Brutal Music

Today's StraightDope reports:

I've heard and read stories about musicians, specifically hand drummers, pissing blood after playing a particularly tough or long set. The great Armando Peraza, Santana's longtime bongo and conga player, told an interviewer: "Playing percussion for Carlos you had to be able to play hard, non-stop for sometimes up to three straight hours, and play loud enough to be heard over the electric instruments. A lot of times I played so hard that I would piss blood after the shows. Santana gigs were an endurance test of the highest order." What would the connection be here? Can blood really get into the urine through this kind of physical exertion?--James

Cecil replies:

Music is a brutal business, James: String and keyboard players can suffer from focal dystonia. Saxophone and clarinet players develop disorders of the temporomandibular joint. At least one guitarist, Terry Balsamo of the metal act Evanescence, apparently gave himself a stroke by head-banging onstage. And hand drummers risk rhabdomyolysis, the disorder you refer to. Typically it's not blood they're seeing in their urine, though — it's muscle.

Rhabdomyolysis occurs when muscle cells are damaged to the extent that they break down in the body, releasing into the bloodstream several substances, including a protein called myoglobin that’s excreted in the urine (if you're lucky) and imparts the reddish brown color.

The condition is sometimes called "crush injury syndrome." Some of the first recorded cases were seen during the London blitz in World War II, resulting from the battering people took when they were trapped inside collapsing buildings. It's also found in the victims of earthquakes — after the 1988 Armenian quake more than 1,000 cases were reported — and auto accidents. Some less typical cases have evidently been caused by lightning, centrifugal pilot training, CPR compressions, riding a mechanical bull, being attacked by a wolf, and taking advice from goons.

For more, see:
www.straightdope.com/columns/read/2848/can-playing-the-bongos-make-you-piss-blood