Understanding Rhabdomyolysis: The Massive Muscle Damage Threatening Unprepared Runners

A participant in the BTN Half Marathon Jakarta International Marathon (Jakim) 2026 was reported to have died after collapsing during the event on Sunday (14/6/2026). The runner from Lombok, named Agus Putranadi, was rushed to hospital for medical treatment, but his life could not be saved. According to reports, the runner suffered from rhabdomyolysis, a massive muscle breakdown that releases myoglobin into the blood and poses a risk of acute kidney failure. So, what are the triggers and early warning signs to watch out for?

Doctor and Secretary General of the Indonesian Health Facilities Doctors Association (HIFDI), dr Putro S Muhammad, revealed three main factors that often trigger rhabdomyolysis in runners. The first is excessive physical load (overexertion) without adequate training preparation. “The second factor is dehydration, and the last is heat stress due to high air temperature and humidity,” said dr Putro when contacted by Republika on Thursday (18/6/2026).

According to dr Putro, runners must understand that the early symptoms of rhabdomyolysis differ from DOMS (Delayed Onset Muscle Soreness), the common muscle pain that appears after strenuous physical activity. DOMS is a normal body response after exercise. This condition typically appears within 24 to 48 hours after physical activity, characterised by muscle pain that develops gradually and tends to improve with light movement. Conversely, rhabdomyolysis symptoms appear more quickly, feel much more severe, and do not improve even after the body has rested. One early sign to be wary of is extremely intense muscle pain, as if being squeezed hard, which already appears while the race is still ongoing or after it finishes. Runners may also experience muscle swelling, especially in the thigh and calf areas. According to dr Putro, the muscles will even feel harder than usual. “Another danger sign is the onset of massive fatigue accompanied by nausea or vomiting, which does not improve despite resting,” said dr Putro.