Jumat, 05 September 2014

Is CrossFit Dangerous?

In early 2012, 54 members of Fit Club, a gym in Columbus, Ohio, went to a lab at Ohio State University. The volunteers, all of whom followed the intense group workout regimen known as CrossFit, left blood samples, tested their maximum oxygen capacity, and had their body fat measured. They went through a round of measured workouts at Fit Club, too. Then, for 70 days, they performed a routine of Olympic lifts with a barbell, did calisthenics and strength work on gymnastics rings, and swung teapot-shaped weights over their heads. Forty-three subjects returned to the lab for analysis. The results were remarkable.

The academic article that followed, “CrossFit-Based High-Intensity Power Training Improves Maximal Aerobic Fitness and Body Composition,” shed scientific light on why CrossFit has grown from 250 affiliate gyms in 2007 to more than 10,000 today. At all levels of fitness, the Ohio volunteers lost body fat and increased oxygen capacity. “It was pretty impressive,” says Mitch Potterf, the gym’s owner. “People had improved quite a bit.”

Potterf agreed to the study thinking it would help take the brand mainstream. “You’re looking for the traditional fitness world to validate you,” he says, “because people think you’re crazy.” But because of a single sentence the paper turned out to be a millstone rather than an advertisement. It states that 9 of the 11 volunteers who failed to show up for the second test cited “overuse or injury.”

Potterf is now suing two of the study’s authors—Michael Smith and Steven Devor, both of Ohio State—and the National Strength and Conditioning Association (NSCA), which published the article. The suit claims that the injury numbers were faked, and alleges fraud and defamation, among other things. CrossFit Inc., the Santa Cruz (Calif.) company in charge of the brand, has also filed its own suit against the NSCA for false advertising and unfair competition, since they both charge to certify trainers. (The NSCA didn’t respond to requests for comment.)

CrossFit has a problem. It looks dangerous. In a way, that’s understandable. CrossFit gyms can push people to attempt things they may not be ready for. Take Olympic lifts: Do one wrong, and you’ll find yourself tumbling over a 125-pound bar. It’s easy to find videos of these accidents online. In January, Kevin Ogar, a CrossFit trainer, suffered a traumatic injury to his spinal cord during a snatch, a move that puts a barbell straight overhead from the ground. The injury did not take place at a CrossFit event. Still, it inspired a new round of articles and an ESPN (DIS) documentary about the workout’s safety.

But the argument is mostly anecdotal. Because the workout has been widely popular for only about five years, actual academic research about it is only just starting to emerge. This makes the nine cases of overuse or injury from the Ohio State study an important and often-quoted point of evidence.

This is driving CrossFit, the company, nuts. In July, I made plans to attend the CrossFit Games, a competition sponsored by Reebok (ADS:GR) and broadcast on ESPN. After the company discovered that I was interested in the Ohio State study, it considered revoking my press access, which it granted only after two days of conversations to determine whether I knew enough about the lawsuit to get past the gate.

CrossFit considers itself to be the future of fitness, to have created a new way of measuring what “fit” is. “World’s Fittest Man” is a CrossFit trademark. In the midst of wild growth, the company has arrived at a Silicon Valley level of self-regard, and the Ohio State study sits at the heart of a growing antagonism between CrossFit and organizations that study and certify fitness. Like the NSCA. And even the Pentagon. CrossFit Inc. doesn’t just want to make people fit. It wants to be fitness. A reputation for injuries, accurate or not, stands in the way of that.
 
 
Most companies confronting an image problem hire an unctuous lobbyist, pay for gently biased research, and veil themselves with charming PR. CrossFit has Russell Berger, a former Army Ranger with several jobs. He trains trainers. He also manages CrossFit’s social media, where he gleefully picks apart the arguments of academics and journalists who write about the company. It was Berger who determined, finally, that I had read enough to write about CrossFit.

He’s hostile and relentless online, dismissive on the phone, and yet earnest and thoughtful in person. Asked whether he’s the company’s defender-in-chief, he answers: “More or less.” Then he thinks for a second. “Maybe the 16th century word would be a polemic,” he says. “It just has such a negative connotation now. I don’t think it did back then.” Polemics made aggressive arguments in church or at court. The word comes from the Greek polemos, which means war.

Berger started doing the workout while serving in the 1st Ranger Battalion in Iraq in 2005. To be a Ranger, “you were either big and strong or you were smart,” he says. “I was probably a bit more of the latter.” On the advice of a friend, he started doing the CrossFit Workout of the Day—posted online, which anyone can still get for free. “There was a huge impact it had on my unit around me,” he says, “and more and more people wanted to know what I was doing every morning.”

Photograph by Andrew Hetherington

Berger’s introduction to CrossFit is a common one. Special forces operators from the U.S. Army and Navy describe similar stories: They didn’t feel that normal training was working, so they tried this thing they found online. This connection, to the military and in particular to the special forces, is also part of how CrossFitters see themselves. On Memorial Day, gyms get together to barbecue and complete a “Murph,” the favorite workout of Michael Murphy, a SEAL killed in Afghanistan in 2005: a mile run, 100 pull-ups, 200 push-ups, 300 squats, and another mile run.

CrossFit doesn’t have franchises. It charges gyms a yearly affiliate fee of $3,000 to use the name CrossFit. Gyms—CrossFit calls them “boxes”—have almost complete freedom over how and where they run their businesses, creating a competitive market that has refined how to bring new members in and get them to stay. The Memorial Day barbecues are not an accident. Boxes have recognized that customers will keep coming back if they feel like they’re part of a group.

“It really is novel,” says Robert Moran, a lecturer at the Unitec Institute of Technology in New Zealand who is now starting his own research on injuries from the workout. “It’s a collection of components that we’ve seen in other places, put together in a unique way with this unique governance, wrapped up in this social glue.” It’s both a workout and a sport, not directly comparable to either Olympic weightlifting or calisthenics. It’s not quite a gym chain and not quite personal training.

New CrossFit trainers—they’re called “coaches”—pay $1,000 for a two-day course, which Berger sometimes teaches, before they can lead a class at an affiliate. I ask Berger whether he’s worried that the rapid growth in affiliates will lead to a decline in the quality of coaching. Not really, he says. “I can’t tell you how many times I hear people in our own community say, ‘CrossFit is really safe if you have a good coach, if you’re doing it right.’ ”

Of course it’s better to train with a good coach and good technique, he explains. But he tells me to compare the risk of imperfect technique and coaching with the alternative: preventing a town from getting its affiliate. “Then,” he says, “you get a bunch of people who are sick and fat and not exposed to the program that, even done poorly, could have made their lives better.” Berger is making the case that the alternative to CrossFit isn’t an exercise bicycle; it’s nothing.

Yuri Feito, who teaches exercise science at Kennesaw State University and studies CrossFit, argues that the workout has no equal in terms of getting people to stick around. “Spinning, Zumba, Insanity, P90X—none of these programs have been able to do, at least from an adherence standpoint, what CrossFit does,” he says. “People start Zumba, they do it for two months, and then they’re like, ‘Oh, whoa, it’s just dancing.’ ” Feito is close to publishing research into why CrossFit generates so much loyalty. He’s found that men like the competition, women like the weight reduction, and everyone likes the camaraderie. “People call it a cult,” he says, “but it’s creating a community, and people adhere to that.”

“The gender thing is what it boils down to,” says Julie Partridge, who teaches kinesiology at Southern Illinois University at Carbondale and co-authored a paper on CrossFit motivation. “I think there is this community aspect that appeals to women in particular, because they may not have always felt welcomed into weightlifting areas in the past.” A CrossFit affiliate is a bit like Ladies’ Night at a bar: Get the women to come, and the men will follow.

In publishing her research, Partridge says she found it curious that journals—she will not say which—asked her to add something about CrossFit’s injury rates. She didn’t have any data on injuries but eventually offered to add a disclaimer to the paper to indicate that her data was not an endorsement. This is not something she normally has to do.

Potterf, the gym owner in Columbus, still conducts his 10-week programs. He uses a CrossFit metric to gauge improvement: He measures workouts. “[CrossFit gyms] are giant exercise labs,” says Potterf. “We just use different tools. We know how to get certain responses because we’ve been doing it. We’re not just making random workouts and grabbing things and being mean to people.”
 
 
Part of the image Berger is fighting was painted by CrossFit itself, which early on was blithely open about risks. In an interview with the New York Times in 2005, Greg Glassman, the man who invented the workout, said, “It can kill you. I’ve always been completely honest about that.” The same year in the CrossFit Journal, a company publication, Glassman documented cases of rhabdomyolysis—a potentially fatal form of kidney failure that can result from overexertion—that had happened in boxes. He laid out steps for avoiding it, including a class for beginners that most gyms now offer. The article was illustrated with a cartoon character known as Uncle Rhabdo, a clown attached to a dialysis machine. The clown is no longer a part of the company’s mythology, but to this day, someone with the handle Pukie posts the Workout of the Day. This lack of corporate fear had always been part of the program’s appeal.

“People call it a cult, but it’s creating a community, and people adhere to that”

After a sailor based in Norfolk, Va., was diagnosed with rhabdomyolysis in 2008 after a CrossFit workout, the Pentagon and the NSCA convened a working group to look broadly at what they called “high impact physical training”—CrossFit as well as Insanity and P90X. The working group concluded that these workouts were effective but potentially dangerous and that more study was needed. CrossFit issued a 92-page rebuttal, and Berger has referred to the working group’s report as a “beleaguered piece of pseudoscience.”

Potterf didn’t see a copy of the Ohio State study until a friend alerted him to a Facebook (FB) post calling his gym dangerous. Potterf says no one at his gym could have possibly cited injury or overuse, because no one at his gym ever spoke to any of the study’s authors. The study was blind: The researchers weren’t present when their subjects were tested and had only numbers to identify them. Further, Potterf says that none of the 11 members who failed to return to the second test ever got a follow-up call from Ohio State.

After several unsuccessful attempts to get the study corrected, Potterf spoke with Berger, who in turn asked Devor, one of the study’s authors, for an interview for the CrossFit Journal. The transcript of that interview, which CrossFit published in full, reads like a deposition. Devor starts the conversation eager to share the good news about his results. By the end he is reduced to frustrated incoherence, concedes that Berger has a point, and promises to get back to him. The two are now speaking only through lawyers, and excerpts from Berger’s interview show up in both lawsuits. Devor did not respond to a request for an interview with Bloomberg Businessweek. Nor did the editor of the NSCA’s journal.

YouTube (GOOG) horror clips aside, there are empirical ways to measure the risks inherent in a workout. The most common is to produce an injury rate—injuries per thousand hours of activity. A survey published by the NSCA last year pegged this around 3.1 per thousand hours for CrossFit, with a high rate of shoulder injuries. The survey found no incidences of rhabdomyolysis. (The author, Paul Hak, didn’t respond to a request for an interview.) Kennesaw State’s Feito is working on research he says will yield a rate of 2.9 per thousand hours. A poster he’s presented on this research recommends that trainers pay close attention to newcomers and those who work out fewer than three days a week.

This injury rate—about 3 per thousand hours—is similar to rates in gymnastics and Olympic lifting and lower than rates for rugby and other competitive contact sports, according to the Hak study. Studies on triathlons range from 1.4 to 5.5 per thousand; for running, 2.5 to 12.1 per thousand. Nothing so far shows that CrossFit is any more dangerous than anything else. Strenuous physical activity carries an injury risk. It may simply be that as more people are doing CrossFit, more people are being injured.

Why, I ask Berger, spend so much energy on the Ohio State study, on a single line in an otherwise glowing report? He explains that the good things in the study were already obvious. The one bad thing is now a point of evidence against CrossFit, and it carries the weight of science. “It’s a poison pill,” he says.

“I’m very interested in what happens around the [Ohio State] case,” says Moran, the researcher from New Zealand. “That’s almost unprecedented—court cases about peer-reviewed literature.” I ask Moran whether Berger’s habit of line-for-line responses to research has him worried as he begins his own study. He pauses. “I’m conscious of it,” he says. “Yeah, absolutely, I’m conscious of it.”
 
 
At the Reebok CrossFit Games at the StubHub Center in Carson, Calif., almost all the spectators sport the same set of CrossFit shoulders: high, roped with muscle, and pushed slightly forward to make room for more muscle on the back. Many of the women wear tank tops. About a third of the men don’t bother with shirts at all.

Andy Petranek has his shirt on. Petranek opened CrossFit Los Angeles back in 2004, “ancient in CrossFit years,” he says. Some of the earliest articles on the workout were written about his gym. He’s noticed a huge increase in interest since ESPN started televising the competitions. Petranek says he now inherits people who have been trained up too rapidly at other gyms. Part of the job of an experienced coach, he says, is to hold people back to prevent injury.

He does worry that the growth of new gyms will affect his brand, but brand differentiation among CrossFit boxes has also allowed him to raise prices, to ensure he gets trainees who take it seriously. Petranek, like Berger, competed in the games in 2009. Now, he says, he couldn’t qualify. People watch the games on television, he says, come into CrossFit Los Angeles, and immediately want to compete. “It’s as insane as saying ‘I just saw Lance Armstrong, and now I want to ride in the Tour de France,’ ” Petranek says. He points to the floor of the stadium. “These are the Olympics!”

Below us, a heat is completing the “speed ladder”: five cleans, which bring a bar from the floor to the shoulders. Mike Douglass, a spectator standing next to me, nudges me to keep my eyes on the floor after the leaders finish. “Last-place guy gets the biggest cheer,” he says. After two and a half minutes, only Cody Anderson, a 22-year-old rookie from Central Oregon CrossFit, is left contemplating his last 310-pound clean. The other competitors gather around him; one raises his arms to get more noise from the stands. Just shy of the three-minute mark, Anderson works himself upright, the bar at his shoulders, and a capacity crowd of 8,000 completely loses it. Douglass grins: “Am I right?”

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