Benjamin Pred on Extreme Fitness

Benjamin Pred, former collegiate athlete, catching a pass during a frisbee game.

Benjamin Pred, Ultimate Frisbee athlete

Benjamin Pred, a former collegiate-level Ultimate Frisbee player, still enjoys working out a few days a week to stay healthy and fit.  While he has a desk job, he follows a general healthy diet and has a relatively active lifestyle in his free time.  He has a membership at his local gym, where he lifts weights a couple times a week and runs on a treadmill.  In the fall of 2012, he tried yoga for the first time.  After starting at a beginner’s level, he worked himself up to doing more and more rigorous classes.  Eventually, he thought that it would be fun to take advantage of all of the variety that NYC has to offer, and when the New Year rolled around, he decided to dabble in some more intense kinds of exercise.  His girlfriend encouraged him to join her in checking out the flying trapeze, as well as some other forms of physical movement that touted themselves as “extreme.”

One afternoon in early January of 2013, Benjamin Pred took a 60-minute fitness class that included spinning and TRX or “total resistance training.”  He left feeling great, like he’d really pushed himself to his limit, and was on his way to a healthy and fit new year.  Over the next few days, his legs became so sore and swollen that he was unable to bend his knees and his urine turned brown.  The pain in his legs every time he tried to stand, sit, or walk became so severe that he hobbled to a cab and checked himself into the emergency room.  He had to stay in the hospital for three days while doctors worked to stabilize his kidneys and his liver.

What Pred was experiencing is called rhabdomyolysis, a life-threatening condition that has become more common as extreme exercise has become increasingly popular (see New York Times: As Workouts Intensify, a Harmful Side Effect Grows More Common).  Rhabdomyolysis is a rare condition that can be induced as a result of crushing injuries, drug abuse, or physical over-exertion. Those familiar with prison initiations might have been more aware of it; inmates sometimes endeavor to induce rhabdomyolysis through physical over-exertion as a rite of initiation, for example, by forcing fellow inmates to perform enormous numbers of squats.  The resulting rhabdomyolysis would be evident from the inmate’s subsequent “stork walk” – the funny way of walking when one can’t bend one’s knees, just as experienced by Pred.  However, with trendy fitness programs such as P90X and Crossfit, as well as the explosion of spinning classes such as SoulCycle, more people are showing up in the emergency room with rhabdomyolysis after merely trying to engage in activities that they think will make their bodies healthier and stronger.  And it’s not just beginners who fall victim to rhabdomyolysis.  Seasoned athletes who push themselves past their limit, especially when attempting to return to high levels of physical activity after a break, are also at risk for developing it.

Interview with Benjamin Pred

Tell us about the exercise class.

Benjamin Pred: Well, it was in a large room with a number of stationary bicycles facing one by itself in the front; it turned out that one was for the instructor. He was a very fit fellow who, according to his profile, was “very passionate about fitness” if I remember correctly. The people in the class, all of us of mixed ages and fitness levels (I think I was at about the median for both, though perhaps below average on the fitness side as events bore out), chose the bike that would be our mechanical partner for the next hour.

I had seen cycling classes in movies and knew about them through other cultural osmosis of course, but had never taken one before. It was definitely a hard workout, and at the end I felt the beginning of soreness in my thighs and especially my quadriceps.   But nothing TOO bad – it wasn’t bad until after the second portion of the class, which I’d foolishly agreed to do, that took place immediately after the cycling. That one involved body weight/resistance training, and it was only then that my legs really started to hurt.

When did you know that your body was in trouble?

Benjamin Pred: When we began walking to the subway station after class, I felt sore in my quads. Like, REALLY sore. I’d been an “athlete” in college, and I’d only ever felt that kind of pain the day after an ultimate frisbee tournament when we’d basically been sprinting all weekend. I chalked it up to getting older and not being in peak condition, but it only got worse.

Over the next couple days, I basically lost the ability to bend my knees, and the pain and swelling in my quads became excruciating.

  Benjamin Pred recovering at the hospital after suffering from an over-exercise injury.

Benjamin Pred recuperating

How did you know you needed to go to the hospital?

Benjamin Pred: My then-girlfriend-now-wife (who’s great and who could have been a great doctor but instead chose to be a great teacher) told me I might have rhabdomyolysis - something I'd never heard of - after I told her my pee was brown (which is a classic symptom and which really should have scared me more than it did!) and she chucked me into a cab.

Were the emergency room doctors familiar with your condition?

Benjamin Pred: Very – I think they expedited me because if you don’t treat the condition very quickly it can cause long-term kidney damage or death. But it’s not uncommon among athletes who are out of condition and push themselves the way they used to when they were in top form, or yutzes like me who just don’t know when to quit.

I remember before they admitted me, the attending physician brought around some med students to review my case, which made me feel special in a dumb way.

What was treatment and recovery like?  Do you have any long-term effects from this condition?

Benjamin Pred: Treatment consisted of bed rest and fluids pumped into me through an IV day and night for about 3 days. Happy to say there have been no long term effects (of which I’m yet aware)!

What advice would you give to other people who are trying out a new exercise program for the first time?

Benjamin Pred: Go slow!

What’s your current exercise regimen?

Benjamin Pred: I haven’t been going to the gym as much, but I do virtual yoga classes (having two small kids makes it tough to go to live classes, plus the videos are less expensive) and HIIT classes. Don’t worry though, I don’t go TOO far.