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Breathing & recovery

Exercise after rhabdomyolysis: a light session for the first weeks back

For the light stage of the return in our rhabdomyolysis guide: only once a doctor has said you can start light exercise, your muscle pain, swelling and weakness have settled, your pee is a normal colour, and any blood tests are normal or falling. Before you start, check how your muscles feel and the colour of your pee. Everything here is light: you should be able to talk in full sentences, finish every set with at least 3 easy reps left, and lower each rep at a normal, controlled pace. No timed efforts and no heat. The session combines NHS Scotland's advice to start with stretching-based exercise such as Pilates, the US military guideline's light, never-to-failure stage, and the easy cycling a university football team used on its way back. The doses are our editorial starting point.

30 minBeginner15 movesCardio machine · A bench or box · A wall · A band · An anchor pointQuads · Abs · Glutes · Back · Hip abductors · Hip flexors
Follow along: a timer, a cue and the next move, one step at a time.

Check in

  1. Slow breathing (6 breaths a minute)1 min
    Beginner · 3D demoSit and check two things: your muscles feel no worse than yesterday, and your pee is a normal colour. If your pee is dark again, don't exercise: get medical help todayEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)

Easy cardio

  1. Stationary cycling10 to 15 min
    Beginner · Quads, Glutes, Hamstrings · 3D demoEasy enough to talk in full sentences, at your own pace. Or walk on the flat for the same time. Not a spin class yetHarder: Air bike intervals

Pilates-style mat work (about 7 minutes)

  1. Lateral breathing (Pilates breathing)5 breaths
    Beginner · Abs · 3D demoOn your back, knees bent: breathe into the sides of your ribsHarder: Roll-up (Pilates)
  2. Pelvic tilt into bridge6 slow reps
    Beginner · Glutes, Abs, Hamstrings · 3D demoTilt, then lift only a little wayHarder: Glute bridge
  3. Dead bug heel taps6 each side
    Beginner · Abs, Hip flexors · 3D demoKeep your back still as each heel taps downHarder: Forearm plank
  4. Bird dog, one limb at a time4 each arm and each leg
    Beginner · Abs, Back, Glutes · 3D demoOne arm or one leg at a time, slowlyHarder: Bird dog
  5. Clamshell8 each side
    Beginner · Hip abductors, Glutes · 3D demoSmall and slowHarder: Lateral band walk
  6. Cat-cow6 slow rounds
    Beginner · Back, Abs · 3D demoHarder: Half lord of the fishes (Ardha Matsyendrasana)

Light strength (once round; twice when that feels easy)

  1. Standing march1 min
    Beginner · Hip flexors, Abs, Glutes · 3D demoTo warm upHarder: Standing band hip flexion
  2. Sit to stand from a chair8 reps
    Beginner · Quads, Glutes, Hamstrings · 3D demoSit down at a normal, steady pace. Stop with at least 3 easy reps leftHarder: Bodyweight squat
  3. Wall push-up8 reps
    Beginner · Chest, Triceps, Shoulders · 3D demoStop with at least 3 easy reps leftHarder: Push-up
  4. Band row10 reps
    Beginner · Back, Biceps, Shoulders · 3D demoA light bandHarder: Supported single-arm dumbbell row
  5. Glute bridge10 reps
    Beginner · Glutes, Hamstrings, Abs · 3D demoEasier: Pelvic tilt into bridgeHarder: Glute kickback (quadruped hip extension)

Cool down

  1. Treadmill walking2 min
    Beginner · Quads, Calves, Glutes · 3D demoSlow, easy walkingHarder: Treadmill jogging
  2. Supine hamstring stretch with a strap30 s each leg
    Beginner · Hamstrings, Calves · 3D demoGently, well short of a strong stretchEasier: Leg-up hamstring stretchHarder: Contract-relax hamstring stretch (PNF)

Tips

  • Do it 3 to 5 days a week. Over 3 to 4 weeks, add 5 minutes of cardio or a second round of strength, one change at a time, and only if the next morning your muscles feel no worse and your pee is a normal colour.
  • Some stiffness the next day is normal. Muscle pain, swelling or weakness that's getting worse is not: stop, go back a stage and see your doctor. Dark pee again means getting medical help the same day: call NHS 111, or go to A&E if you feel very unwell.
  • Not yet: slow lowering ("negatives"), sets to failure, jumping, sprints, timed efforts, heavy weights, hot rooms and new classes. Bring them back last, one at a time: start with a short, light session and wait 2 days before doing more.
  • Drink normally before and after, and keep cool: no training in the heat while you recover.
  • Don't take ibuprofen or similar painkillers to get through a session without asking a pharmacist or your doctor: muscle pain is your guide, and your kidneys may still be recovering. Don't stop or change a prescribed medicine without talking to your doctor.
  • Call 999 (911 in the US) for sudden, severe pain in a swollen, tight muscle, or signs of heatstroke.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

Guides that recommend it

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Questions people ask

How long does the exercise after rhabdomyolysis: a light session for the first weeks back take?

About 30 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: Cardio machine, A bench or box, A wall, A band, An anchor point. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 3 of its 15 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.