CrossFit, Injury, and Risk: A Paradigm Shift

"Your diabetes has been cured with lifestyle regimen ... It's out there for everyone." —Dr. Isaacson“Your diabetes has been cured with lifestyle regimen” Says Dr. Harry Isaacson from the Cleveland Clinic Lerner College of Medicine. He’s speaking to his patient, Pete Katz. After following CrossFit’s approach to nutrition and fitness through his local affiliate, CrossFit Painesville, Katz lost weight, cured his Type 2 Diabetes, and no longer suffers from sleep apnea or anxiety. Julie Foucher’s full interview with Dr. Isaacson and Katz can be seen here.

This account is not unique. Our affiliates regularly report stories of clients who have been cured of conditions such as Type 2 Diabetes, rheumatoid arthritis, congestive heart failure, Osteopenia, and Gout. For every one of these accounts, there are ten in which clients are able to reduce the symptoms of a chronic disease.

We have spent years battling the persistent claim that the CrossFit program is dangerous. Those who cry this loudest are our competitors in the industry. Yellow Journalists echo these cries not because they are genuine, but because raising the alarm of hidden danger in everyday life has become standard practice. And yet everywhere in the world, CrossFit participation is growing. The speculation of reporters and industry critics clearly does not match the personal experience of the millions utilizing the CrossFit program. Moreover, the academic data we have is unanimous: CrossFit’s injury rate is comparable to any other fitness program, and vastly safer than most sports.

What we need then is not another defense of CrossFit’s safety, but a fundamental change in the way we talk about safety in fitness. Since the beginning, the conversation about CrossFit and risk has had an enormous blind-spot: Any claim of “risk” must be considered against a backdrop of potential reward. Without this consideration, discussion of a fitness program’s risk lacks essential context. Rarely do our critics reference this risk vs. reward paradigm, and none have fully appreciated what it means.

Would you be willing to leave your house today if in doing so you dramatically increased the probability that you might fall and break both of your legs? We might foolishly rush to answer “of course not!” without considering that the houses of our neighbors on both sides have caught fire. Well intended concern for musculoskeletal injury might ultimately lead to the fire department finding your charred corpse sitting on the couch.

Thus, when we consider the risk of musculoskeletal injury associated with CrossFit, we must consider another fact: Chronic disease is the leading cause of death and disability in the united states, with half of all Americans (117 million people) have one or more chronic health conditions. As CrossFit’s CEO and founder Greg Glassman has said, “If we don’t ratchet up our tolerance for sprains, strains, ACL tears, and the like, we are never going to address systemic illness headlong.”

It is precisely this tolerance that the rest of the fitness industry lacks on a grand scale. When I began CrossFit over 10 years ago, it was common knowledge that movements like the squat, deadlift, and press were inherently dangerous and should never be trained. Yet even now you can find trainers who advocate the general population avoid all of these movements. It was not until considering the risk vs. reward paradigm that I fully understood the fitness industry’s culture of risk intolerance: They idolize safety because their programs offer little to no reward. The physiological benefits of the exercise prescriptions recommended by organizations such as the ACSM and ACE are so poor that the balance of risk and reward tips dramatically toward the negative at even the hint of injury.

In popular parlance the reward of a fitness program should be “fitness,” but this term has only relatively recently taken on meaning that permits accurate and precise measurement. In February of 2009, Greg Glassman defined fitness as a calculation of an individual’s work capacity across broad time and modal domains. Since then we have witnessed that this metric represents far more than physical prowess. Increases to work capacity practically guarantee improvement in all of the correlates to fitness that we desire: Body fat percentage, blood lipid profile, bone density, sex drive, mental acuity, confidence, blood pressure, fertility… etc.

Improved fitness, by CrossFit’s definition, leads to improved quality of life. While our top athletes display CrossFit’s potential for creating physical dominance, it is those farthest from physical dominance that best display the life-changing power of striving to improve work capacity. This “reward” is vastly under appreciated by the general public.

Our nations is suffering physically and economically from a epidemic that can be prevented, managed, and even cured through a 100-word prescription published by Greg Glassman over a decade ago.

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While our critics seek to portray the risk associated with the CrossFit program as high rates of musculoskeletal injury and rhabdomyolysis, they have failed to ask a fundamental question: what of the risk of not participating in CrossFit?

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