Injury Prevention
High Intensity Does Not Equal High Risk Of Injury
Every once in a while I come across an article by some well-meaning but ignorant trainer warning people of the dangers of training to failure.
If the point of failure is defined as the moment where it is no longer possible to continue an exercise in the prescribed form, than there is nothing dangerous about training to failure. Unless there is a pre-existing injury or condition which would contraindicate performance of the exercise to begin with, risk of injury only increases when one attempts to continue an exercise beyond the point where they are capable of using proper form.
Due to the greater physical and mental demands of to-failure training, a lower volume of work is necessary. I strongly suspect many of the beliefs about problems with training to failure, such as concerns over injuries, CNS “burnout”, etc., are probably the result of people attempting to train with a high level of intensity without an appropriate reduction in training volume.
I’ve been training people using high intensity training methods for over 15 years, and the majority of my clients train to failure almost all of the time after their first few weeks. None of them have ever been injured as a result, and this includes clients with various lower back problems. There is no merit to the claim that training to failure in and of itself leads to or is associated with injury, and while trainers who say so may mean well, they are mistaken.
Crossfit Lawsuit Update 2
I was recently notified the defendent in the lawsuit against a CrossFit instructor over a workout he claims caused injuries and rhabdomyolysis was awarded $300,000.
The following is from the Washington Post web site:
A Prince William County jury awarded $300,000 yesterday to a Bristow man who sued a gym, a training company and one of its employees for administering an intense strength workout to him that he claimed left him disabled.
Makimba Mimms, 29, of Bristow sued Manassas World Gym, Ruthless Training Concepts and its former employee, Javier Lopez. Mimms, a former Navy information systems technician first class, said Lopez oversaw a CrossFit workout at the gym in 2005 that caused his leg muscles to break down. The jury found all three defendants liable.
CrossFit, which was not named as a defendant in the suit, is a fitness program popular in law enforcement and military circles and has been criticized as being dangerously intense.
Without knowing more details it is hard to comment on the case itself, but this does bring up some important points. If you’re training people it is essential to know their medical history, physical capabilities and limitations and design their workouts accordingly. People need to be motivated to train at a high level of intensity, which often requires pushing them beyond their perceived limitations. However, it is important to be aware and considerate of their actual physical limitations and avoid pushing or in some cases avoid allowing them to attempt to exceed those. › Continue reading
Lawsuit Alleges CrossFit Workout Damaging
There is an article in the Navy Times on a former sailor suing for permanent injury resulting in disability he claims resulted from a CrossFit workout. The article states:
“Several [experts] in the sports medicine field (military and civilian) have addressed a concern that the program has the potential for causing an increased incidence of musculoskeletal injuries and even muscle breakdown (rhabdomyoloysis) and therefore is not supported by [Navy Center for Personal and Professional Development],” the story states. “Granted, anyone can develop a program that’s very intense, but there’s a safer way of doing this for our sailors.” Picker could not be reached for comment.”
Later in the article,
“Several physicians, including Walter Reed Army Medical Center neurophysiologist Lt. Col. Mark Landau, concluded that Mimms suffered severe injuries following his intense CrossFit workout, according to court records.
The injuries included rhabdomyolysis, lumbosacral spine strain and strain of the bilateral quadriceps, according to court documents. As a result of these injuries, Mimms was incapacitated, lost time from work and required surgery, court records show.”
Without knowing the specific workout performed I can’t be certain, but I think it’s a safe bet the spine and quadriceps injuries resulted from performing one or more Olympic lifts or other exercises in an explosive manner.
This was the point of the CrossFit post I wrote a few weeks back. Many of the exercises recommended and the sloppy form resulting from attempting to move too quickly carry an unnecessarily high risk of injury. The same or better benefits could be had from replacing the Olympic lifts and other explosive movements with exercises that can be performed without reliance on momentum and using stricter form. I have some clients who regularly perform modified versions of the CrossFit routines Fran, Diane and Cindy (many of the CrossFit routines have women’s names) to focus on metabolic and cardiovascular conditioning, and none have have been injured in the process. By replacing the explosive movements with exercises performed in a controlled fashion the routines can be performed with a much lower risk of injury while maintaining the high level of metabolic and cardiovascular demand.
The thrusters in Fran (combined squat and press) can be performed in a controlled fashion, and the kipping pull-ups in both Fran and Cindy and can be replaced with strict pull-ups or chin-ups. I have one client with a grade 3 spondylolisthesis at L5-S1 and others with various knee and back problems who have been able to perform these routines with no problems. If these people can do them safely, they certainly shouldn’t cause spine and quadriceps injuries in a healthy person.
“The suit claims Mimms suffered from rhabdomyolysis — which occurs when tiny shreds of muscle fiber are absorbed by the bloodstream and ultimately poison the kidneys — as a result of performing a CrossFit workout under the direction of Lopez, who worked as Ruthless Training Concepts trainer at the now-defunct Manassas World Gym.”
I do not believe rhabdomyolysis is a problem with CrossFit training any more than it is a problem with high intensity training or any other exercise method, but rather a failure of the trainee or instructor to properly scale the routine to their current level of conditioning. Any workout can cause this if the intensity and volume exceed what is appropriate for the trainee. In addition to prescribing workouts of appropriate intensity and volume, the chances of developing rhabdomyolysis can be reduced by staying adequately hydrated and keeping the training environment as cool as possible. Extra care should be taken with trainees with kidney problems or other conditions such as sickle-cell trait which predispose them to a greater risk of developing rhabdomyolysis.
Trainees should be motivated to perform to the best of their abilities, and to train at a high level of intensity, but not encouraged to push harder or do more than they can handle.
References:
Kark JA, Ward FT. Exercise and hemoglobin S. Semin in Hematol. 1994;31:181-225.
Explosive Training
The following article is published here with the permission of the author, Ken Mannie, Head Strength & Conditioning Coach at Michigan State University
The subject of explosive weight training is one that has been in the center of a maelstrom among strength and conditioning practitioners for quite some time. Many individuals and some associations advocate the use of so-called explosive weight training movements, which purportedly offer trainees a distinct advantage in speed and power development over those who choose to incorporate more controlled movements.
It is also suggested by some that explosive weight training movements prepare the body for the exorbitant, potentially traumatic forces of competition more so than other strength training techniques.
For the purpose of this article, only the explosive lifts will be discussed. These include-but are not solely restricted to-the Olympic lifts (i.e., the snatch and clean and jerk), power clean, speed-squats, push jerks and any variations of these movements. Basically any movement performed in a rapid, jerky manner where momentum plays a key role in the execution and or completion of the movement would be included. › Continue reading
Warming Up
Most of the physical benefits of a warm up - increased blood flow to the muscles, enhanced metabolic reactions, reduced muscle viscosity, increased extensibility of connective tissue, improved conduction velocity of action potentials, etc. - are obtained during the first few repetitions of an exercise. If a moderate or higher repetition range is used, the first few repetitions of an exercise warm up and prepare the muscles and joints involved for the harder reps later in the set and a separate warm up is not required. Additionally, each exercise performed helps prepare the muscles and joints for subsequent exercises they’re involved in.
I do not perform a warm up for the majority of exercises in my workout, and do not have the people I train warm up for their workouts with a few of the following exceptions, and no one has been injured as a result. Like most aspects of exercise, whether to perform a warm up or not depends on the individual and the specifics of the workout being performed. › Continue reading