As a general rule, you'll reap the most from any regular exercise regimen by including plenty of variety. In this interview, Dr. Kelly Starrett, who is one of the leaders in the CrossFit movement, shares what CrossFit is and the importance of proper body mechanics, both in and outside the gym.  

CrossFit was started in 2000 and has about 7,000 gyms, most in the US. It is a strength and conditioning program that advocates a perpetually changing mix of aerobics, body weight lifting, gymnastics and Olympic weight lifting. It is one of the most extreme forms of exercise out there, is not for everyone, and I advise you to use caution if you decide to try it, as doing it incorrectly can lead to injury. 

Dr. Kelly has a Doctor of Physical Therapy (DPT) degree, so he's a clinical doctor. He's also the author of the book Becoming a Supple Leopard, which is an excellent resource for exploring and addressing any biomechanical inadequacies you may have, which could increase your risk of injury.

For the last nine years, he's been running his own independent training center in San Francisco called San Francisco CrossFit. Dr. Kelly estimates tens of thousands of athletes have trained there, and he also has a clinical practice there.

"When they come to us, we find out that most people don't have a schema for understanding how their body works," he says.

"[But] people are taking their health much more seriously... They're realizing that you just can't wait for a set of nagging indicators like pain and disease, numbness and tingling and swelling to pop up..."

Dysfunctional Movement Patterns May Be the Root of Your Pain

The fact that more people are starting to take proactive health steps is encouraging. Increasingly, and perhaps you're one of them, people are starting to realize that a major part of being healthy is to be pain-free, and they're realizing that pain doesn't have to be an inevitable part of aging. Part of being pain free is re-learning how to move your body properly.

"The central tenet of CrossFit is that we're going to help [you] be able to express all the things a human being should be able to do," he says. "Can you close your ankle down all the way? If so, you are going to squat all the way down – this is an easy task for people to do. Can you squat all the way down with your feet and knees together? That is an expression of full hip motion. Turns out, most people can't do that without falling over or without their heels coming up.

What we know is that in exercise, in strength and conditioning, is it's really become a formal language of human movement... I'm [teaching] people to express full range motion, and being able to manage those independent loads on your spine."

Essentially, CrossFit takes basic, fundamental movements that you should be able to perform, and then bumps up the intensity. For example, once you can properly perform a squat, you add a bit of weight, or perform it while breathing hard, or moving faster, or for more reps, or you increase the intensity by performing it at a faster pace. The idea is to increase the challenge of performing basic movements, because under intensity, your cardiovascular and respiratory systems are greatly stimulated.

"That's the heart and soul of what CrossFit really is. At the end of it, I teach a course for CrossFit called a Movement and Mobility Course, where we teach people the principles of how their bodies are wired to move, and how to fix them when they can't," he says.

The Importance of Having Good Range of Motion

According to Dr. Kelly, movement is actually an excellent diagnostic tool. Once you come up against the limits of your range of motion and capacity, you know where your problem is, and where you need to focus your attention. Having good range of motion and flexibility is particularly important when you're engaging in high intensity exercises.

A lot of the common musculoskeletal problems that clinicians encounter are the result of poor or improper movement. So the first thing Dr. Kelly does in his clinic, and in the gym, is to correct your movement pattern. Once your joints are properly aligned, your muscles and soft tissues can perform better, and typically this will resolve your initial dysfunction and put you in a position where you can safely exercise at higher levels of intensity.

I do believe that CrossFit can be an exceptional exercise program as long as it is used properly and one doesn't violate any individual range of motion challenges. It can be an excellent tool to get in highly competitive shape. However, for my tastes it can be too intense and it is easy for many to push beyond their limits and become injured and some seriously.

As long as you know these are dangers and compensate for them by having individualized instruction that addresses your specific range of motion challenges it can be a phenomenal way to get in shape. Just be very careful to listen to your body and honor any feedback it is giving you. It would be really sad to develop a serious injury that would prevent you from exercising long term. Remember, health is a journey, it is not a destination and you will need to continue this journey the rest of your life.

Potential Dangers You Need to Be Aware Of

Some have criticized CrossFit as being dangerous, and dysfunctional movement is one factor that can play a role in that risk. Personally, I would advise you to use caution when trying a program like CrossFit, as most people do have some biomechanical challenge and would benefit from personal rather than group instruction. But there are also other risks to consider. The potential hazards of this extreme form of exercise were recently highlighted in the media.¹ According to Eric Robertson, an assistant professor of physical therapy at Regis University in Denver, CrossFit could lead to a condition called rhabdomyolysis, oftentimes referred to as "rhabdo."

Severe exertion is one factor that can set off this potentially fatal condition, which rapidly releases proteins into your blood, resulting in kidney damage and, potentially, kidney failure. Last year, Robertson penned an article² titled "CrossFit's Dirty Little Secret," in which he states: "Rhabdomyolysis isn't a common condition, yet it's so commonly encountered in CrossFit that they have a cartoon about it, nonchalantly casting humor on something that should never happen."

 

This is a Flash-based video and may not be viewable on mobile devices.

According to ABC News³:

"Dr. Richard Besser, chief health and medical editor for ABC News, says cases of rhabdo, which he describes as a 'death of muscle cells, occur only after you ask your muscles, 'to keep working after they've stopped getting any energy to get the job done.'' 'That's really dangerous,' Besser said... adding that the condition can be prevented.

'If you're listening to your body and you're getting that burn and you say, 'Okay I've reached my limit,' and you stop, you're never going to see this happen,' he said. 'One of the warning signs is your muscles are saying, 'I need to stop now.'' To prevent rhabdo, Besser recommends staying hydrated both before and during exercise, taking breaks and listening to your body. 'No pain, no gain is the worst approach to exercise,' he said."

Intensity Is Key for an Effective Workout, But Use Caution

According to Dr. Kelly, long-distance running is far more dangerous than CrossFit, in large part due to the repetitiveness of the motion. Well, that may be true for some, as an uninjured long distance runner for over four decades, I believe the potential for overexertion and injury makes CrossFit a riskier proposition than many other forms of exercise. And the major downside is that many people who don't really exercise and become injured after trying CrossFit may never return to an exercise program.

I ran for 43 years and even did a sub 2:50 marathon. But this wasn't because of brilliance and was largely due to ignorance of better exercising strategies. I didn't really pursue any other exercises until seven or eight years ago. It has now become really clear to me that high-intensity exercise is a FAR more effective strategy for building cardiovascular and overall fitness.

However, recovery is also part of the equation, and I would not recommend doing high intensity exercises more than three times per week. Your body needs to properly recover in between. Dr. Kelly agrees that intensity is the key to an effective workout, but believes competitive athletes can train hard nearly every day as long as they are using different movements. After all, CrossFit is nothing if not intense!

"We see that metabolic and respiratory conditioning has the greatest impact... You know, by raising the average intensity, what you're doing is upsetting homeostasis, which is what you need to do. By making something more intense, what you're really doing is causing a change in that second wave adaptation [in your body]. That can be done by sprinting. It can also be done in air squats, push-ups, pull-ups, or in multiple joint movements.

We don't have to relegate ourselves looking at cardio-respiratory health simply as 'you have to be on a bike or run and win.' Those things are easy to measure, but then you could also be climbing a hill, putting dumbbells over your head, carrying something heavy around, or pulling a sled.

All I'm trying to do is raise the average intensity of the exercises that I do. We use Tabata... We do sprints... We do a lot of rowing. But we start adding the intervals and we build couplets in between some simple bodyweight exercises or some elemental strength and conditioning exercises, and some of these mixed modalities of running, jumping, or rowing. Then we can have a fantastic, very short workout that has you trained at the limits of your ability, where we raise the average intensity."

The Importance of Recovery

If you're committed and disciplined, you may be more likely to ignore or discount the importance of recovery. This could easily become your undoing, as recovery is just as important as any other aspect of your fitness regimen. I believe that high intensity exercises such as my Peak Exercises should not be done more than three times a week. As explained by Dr. Kelly, other movements that cause your heart rate to go higher, or even peak, can make you exceed that three-times-a-week limit, but you want to be cautious, and as a simple guideline not do a single-motion type exercise at high intensity more than three times a week to start. The key concept here is to train your body gradually, over time, to be able to handle higher intensity workloads. You really need to learn to listen to your body, and not push it too far.

"[A]thletes, they're training six days a week, sometimes twice a day [but] the thing that allows that to happen is that they manage their recovery," he says. "For example, we will look at ways to measure heart rate variability, which is a fantastic measurement of sort of dystopia between your parasympathetic and your sympathetic nervous system, your recovery nervous system, and your fight-or-flight nervous system.

We see that when people are very stressed, training very hard, or engaged in monostructural, long-term aerobic work, we see decreases in testosterone, increases in cortisol, and in that change in that heart rate… As you breathe in, your heart rate should increase. As you breathe out, your heart rate should decrease."

Sitting Kills... Even if You Exercise Regularly

Over the past year, I've become increasingly focused on understanding the biomechanics of the sitting process, which research tells us is an independent risk factor for chronic disease and reduced lifespan—even if you exercise regularly.

I've interviewed experts on this issue to learn what we can do to mitigate such risks. One such expert is NASA scientist Dr. Joan Vernikos, who promotes non-exercise activities, such as simply standing up every 10 minutes, as the remedy. Another facet of the issue of why sitting can wreak such havoc on your health is your posture mechanics while seated. Esther Gokhale, creator of the Gokhale Method, has come up with sitting techniques that essentially turn sitting itself into an exercise that benefits your entire system.

"When we say exercise, you're training for an hour. If you go back and sit 10 to 12 hours a day, which is where most people are sitting, that is, by definition, a sedentary lifestyle" Dr. Kelly says. "Metabolically, the equivalent of smoking and running... When you sit down, a whole bunch of complex biomechanical things happen, including the fact that when you sit down, you turn the leg musculature off. It literally turns off. The mechanism to clear congestion and limp in your system is muscle contraction. That's what drives you lymphatic system.

You know, sitting is a skill and you should be able to handle some sitting, but two out of the three primary components that's helping stabilize your spine are knocked out. You don't have any hip stability. You can't manage your pelvic position with your glutes anymore."

Improper sitting can actually lead to workout injuries. Overextension injuries, Dr. Kelly claims, is a rather common problem. To address the issue of prolonged sitting and its associated health consequences, Dr. Kelly gives the following advice:

"What we recommend is that, in your work environment, where you have to sit, you should not sit. You can raise up your workstation and lean against the stool, and change your position often. You're going to have a much different impact.You know, there was some great research on the Wii that showed that the Wii video game system was pretty successful at burning calories. Turned out that it burned as many calories as standing, which I think is totally ironic. People don't need a $10,000 treadmill desk. They need a phonebook, something they can put their foot on. They need a really cheap bar stool, and the idea is to have you constantly moving through the day that doesn't look like sitting."

Proper Posture Is Key for Good Health

In Dr. Kelly's experience, one of the most common mistakes people make is that they don't brace their spine. By understanding how to brace, and learning the correct sequence of movement, you can reduce your risk of injury—in and out of the gym. Proper posture and correct movement also affects your overall health in ways you may never have considered. As Dr. Kelly explains:

"We see, for example, there's a lot of emphasis on pelvic floor dysfunction in women. But what we know is that when your spine is in a disorganized position, then you're either overextended or flexed... What ends up happening is that in the diaphragm, mechanics are actually compromised. What we see is decreased excursion of the diaphragm and we start to see more patterned breathing up to the neck, which is inefficient... You cannot stabilize your spine as well [either] because you cannot use your diaphragm to create strong intra-abdominal pressure.

So you end up creating a very dysfunctional, stressed breathing pattern that also impacts your cortisol levels – your stress hormones... If I can get your spine organized and cultivate that, we clean up breathing problems, we clear up pelvic floor dysfunction, and spine dysfunction. That's number one – we always prioritize spine first in everything we do."

More Information

To learn more, I recommend picking up a copy of Dr. Kelly's book, Becoming a Supple Leopard, which is a great resource. His training center also has a website, www.mobilityWOD.com, where you can find about 800 videos, including "mobility workout's of the day."

"We advocate that people try to change their own personal biomechanics," he says. "It takes about 10 to 15 minutes a day of working on your positions, and all of that stuff is available for free on our site."