What a fun week it’s been in the “CrossFit” Community! I feel like the conversation about “Rhabdomyolysis” is at an all-time high in my history of being a CrossFit athlete. And to think this all started from one little article is amazing.
The article in question is entitled: “CrossFit’s Dirty Little Secret“, written by a guy named Eric Robertson, and has CFers furious all over the world. You know those articles that FB tells you seventy-five of your friends have shared? Yeah, this is one of those pieces.
To summarize it poorly, I assume he is trying to bash CrossFit and say that they hide Rhabdo from its athletes, in essence, stating how unsafe and irresponsible the program is to follow. For those of you who have read the piece, do you think that’s a fair summary (without getting into the inconsistencies or simply false statements made)?
So, a few days later, one of the first “rebuttal” articles came out. This one from a woman named Ericka Andersen, and her piece was called: “CrossFit Doesn’t Have a Dirty Little Secret — You’re Just Irresponsible“. Ericka goes ahead and takes the exact opposite side of the coin. Her stance is that no trainer or gym owner should be held responsible for Rhabdo, rather the athlete should know themselves well enough to know when to stop pushing.
Here are two quotes from her post:
“Rhabdomyolysis — an extreme condition thwarted upon oneself — is not the fault of CrossFit. It’s not the sport, the organization or even the coaches. It’s your own fault.”
“But use your common sense! Don’t do something that will hurt yourself. Listen to your body. Go slowly when you start. Learn correct form. Don’t lift too heavy. Scale down if you need to. Take it seriously — weightlifting isn’t a joke.
Any good CrossFit coach will tell you these things. Of course, there are bad coaches! There are bad gyms. There are people who will tell you to do things that may be harmful. Be smart.”
My take on her article, is that Ericka puts a little bit TOO MUCH responsibility on the athlete. While I do believe that people need to be aware of their body, and know when to stop pushing, I also have experienced first-hand… HUNDREDS of times, that some people simply don’t know how to do that. Some folks that walk into the gyms where I coach have never worked out a day in their lives. Others were potentially elite-level athletes…. twenty, thirty, forty years ago, and truly believe their bodies can go back to that level of performance overnight. That’s not quite how it works.
While I absolutely side with Ericka if I had to pick one of the two articles discussed so far, I 100% put a large amount of responsibility on the gym owners and coaches to know enough about the human body, and their athletes, to try their best not to let people hurt themselves. One of my favorite parts of coaching is looking around a full class of athletes and knowing them well enough to be able to safely and correctly pick weights that they should use for strength training or workouts.
So there you have it, the two opposite ends of the spectrum on whose fault it is that Rhabdo occurs. Now, the gel to bring them both together. Mike Ray, one of the owners of CrossFit Flagstaff (who has been in the CrossFit game with his wife Lisa for a lonnnng time), posted his thoughts on the situation. I read his post and thought… perfect. He addresses the potential risks of CrossFit, of lifting, of working out in general, as one should. He also mentions the potential benefits of that type of training, when done right. He brings up the different workout styles associated with an individuals’ fitness goals. I mean, he touches on basically everything that I thought about when I tried to record the video below a few days ago.
The bottom line, if you want to read someone who is articulate and sounds intelligent covering “all of the bases” on this topic, and someone who I agree with basically 100%, please read this article: “Secret” Rhabdo. It’s beautiful.
Now, here’s my rambling attempt at addressing my thoughts on this situation. Before I started recording I had 5 or 6 talking points, but when the camera started rolling. It rambling at parts, misses some of the key points, but as it is, it’s taken me 3 days to post my thoughts because I wanted this post to be all-inclusive. HA! Anyways, there you have it, folks. Rhabdo discussed. I am incredibly interested in hearing what you guys think on this situation. Let’s discuss….
Smashby's Training Blog 
Great article and video Tom!
Responsibility lies with all parties for sure, and to say rhabdo is a secret or frequent is someone trying to make a huge deal out of something with no evidence.
I’ve been lucky enough to have wonderful gym owners and trainers around during my 8 months of crossfitting, and I heard about rhabdo fairly early on, but have yet to meet anyone who has directly suffered from it.
Like football and the ACL, baseball and the rotator cuff, every physical activity has its risk, but the rewards far outweigh the risks as far as I’m concerned. Plus the alternative is being far and lazy doing no exercise.
I’ll take a rock hard body and a great community any day of the week.
Again, well spoken and great job Tom!
Jake, what am awesome reply! Thanks so much for your words. I agree with everything you said, and think that risk is inherent in some way, shape, or form in any medium that could possibly produce positive change. Keep up what you’re doing, brother. You’re making huge gains!!
Hi Tom!
Great to see you’re getting back to regular postings, always an interesting read! Also, your way of welcoming discussion is what really sets this blog apart and gives it quite richer content.
As a scientist and coach, I wanted to add my opinions to the conversation, and since reading the article this week I was actually hoping to chat with you about it! There are many benefits to CrossFit. I think there is evidence of many people improving their overall health through it, but I don’t think saying they outweigh the risks is the way to approach a potentially lethal issue. Benefits and risks are unrelated, and it is the responsibility of the Coaches to be effectively educated and effectively educate their athletes when addressing life-threatening risks associated with their sport. In my opinion, it is not that a discussion of rhabdo is a ‘secret,’ cause its not, it is that its discussion is dismissive and not serious for the weight it might carry for an athlete.
Certainly the title of the original article is designed to attract readers. I don’t like the ‘dirty little secret’ fluff. However, based upon what you discussed, it seems to me that CrossFit isn’t giving this the true serious addressing on the Coach, Gym and Athlete level that is deserves. You could certainly correct me here if I am wrong. On the corporate level, it seems like the training of their Coaches aren’t rigorous enough when the nature of the sport increases the risk of a life-threatening physiologic condition.
This really isn’t the same as knowing people being told about the risk of breaking bones skiing or playing football, its more equal to the risk of catastrophic head/spinal injury in football. The risk is elevated for this type of injury in this specific sport. With the more significant risk during contact sports, the NFL and NCAA in the last few years have made a very public, very serious, and very aggressive approach to addressing and helping mitigate this risk. I don’t believe that putting a waiver on a website of a gym, or a post in a CrossFit magazine really equates to actively informing and educating athletes and coaches about a life-threatening systematic condition. Rhabdomyolysis shouldn’t be equated and discusses the same as broken bones or pulled muscles or other fitness injury risks associated with CrossFit (or other training), as the seriousness of the condition is quite higher.
Dr. Mike Ray said in the article, “There is no way to separate the effectiveness of the training from all risk.” This is a given, but exceptional risk for potentially lethal conditions has always been addressed in a serious tone for athletes, and his article seems to be dismissive of responsibility of Coaches to be effectively educated by CrossFit and to educated/advise their athletes.
Rhabdomyolysis incidence is about 0.06% nationwide (Park et al 2013), of which about 85% are due to catastrophic injury (Huerta-Alardin et al 2005) (crush injuries could lead to rhabdo through muscle tissue damage)(Goldfarb and Chung 2002). Leaving an incidence of about 0.009% for things like exercise induced rhabdo.
You mentioned you knew of 3-4 people who have had exercise induced rhabdomyolysis in your experience with CrossFit. For this seeming low number to be non-significantly different from the general population, you would have to have known and encountered 39000 CrossFit athletes to have an incidence equal to the national average. While certainly not acceptable in peer-review, seems at least anecdotally that the incidence of exercise-induced rhabdomyolsys in CrossFit is elevated higher than in the general public. With the fact that this is life-threatening systemic condition, that can lead to multi-system organ failure, it should certainly carry more weight and more responsibility for coaches to have real, frank and educated conversations with those they are coaching. A Coach can’t responsibly say to an incoming athlete, “With CrossFit there is a risk of muscle strain, bone injury and rhabdomyolysis, now lets begin.” Just as the NFL can’t say to incoming players, “You might break a finger or hit your head.” I agree like you mentioned that 100% of the responsibility must be on the coach/gym.
I think you hit the nail on the head, with the fact that CrossFit Coaches (and they are coaches not personal trainers) need to have more education than just “$1000 and some training” to become a Coach. You would know more than me, and I will admit to not knowing what is done in the training, but do Coaches receive training on physiology? Not movements or safe training practices, but an understanding of the ‘why’ does something like rhabdomyolysis occur? What are the warning signs? A couple other genuine questions: do you think that CrossFit Coaches sit down with incoming potential athletes and tell them they risk a life threatening condition, and really explain what rhabdo is, and educate their potential athletes in direct and informative way? How will you discuss rhabdo with your potential athletes?
While certainly an inflammatory title that has sparked much debate and rebuttal, it likely has done its job if CrossFit Coaches, Athletes, and Corporate offices are addressing the real risks of rhabdomyolysis and hopefully driving more education and discussion in to mitigate those risks.
Love to discuss more and hear your thoughts!
Jack
(1) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744708/
(2) http://www.ncbi.nlm.nih.gov/pubmed/15774072
(3) http://www.ncbi.nlm.nih.gov/pubmed/12208396