A 24-year-old woman who died after the New York City Marathon on Sunday was suffering from a rare side effect of exercise called rhabdomyolysis, her family said.
Rachel Apa, an experienced D1 field hockey athlete who spent months training for the race, collapsed near mile 24 in Central Park and was taken by ambulance to the hospital, her father told The New York Times.
Apa was a product manager for an electronic manufacturing company. Earlier this year, she posted on LinkedIn that she was running the marathon to raise money for the Parkinson's Foundation, in honor of her grandfather.
The New York Road Runners, the group that organizes the marathon, and Apa's family did not immediately respond to a request for comment from Business Insider.
Rhabdomyolysis, known as rhabdo, is a risk of extensive strenuous exercise caused by muscle tissue breaking down and overloading the kidneys.
Without prompt medical treatment, it can be life-threatening. Here's what to know about rhabdo, including the symptoms to look out for and how to prevent it.
What is rhabdomyolysis and what causes it?
Rhabdomyolysis can occur after severe muscle injury or intense exertion. As damaged muscle tissue breaks down, it releases compounds into the bloodstream that the kidneys typically filter out.
In rare cases, those byproducts can overwhelm the kidneys and lead to kidney damage or acute kidney failure.
About 26,000 cases of rhabdo are reported in the US each year, research suggests.
Anyone can suffer from rhabdo, but factors like hot environments and dehydration can increase the risk, according to Cleveland Clinic.
While it's generally not common, cases of rhabdo are often caused by high-intensity exercise or long endurance sessions without rest. For instance, research has previously linked cases of rhabdo to marathons (particularly during high temperatures) and vigorous spin classes.
It's also increasingly a concern for the military, which is working to spot rhabdo in troops more quickly.
What are the symptoms of rhabdo?
Symptoms of rhabdo include fatigue, muscle cramps or unexpected pain, and dark-colored urine, which can show up hours or days after exercise, according to the CDC.
Rhabdo can be diagnosed with a blood test and treated with IV fluids to help flush out the waste products.
To prevent rhabdo, avoid pushing too hard during exercise, take breaks as needed, and drink plenty of water, especially in hot, humid weather.
This article is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your qualified physician or healthcare provider.
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Gabby is a Health Correspondent with a focus on nutrition, fitness, longevity, and all things performance.Her coverage spans from the daily routines of top athletes like Michael Phelps and Coco Gauff to the latest cutting-edge science on building muscle to the rise of peptides, supplements, and GLP medications. She loves a deep dive into fitness subcultures, health companies, or the science behind managing and preventing disease, particularly early-onset cancers. Gabby has a background in investigative journalism (previously contributing research for an investigation on correctional healthcare for the New Yorker).In her free time, she likes lifting heavy, running fast, and playing roller derby for Gotham in New York City.Send story ideas and tips to [email protected].Expertise/Interests
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- Medical weight loss: how emerging science around treatments like GLP medications are shaping the connections between food, weight, and health.
- Digital wellness: investigating how telehealth is changing access to healthcare, including through peptides, hormones, and direct-to-consumer lab tests.
- Strength sports, including Olympic weightlifting, powerlifting, Hyrox, and CrossFit.
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