Rhabdomyolysis and a New York City Marathon Tragedy: Symptoms, Causes, and When to Seek Care
- A recent incident at the New York City Marathon brings attention to a muscle condition that’s often treatable when recognized early.
- Rhabdomyolysis occurs when damaged muscles release substances into the bloodstream, sometimes after intense exercise, but most people recover with the right treatment.
- Warning signs of rhabdomyolysis include severe muscle pain, cramps, swelling, unusual weakness, and dark urine that resembles tea or cola.
- Get medical care fast for severe or worsening muscle pain, unusual weakness, or dark urine after exercise to help prevent complications.
The death of 24-year-old Rachel Apa, who collapsed near mile 24 of the 2026 New York City Marathon, has brought attention to rhabdomyolysis, a condition that can develop when muscles are injured during intense physical activity.
Apa’s father reported to news outlets that his daughter died of rhabdomyolysis. However, the New York City Office of Chief Medical Examiner had not confirmed an official cause of death as of November 3.
Although severe cases can lead to complications, most people with rhabdomyolysis recover with appropriate treatment.
What’s rhabdomyolysis?
Rhabdomyolysis, sometimes called “rhabdo,” happens when damaged muscles break down and release substances into the bloodstream. These include myoglobin, a muscle protein, and potassium, a mineral that helps the heart and muscles work properly.
In severe cases, the condition can damage the kidneys or affect heart rhythm.
“Rhabdomyolysis can occur after strenuous exercise, particularly when someone pushes beyond their usual activity level,” said Mark Supino, MD, an emergency medicine doctor, director of clinical services, and director of the emergency observation unit at Jackson Memorial Hospital. “The good news is that complications are rare and the majority of patients do great after being treated with IV fluids.”
What are the warning signs of rhabdomyolysis?
According to the Centers for Disease Control and Prevention, common symptoms include:
- Muscle pain, cramps, or swelling that are more severe than expected
- Unusual muscle weakness or fatigue
- Dark urine that looks like tea or cola
Symptoms can appear hours or days after exercise, and not everyone experiences all three.
When should you seek emergency care?
Muscle soreness after exercise is common and usually improves with rest. However, if muscle pain worsens, you experience unusual weakness, or your urine is dark, see a doctor right away.
Emergency care at Jackson Memorial Hospital
Gradually increasing exercise intensity, staying hydrated, and allowing time for recovery can help reduce the risk of injury.
Jackson Memorial Hospital’s new emergency room offers expanded treatment areas, advanced imaging, and dedicated spaces to care for patients with serious medical issues, including exercise-related muscle conditions. Learn more about emergency care at Jackson Memorial.