergency. Often times severe rhabdomyolysis will be because of a hiker not taking adequate measures to prevent the illness like not hydrating, not taking in electrolytes, hiking in excessive heat or cold, lack of nutrition, and pushing a body to the limits. These are some of the more severe complications that can occur from rhabdomyolysis:


In more rare instances, rhabdomyolysis can cause your kidneys to completely stop working. Hopefully this damage is just temporary and not permanent. For those people whose kidneys aren’t showing signs of working, toxins can start to build up in the body. These toxins can become fatal if left untreated so emergent dialysis to filter the blood can be ordered. If removal of these toxins aren’t addressed, eventually death will occur.

Compartment Syndrome

As I talked about in an earlier post, swelling in the limbs is something that can occur where the damaged muscle is. For example, if the muscle injury is to the legs, severe swelling can occur to those extremities. The swelling can cause something called compartment syndrome. With compartment syndrome your skin acts like a compartment that holds in all the fluid. If that compartment gets too tight the extra fluid can start to compress nerves and blood vessels and cut off circulation. Compartment syndrome is a medical emergency and emergent surgery is required to help relieve the pressure.

Signs of compartment syndrome are numbness and decreased sensation, swelling, oozing of fluid outside the skin, pale and cool skin, and a decreased pulse in the affected region.


If removal of the toxins that are caused by kidney failure is not addressed, death can occur. This is an extreme example of a rhabdomyolysis complication.

Summing Up What Hikers Need To Know About Rhabdomyolysis Treatment

I know that some aspects of this post like dialysis and death are less likely to occur but rhabdomyolysis is something that I still believe all hikers need to be aware of. There are things that hikers can do to prevent rhabdo. I hope that some of the complications make hikers aware of the severity of the diagnosis and will help people be aware of things that could indicate whether or not they have rhabdo.

If any hikers who read this have ever had rhabdo I’d love to hear about your experience. Please share your story in the comments.