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Is CrossFit Safe?

Dr. Mercola

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May 22, 2015

CrossFit, created by Greg Glassman, is an intense strength and conditioning program involving perpetually changing and challenging intervals of aerobics, body weight exercises, gymnastics, and Olympic weight lifting.

It's a workout that Glassman says will "deliver you to your genetic potential." CrossFit is one of the most extreme forms of exercise out there, and I advise using caution if you decide to try it, as doing it incorrectly can easily lead to injury.

Glassman has over 90 lawyers defending the CrossFit brand, and that includes a lawsuit against researchers who reported some of the participants dropped out of the CrossFit study due to injuries.

Clearly, extreme sport has risks, and the nature of CrossFit can heighten the risk of injury if you're not taught correctly from the start, or fail to heed your own limits.

Glassman has even gone on record saying:1 "It can kill you. I've always been completely honest about that." That and the fact that he says in the interview he has 90 lawyers on staff to defend him from lawsuits suggests you clearly need to exercise caution when considering a CrossFit gym.

Part of the company's success, and probably part of its problem, is that anyone who wants to open a CrossFit gym (referred to as "a box") can do so. All that's required is a $3,000 annual fee and a two-day certification course.

It's certainly better than nothing, but it's much like seeing a doctor who went to medical school for one month instead of 7-10 years.

It's quite possible to join a CrossFit gym where the trainers have minimal knowledge, so it's imperative to make sure your trainer has additional certification to make sure they understand proper form and body mechanics.

That said, there's no denying it can be effective if and when done with proper form and some common sense. In fact, in a gym with good trainers it may be one of the best fitness programs you can engage in.

Proper Body Mechanics Is Crucial for Safe CrossFit Practice

Dr. Kelly Starrett, one of the leaders in the CrossFit movement, was previously featured in another 60 Minutes segment on CrossFit, in which he stressed the importance of proper body mechanics, both in and outside the gym.

He's also the author of the book Becoming a Supple Leopard, which is an excellent resource for exploring and addressing biomechanical inadequacies that might increase your risk of injury.

I interviewed him about his views on CrossFit and body mechanics last year. According to Dr. Starrett, the central tenet of CrossFit is to help you move and function at full capacity, expressing "all the things a human being should be able to do."

For example, can you squat all the way down with your feet and knees together, feet flat on the floor? That's an expression of full hip motion. As it turns out, most people can't do that without falling over or lifting their heels.

Dr. Starrett views movement as a convenient 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, which I believe are foundational for optimal health and fitness.


Common CrossFit Injuries

While there's a slim supply of studies looking at CrossFit's safety, at least a couple have shed light on some of the potential dangers of this extreme practice.

A 2013 study2 published in the Journal of Strength and Conditioning Research found that nearly 75 percent of CrossFit participants were injured during training. The most common injuries involved the spine and shoulders. Of 186 reported injuries, nine ended up requiring surgery.

A more recent study3 published in Orthopaedic Journal of Sports Medicine found an injury rate of about 20 percent, with low back, shoulder, and knee injuries being the most common. According to the authors:

"The involvement of trainers in coaching participants on their form and guiding them through the workout correlates with a decreased injury rate.

The shoulder and lower back were the most commonly injured in gymnastic and power lifting movements, respectively. Participants reported primarily acute and fairly mild injuries."

By understanding how to brace your spine, and learning the correct sequence of movement, you can reduce your risk of most injuries. Proper posture and correct movement also affects your overall health in ways you may never have considered.


Download Interview Transcript

As Dr. Starrett explained in my interview with him above:

"There's a lot of emphasis on pelvic floor dysfunction in women. But 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 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."

What You Need to Know About Rhabdomyolysis

Forbes4 recently addressed some of the hazards and potential downsides of CrossFit that 60 Minutes failed to include in its segment:

"One challenge, which60 Minutes didn't mention at all, is a condition called rhabdomyolysis. It's generally rare, but involves muscle fibers being pushed to the point that they break down, enter the bloodstream, and lead to life-threatening kidney damage...5

CrossFit disputes that the risk of rhabdomyolysis is higher among its clients. But on some level, they have acknowledged the danger, with a bloody 'Uncle Rhabdo' cartoon clown6 designed to warn athletes from pushing themselves too hard."

ABC News also addressed this issue in a 2013 report,7 stating:

"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."

Advice from the Fittest Man on Earth

CrossFit is also becoming known for its annual CrossFit Games. Described by Sharon Alfonsi as "part Olympic Games, part Hunger Games," CrossFit athletes from around the world compete in a four-day long event to see who's The Fittest Man, or Woman on Earth—a title Glassman has actually trademarked. Last year, CNN8 interviewed Rich Froning after he won for the fourth year in a row.

"Picture it: a four-day competition, with two to four workouts a day that consist of running, swimming, muscle-ups, 345-pound squat cleans, handstand push-ups, rope climbs, double unders, handstand walks, 245-pound overhead squats, and more, against 43 of the most in-shape competitors you know, all with the title of Fittest on Earth on the line. Now imagine doing it four years in a row — and winning every time. That's what Rich Froning did as he secured his fourth consecutive title as the Fittest Man on Earth..."

As for avoiding injuries, "the world's fittest man" cautions people to start slow when getting into CrossFit training.

"I think people start out too quickly and say things like, 'Rich does several workouts a day so I can do several workouts a day, too.' No, you need to ease into it and find a good coach... [T]he best-case scenario is doing it with a good coach and learning the right movements," he says, adding:

"For me, doing bodybuilding-type workouts using single-joint movements led to more injuries and more flair ups than I've had doing CrossFit. I had shoulder surgery before I did CrossFit, and my shoulder has never been stronger, so I think it's great."

Recovery Is an Important Part of the Fitness Equation

While Froning trains up to three hours a day, I would caution you not to follow his lead as recovery is an important part of the equation. Dr. Starrett believes competitive athletes can train hard nearly every day as long as they are using different movements, but as a general rule, I would not recommend doing high-intensity exercises more than three times per week.

Your body needs to properly recover in between. 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.

While CrossFit has many potential pitfalls, it's hard to deny it can be incredibly effective. After all, intense interval-type training has repeatedly been shown to be the most effective and efficient way to get fit. A 2013 study9 done by Ohio State University researchers found 10 weeks of CrossFit-based high-intensity power training resulted in significant improvements in VO2 max and body composition in both men and women, regardless of their initial fitness level.

Incidentally, Ohio State University is now being sued10 by the owner of the CrossFit gym where the research participants trained—an action that may put a damper on future research into the benefits and hazards of CrossFit. Gym owner Mitch Potterf claims the researchers faked data for the study, which Ohio State University used to obtain $273 million in Federal research grants. According to Potterf, the scientists falsely reported that nine subjects dropped out of the study due to "overuse or injury."

Exercise Wisely for Optimal Health

So what's the final word on CrossFit? I believe it can be an effective workout, but unless you're already a well-trained athlete there are safer ways to optimize your fitness. High-intensity interval training (HIIT) is ideal as it boosts fat burning, muscle building, and cardiovascular fitness, and there are many ways to get HIIT into your program—you don't have to jump into CrossFit right from the start. Greatist11 has summed up several of the HIIT programs available, along with its benefits, in the following infographic. This is the place to start if you want to give HIIT a try.

The Complete Guide to Interval Training

That said, if you're already fit and want to take your workout to a whole new level, CrossFit may be what you're looking for. Just be certain that the CrossFit gym you use has professional trainers that can monitor your form and make sure you don't get injured. To learn more about CrossFit and proper body mechanics, check out the following London Real segment on Kelly Starrett's "Supple Leopard" ideology. Starrett's training center also has a website12 where you can find about 800 videos, including "mobility workout's of the day.