It’s important to learn the signs and symptoms of rhabdo that may be present. Learning the symptoms can help you figure out if you or someone else needs to seek medical attention. If you develop rhabdo, you might have one or more of these symptoms:

Rhabdo_Muscle Cramps

Rhabdo Dark Urine

Rhabdo_Man learning over

  • Muscle cramps, aches, or pains that are more severe than expected
  • Dark urine (tea- or cola-colored)
  • Feeling weak or tired, unable to complete job tasks or finish a workout routine

You can also have rhabdo and show no symptoms, so it’s important to seek medical care immediately once you do start having symptoms!

When will symptoms appear?

Medical professional drawing blood from patient’s arm

The only way to know you have rhabdo is through a blood test that checks for the presence of a muscle protein, creatine kinase (CK), in the blood. Seek medical attention when you have any rhabdo symptoms and be sure to ask to have your CK levels checked.

Symptoms can appear any time after muscle injury. For some people, symptoms might not start to appear until several days after the initial injury. If you have any of these symptoms at any time, do not ignore them. Seek immediate medical treatment. Earlier diagnosis means an earlier start to treatment and a greater chance of recovery without permanent health effects.

How is rhabdo diagnosed?

You can’t tell by symptoms alone if you have rhabdo. Other conditions like dehydration and heat cramps can cause the same symptoms. The only way to know for sure is to see a healthcare provider who can perform a blood test to check for rhabdo.

Repeated blood tests for a muscle protein known as creatine kinase (CK or creatine phosphokinase [CPK]) are the only reliable test for rhabdo

A healthcare provider can do a blood test for CK:

  • CK is a muscle protein that is released into the blood when muscle tissue is damaged.
  • When rhabdo is present, CK levels will rise.

Repeat blood tests are needed to determine if CK levels are going up or down:

  • Like the appearance of symptoms, the rise in CK may be delayed.
  • Healthcare providers should test CK levels until 2 consecutive tests show levels lowering.

Urine dipstick tests are not a good way to diagnose rhabdo:

  • These tests check for myoglobin (a muscle cell component) indirectly.
  • Myoglobin is quickly cleared from the body so it may not be detected in urine while CK elevations in the blood may persist for days.

If your healthcare provider does not check your serial CK levels when you’re being checked for possible rhabdo, be sure to ask for it!

Firefighters can download a rhabdo wallet card. The wallet card gives healthcare providers information about firefighters’ increased risk for rhabdo and a reminder to check their repeated (serial) CK levels if they present for evaluation of possible rhabdo signs and symptoms.

Page last reviewed: April 22, 2019