I wanted to share an article today that is actually a collaborative piece from myself and other healthcare professionals who write an Ask the Doc column for Tabata Times. The sustainability of CrossFit as a form of exercise is in question frequently and my goal is to make sure we create healthy athletes who can withstand these workouts for years to come. Below is a group of healthcare professionals who know CrossFit and want to help CrossFit be sustainable for those who love it. Starting with my opinion first……enjoy!
Article re-posted from Tabata Times.
How sustainable is CrossFit? Will this so-called fad be around for years to come? Can people continue to work out this way and not slowly fall apart due to injury? These are questions that we’ve come across a lot, especially from other healthcare professionals and outsiders who have never done CrossFit before. Although we all want to scream “yes!” and rally everyone to join, it’s a tough question to answer to make that “yes” convincing without the right back-up info. Our Docs in the Ask the Doc column have a lot of different opinions and experiences, so we wanted to all come together and help support the sport that we all love by answering the question: “Is CrossFit sustainable?”
Missy Albrecht DPT, CSCS, FMS
I was drawn into my first CrossFit gym in 2010 and was coaching by the end of the year. I received my doctorate in physical therapy in 2011 and began helping CrossFitters prevent and treat injuries. I’m currently starting to see athletes at the gym who have been at the gym either the same length as me or longer. Most are coming to me with nagging injuries that they admit to not taking care of right away — they are either hoping the injuries will go away, or they rest for a week and never take the time to figure out the initial cause so the injury comes back to haunt them every few months. What’s a little bit of pain now and then anyways? A few of the athletes also have not taken a break since they started in 2010, 2009, 2008, etc. Beyond not correcting mobility issues, faulty movement patterns, and old/new injuries, I think a major issue that is surfacing (or maybe it’s been happening for a while) is that athletes are not taking the necessary breaks their bodies need. Do professional athletes take breaks from their sport? Yes. Do competitive CrossFitters take breaks from their sports? Yes, most of the athletes you see competing in the Games do.
I believe the answer to this (after solving ALL mobility, movement pattern and/or injury issues) is incorporating other avenues of exercise for these athletes to rest from CrossFit but still stay active. I’m a big fan of active recovery. The challenge sometimes is pulling the athlete away from the gym, community and workout that they love so much. Using my own gym (CrossFit Southbay) as an example, we are trying to cater to these needs by incorporating yoga, Pilates, running, swimming, and spin into our gyms so that athletes have options. We also have a few de-load weeks, but I’m not sure if that’s enough for everyone. So now instead of telling the athletes to take 1-2 weeks off and find something else to do, they can stay within the community and rest their bodies through a variety of different exercises and maybe incorporate a few alternatives into their normal routine to stay healthy (yoga has been my favorite balance 1-2x/week). I’ve seen a few other gyms with these options and believe it may be an excellent way to help keep CrossFit sustainable. If you don’t have the luxury of having these options, research your area and find some local places where you or your athletes can incorporate variety and/or take breaks. If we want to keep this sport going (because we all love it) we need to treat it as the extreme sport that it is and be willing to give our bodies a break!
Joshua Zavertnik, PT, DPT, FAAOMPT
My experience as a true “CrossFitter” is measured in months, not years, but I have been involved in high intensity interval training (HIIT) and similar training styles for years. My first exposure to CrossFit was in 2009 while treating patients. I had two separate individuals come in to the clinic, one with a shoulder issues and the other a knee. Nothing serious — just a “nagging pain” that wasn’t getting better and had been there “for a while.” It became quickly apparent that the problem wasn’t the exercise or the movement itself but how the athlete was approaching the workout, the athlete’s body’s limitations, and general neglect of some basic movement principles. As a physical therapist and an athlete, I love what CrossFit has done for health, fitness, and movement. It has brought together an incredibly diverse community from various backgrounds, fitness levels, and athletic experiences. The intrinsic and extrinsic motivation that is fostered in the gym drives us to push harder and try and achieve more every day, whether it is during a WOD or in everyday life.
That being said, there are several areas where we can get into trouble. First, we need to understand our purpose for training. Whether it is weight loss, strength, preparing for a CrossFit event or sport competition, the goals you have can help lay out the framework for you to develop your training regimen. Within your programming and goal setting should be elements of periodization, rest, recovery, and time out of the gym! It is a hard sell, I know, to convince yourself that you can improve by stepping away — it sounds counterintuitive — but you will be better for it.
Know when to say when
Second, respect the fact that load, speed, power, and volume are principles that we use to elicit positive change in the body, but at a certain point can have a negative impact. Repetitive strain injuries are common in the workplace. The day in and out of the same movements with little rest and recovery progressively wears down tissues and structures of the body. Training is no different. We need to be aware of the movement patterns that we get into. Whether it is an aggressive WOD with muscle ups or high volume squat snatches, the system can tolerate only so much if we don’t spend the necessary time to recover and rebalance the movement patterns of the body. This is no more apparent than in youth sports. The book Any Given Monday, by Dr. James Andrews, highlights how his practice as a surgeon had been treating more and more young patients due to the high level of demand that is being placed on the body with little to no rest or recovery.
Finally, movement and the quality of movement should always trump load, speed and volume. For all of us the quality of the movement starts before the WOD is even posted. You know what I’m talking about: it’s the M word – mobility. It is a very popular word and for good reason. But keep in mind that mobility doesn’t just refer to one’s ability to reach overhead with adequate shoulder external rotation. With mobility we need adequate stability and motor control. It does us no good to have the ankle range for a squat if we lack the ability to control the movement through the various phases. Be sure you are taking the time to correct the movement and positional faults that you may have as well as working on the quality of the movement with consistent precision.
To answer the question “Is CrossFit sustainable?”, my answer is yes, but with one caveat: respect the fact that this isn’t like going to the gym to “get a workout.” The level of skill, physical demand, and effort that is needed to successfully complete a training session requires that you also spend time away from the gym recovering, planning, and self treating so that your body will be prepared to consistently meet those demands. Listen to your body, use the knowledge of your coaches, get help when needed, and I’ll look forward to seeing you all in the box for years to come!
Alex Wiant, DC
How sustainable is CrossFit? The beauty of functional movement is how applicable it is to life, especially in performing those movements in advanced age. Everyone should train their body in functional movement for health and longevity. On the contrary, when functional movement is designed to be performed with super high intensity like in CrossFit, its sustainability is reduced. In order to maximize CrossFit sustainability, it is crucial to fully grasp the movements, properly attend to prior injuries that may cause physical limitations, rest adequately, and think critically about programming.
Properly performed functional movements can be used as a great tool for health. Improperly performed functional movements can lead to injury. It is paramount for a beginning CrossFitter to understand the movements and perform them with proper biomechanics before they start piling weight on the bar. Coaches should scrutinize newcomers carefully in on-ramp classes and make sure the new trainees know what they are doing before allowing them to continue to full speed classes. If someone does get injured, or has issues with movements from past injuries, they should seek a professional for assistance.
Someone serious about health and performance can greatly benefit from the regular help of health professionals. Most CrossFitters I’ve met started doing CrossFit in their twenties and thirties. Between birth and your 30s a lot of physical trauma and repetitive stress can occur. Injuries from your youth can leave you with structural dysfunctions, ROM inhibiting scar tissue and muscular adhesions.
Most professional and amateur athletes in other sports visit health related specialists on a regular basis. Most pro teams have chiropractors, PTs and massage therapists on staff. If CrossFitters want to perform at their peak, or just do the right thing for their bodies, they should be getting adjusted regularly by a chiropractor, getting muscle therapy regularly, and seeing a PT or trainer if they are rehabbing an injury or need some specific strength work.
Under-recovery can also stymie a CrossFitter’s desire to stick with their workout regimen. Most gyms have programming five days out of the week. That’s a lot! With the difficulty of some WODs, it might be smart to rest a day or two between workouts. Additionally, think critically about your gym’s programming. If you see your gym program similar movements two days in a row, like snatches one day and overhead squats the next, it might be prudent to take a day off to fully recover. Alternatively, do some physical activity other than CrossFit, like going for a bike ride, hike or swim. Beating your body down five days a week is a recipe for disaster. Taking a few weeks off from the gym periodically to explore other physical activities is also worthwhile. This will prevent burnout and help keep things interesting. No sport goes year round.
Functional movements are great, but when performed in the high intensity manner of CrossFit, for best results it’s important to learn the movements and perform them properly; treat your body like the high performance machine it is by getting regular professional tuning and rest and take time off regularly.
Theresa Larson, DPT
(Photo taken at Team Red White and Blue Veterans Functional Fitness Camp@ CrossFit Rubicon in Tysons Corner, VA June 20-23rd 2013)
Is CrossFit sustainable? YES, by virtue of its benefits! However, I am going to spend less time on the physical benefits, and focus on the mental and spiritual benefits. Sure, CrossFit helps you get in kick-ass shape as you learn to exercise at a level that totally blows your mind, and it espouses a philosophy of eating that is more sustainable for you. But more important to its sustainability, CrossFit builds a community of followers that will do anything to be in it or a part of it, and will travel across the globe to learn more about it. Why is this? To start with, a CrossFit experience offers something greater than just the WOD. Philosophically, it offers men and women a better way to identify with their body based on what it CAN DO versus what IT LOOKS LIKE (there are no mirrors in a CrossFit box). Through its intensity it humbles its participants while helping them demand more of themselves (a big reason why veterans flock to CrossFit). Through communal effort and suffering, it offers a way for grandfathers, teens, lawyers, mechanics, and foreigners to gather and workout together.
Now to get a little nerdy with it…..
Similar to the physical benefits of other intensive exercise programs, CrossFit over time helps reduce resting heart rate, decreases cortisol productivity, heightens vascular function, improves sexual function, decreases adipose (fat) tissue, increases lean muscle mass, reduces metabolic disturbances such as insulin and inflammation (with good movement patterns), improves maximum V02 capacity, and — last but not least — improves all three energy systems. So basically as my colleagues mentioned previously, you should be ready for anything over time as long as you do not compromise your movement patterns with your CrossFit training.
As also mentioned above, the physical benefits are only part of CrossFit’s impact. In doing some research and speaking with colleagues, I’ve come to recognize in my client base that CrossFit has mental and perhaps spiritual benefit for veterans wounded at war and those that have any type of anxiety disorder. It seems to provide a somatic arousal that actually reduces anxiety sensitivity and is effective for the treatment of panic and other related disorders. For those who suffer with post traumatic stress disorder (PTSD) or other anxiety related disorders, CrossFit can be seen as Interoceptive. This form of exercise can help individuals directly confront bodily systems related to anxiety such as increased heart rate or shortness of breath as well as learn to tolerate distress.  Would I prescribe CrossFit to anyone and everyone with PTSD or any form of anxiety or depression? No, but I would recommend it to those who have been or are already being treated for their conditions and need an outlet. Yoga is also another wonderful physical, mental, and spiritual practice (however you want to see it) that is effective for those suffering with any form of anxiety disorders as well.
CrossFit, especially for those that are passionate about it, may actually make one smarter. (Hopefully that alone is interesting to enough people to make CrossFit sustainable…although if the baby name North West becomes a fad, I have little hope for our collective future). How will it do this? Well, it impacts our memory, our ability to learn, and our higher thinking areas of our brain called the hippocampus, cortex, and basal forebrain. Through the appropriate dosage of CrossFit (or any form of activity you LOVE), one’s body releases an increased amount of a neuropeptide or protein called Brain-Derived Neurotrophic Factor (BDNF). This protein improves the growth of neurons old and new, along with preventing apoptosis-otherwise known as programmed cell death. This protein is essential for learning, growing, and ultimately staying as young as you feel for a really long time.
Now, can you have too much of a good thing? Yes! As explained by my colleagues above, CrossFit with no rest and with inefficient/incorrect movement is a recipe for potential chronic wear and tear, and worse. As with anything else, a balance is required. Even with the ability for CrossFit to improve mood and help manage anxiety, as well as improve the brain’s higher level of thinking, there are reduced benefits and negative side effects if there are no breaks.
Think of it like this…..
Like your garden and American Idol, our bodies have seasons, too. So give it the balance it needs physically, spiritually, and mentally. If you are just adding more to your plate or training because you want to workout like the 21-year-old who can lift twice her body weight, your BDNF and your mood will actually not improve. But if you have a healthy balance of intense exercise with recovery (which can take on many different forms), then you are on the right path.
Closing thoughts and motivation….
Not only is it how you workout, but why that provides you the benefit. As a human performance specialist, I preach that how you move is vital, but why you move is equally important. Ask yourself: why do you do CrossFit? Why do you want to learn to surf after losing a limb? Why do you want to be able to play catch with your children until you are 101 years old?
Check out this video and prepare to be motivated to demand more of yourself. But remember, by “demand” I mean demand that you take control of your body, mind, and spirit and program rest periods, vacations, times to train intensely, and times to get your meditation on.
Video: Warrior WOD, 21 Gun Salute at CrossFit Rubicon
 Lickel J., Nelson E. et al, Interoceptive Exposure Exercise for Evoking Depersonalization and Derealization: A Pilot Study. Journal of Cognitive Psychotherapy: An International Quarterly. 2008; 22.
 Murray P.S, Holmes P.V, An Overview of Brain-Derived Neurotrophic Factor and Implications for Excitotoxic Vulnerability in the Hippocampus. International Journal of Peptides. 2011