I tried to ignore it for awhile because I didn’t really think it deserved a response, but so many people have forwarded me this article I guess it’s time that I address it. Especially since I have clients’ and their friends concerned about my clients safety due to this article. I hate to even link back to it because it just helps their google rankings.
First thing is first. You must realize that this is an anti-CrossFit article. Clearly the author had an agenda and that is to disparage CrossFit in the name of journalism but that’s a whole other point.
What I want to address is the content of the article. The major concern here is Exertional Rhabdomyolosis. What the heck is that you may ask? Here’s the explanation. When there is significant muscle damage (more than the body can handle) certain chemicals are released from the damaged muscle tissue into the blood stream. The kidneys who filter the blood can not handle the chemicals and it can cause kidney damage and can lead to kidney failure. This is a serious condition and certainly should not be taken lightly, however it’s occurrence is EXTREMELY rare.
The article is written as if this is a new occurrence that CrossFit created. It’s not. It’s been around forever. In fact it’s most common occurrence is in US Military bootcamps, but you never hear about ‘Bootcamps Dirty Little Secret.’ It also occurs more often in high school and college football workouts, especially during two a days. Trust me, I worked in college football for 3 years. My boss and our internal medicine doctor at Oklahoma were two of the leading experts on Rhabdo in the country, so we are well aware of it’s implications and effects. In fact, they would argue that almost every case where you hear of a college football player death during summer workouts, it was not due to heat, it was due to Rhabdo. Again, you never hear about it in these situations. Is this a cause to say that we should discourage everyone from joining the armed services, or playing Division 1 football? Of course not, these cases are outliers. Such is the case of CrossFit occurrences.
CrossFit is getting attention because they actually make an effort to make people aware of it. Yes they have a cartoon that is tongue and cheek about it. I don’t agree that it is appropriate but it’s how CF HQ rolls. Either way, it may even be more affective because you remember it. They have journal articles warning about it, and they also spend a portion of the Level 1 certification talking about it. They take a responsible stance and let people know that it can occur, instead of sweeping it under the rug.
The truth is, it can occur with anyone who is participating in any type of high intensity training, but if you have risk factors the chances of it occurring are higher. The likelihood of it occurring in a beginner without risk factors is extremely rare. It’s far more likely to occur in a person who is fairly fit because typically beginners will quit before they cross that threshold. The person that is in more danger is someone like a former Navy SEAL who hasn’t trained in 5 years but has the mental fortitude to push past pain barriers. They do a workout with a lot of reps in it and push further then a normal person would. This can result in too much muscle damage and can lead to Rhabdo, but again this is extremely rare.
Here are some other risk factors that can put someone at greater risk of Rhabdo in any high intensity training:
Idiot coaches and programming
CrossFit and personal training in general is littered with stupidity just like every other profession. If you are working with a coach who doesn’t actually know what they are doing, your risk of injury in general is increased. Ask about your coaches’ credentials, training, and experience. A CrossFit certification is just a weekend course, so if that’s all your coach has to offer, I would be weary.
High Rep Programming
Although, high rep programming sometimes is not necessarily a bad thing, doing it all the time is a problem and repetitive exposure can lead to too much damage. Refer to the first point. If you do not have an experienced coach who knows the implications of the programming you could be exposed to greater risk. Certain movements are also a higher risk factor, so it’s not a good idea to do 100 reps of GHD sit ups if it’s your first exposure to the movement. Communicate with your coaches here and check your ego if necessary. Your coaches should be able to scale the movements or reps for you if necessary. Also, if you are participating in a high rep workout and experience sharp pains…. stop.
Dehydration
If you are extremely dehydrated, your muscles can not function the way they are supposed to and more then necessary muscle damage can occur. Make sure you are well hydrated in order to participate in high intensity, high rep programming.
Statin Drugs
These drugs can cause all kinds of issues, but they are also a risk factor for Rhabdo, so if you are on these, it is important for you to let your coaches know.
Sickle Cell Trait
A lot of people don’t know this, but Sickle Cell Trait is a significant risk factor for Exertional Rhabo. This is not Sickle Cell Anemia, but rather the recessive gene trait. If you have this trait, your red blood cells will be normal most of the time, but when exposed to intense exercise and dehydration, the cells take on the sickle shape and can not deliver oxygen to the muscle cells appropriately. This can result in excessive muscle damage in a workout that would normally be ok. This trait is fairly common in African American decent (8-10% of the US population and up to 30% in western Africa) Indian and Greece decent, and Hispanic decent prevalence is 1 in 180 people. This can be shown through a simple blood test and should be something that you are aware of.
At CrossFit Bartlett with my experience actually working with some of the best in the field on the subject of Rhabdo, we do our best to mitigate the issue. Per exposure in CrossFit alone the incidence of reported Rhabo cases is somewhere around 1 per several million exposures a year. You have a much greater chance of getting struck by lightning or getting killed in a car crash then you do of getting Rhabdo, but it is something that you should be aware of. At CFB we talk about a red line or cliff. We don’t want you going over the cliff, just up to the edge. Keep that in mind and pay attention to the risk factors and you should be fine. Tell your family and friends to calm down, with us, it’ll be ok.
10-1-13 WOD
Strength:
To be discussed in class
Met Con:
KB Swings x 5 (heavy)
Dead Hang Pull ups x 5
10 rounds for
time
