Rhabdomyolysis Can Strike Even Fit Athletes: The Warning Signs to Know

The serious muscle condition linked to a young runner’s recent death can affect even the fittest athletes. Here’s what to know about rhabdo, the warning signs to take seriously, and why early treatment matters.

Following news of a 24-year-old marathon runner’s death, a serious muscle condition called rhabdomyolysis is gaining attention.

Rachel Apa, a former Division I field hockey player at Bucknell University, was running her first marathon at the 2026 New York City Marathon when she collapsed near Mile 24 in Central Park. Her father told The New York Times that she died of rhabdomyolysis. “It’s unfathomable,” he said. “Perfect health, perfect shape, 24 years old.”

Apa, who had trained for the marathon for months, was running for a cause close to her heart. She was raising money for Parkinson’s disease research, in honor of her late grandfather. Her sudden death has now raised questions about rhabdomyolysis, also known as rhabdo, which many are hearing about for the first time.

What is Rhabdomyolysis?

Rhabdomyolysis occurs when a person’s muscle tissue gets damaged, causing it to break down and release proteins and electrolytes into the bloodstream. These substances can harm the organs and lead to kidney damage or failure, dangerous heart rhythms, seizures, permanent disability, or even death.

There are several factors that can cause the muscles to break down, including heat, overexertion, or injury. About 26,000 cases of rhabdo are reported in the U.S. each year, many among competitive athletes, though researchers believe the true number is likely higher.

It Can Happen to Anyone

One common misconception is that only people who aren’t physically fit get rhabdo, but even firefighters, marathon runners, and professional athletes can develop it, too. Moreover, it can happen while you’re doing activities you’ve done before without a problem.

Major factors that can trigger the condition include intense physical exertion and heat exposure. Certain medical conditions, medications, and behaviors can also raise the risk.

While dehydration in itself cannot cause rhabdo, it can worsen the condition. The body needs enough fluids to flush out the substances released from damaged muscle, and dehydration makes that harder, which can increase the risk of organ damage.

Warning Signs to Watch For

According to the CDC, symptoms of rhabdo can include:

• Muscle cramps, aches, or pain that feel more severe than expected
• Dark, tea- or cola-colored urine
• Feeling weak or tired, or being unable to finish a workout you could normally complete

The symptoms of rhabdo can be easily mistaken for heat-related illnesses or dehydration, which makes it difficult to tell them apart. Only blood tests can confirm a diagnosis of rhabdo.

What to Do

If you notice any of these symptoms, don’t ignore them. The CDC recommends stopping the activity you’re engaged in and drinking more fluids, especially water. It’s also best to seek care immediately.

Rhabdo is treatable if addressed promptly, but it can be fatal if not treated quickly, says Dr. Bradley Uren, an emergency medicine physician at University of Michigan Health. Treatment can include intravenous fluids to help flush out toxins and, in severe cases, dialysis. In Apa’s case, Uren said, it appeared that the “worst case scenario happened just very, very quickly.”

The earlier rhabdo is diagnosed, the better the chances of recovering without permanent health effects.