If any of you have come across the newest fitness craze, CrossFit, you know that this is hyped as the next best thing in personal training. I was introduced to this program at a party a few months ago where I was able to talk to an owner of 2 such facilities. He let me know that these programs are run in his gyms at a cost of roughly $135/ month per client. Their programs emphasize small group workouts with personal trainers that specialize in high intensity, compound movement exercises that get your heart rate up quickly and fatigue you in a 20-30 minute session. Appropriate warm up is provided before the workout. He emphasized that their trainers carefully watch form and provide close supervision at all times. It all sounded like stuff I'd heard before and I didn't think much of it, until I saw the CrossFit World Championships last weekend on ESPN2. After witnessing that, I became much more interested. To bring you up to speed, here's what it all seems to be about:
- Crossfit World Championships show young, incredible athletes going through a series of activities that would put the average person in bed on Advil and ice for a week. It is a newer, hipper version of the Worlds Strongest Man contests that you can usually catch at 2 am on ESPN. Check out this link to get a feel for it. http://games.crossfit.com/ I had such a montage of emotions watching this event, I had to write this blog. A combination of laughing, wincing, analyzing body mechanics, and watching in amazement at what the athletes could tolerate and overcome. Certainly worth tuning in if you get the chance. I was amazed I didn't witness a significant shoulder or knee injury during the finals due to the brutality of the event activities.
- CrossFit Centers regularly include exercises in their training workouts that include squats, box jumps, lifting objects such as tires, various types of push-ups, inverted push-ups, lunges, medicine ball activities, and most accepted types of plyometric exercises for the upper and lower extremities to name a few.
- The workouts are changed almost daily, to help confuse the muscles and get better strength results. Similar to the P90X philosophy. The list of exercise activities I made above is only a small slice of what you would see at one of these facilities.
- An entire video library of examples can be seen at: http://www.crossfit.com/cf-info/excercise.html#Exer. I added one here so you can get a feel for one of their milder exercises.
This quote was taken directly from their website:
The CrossFit program is designed for universal scalability making it the perfect application for any committed individual regardless of experience. We’ve used our same routines for elderly individuals with heart disease and cage fighters one month out from televised bouts. We scale load and intensity; we don’t change programs.
Isn't that great,
the same routines for our elderly and our cage fighters. I don't care how you scale it down, certain exercises are
not appropriate for the elderly. The above example, the full squat, while great on a young healthy knee, puts incredible compressive force on the knee cap as well as the knee joint surfaces between the thigh and leg bones of the knee. This video would be the perfect way to tear a meniscus or irritate a mildly arthritic knee. The real question you should ask yourself before trying an exercise like this is, why do I need to do this exercise? If you are a furniture mover and need to bend down fully many times a day, you might have a reason. But if you are the average 9 to 5'er that sits at a desk all day, you really don't need to punish your knee joint like this to strengthen your hips and thigh muscles. If you don't believe me, go see a physical therapist and they will show you how to save your knees while doing squats. Maybe a good topic to discuss in a future blog.
After looking at a few of the exercises on the CrossFit website, I thought I'd pull out an example of an exercise that really has no place in an exercise regimen when exercising the elderly (or average weekend warriors for that matter). An example would be the box jump, which is an activity where an individual either jumps down from a box, or up onto a box repeatedly. The faster the transition from the jump down to the jump back up, the better. This family of training techniques are referred to as plyometrics and were originated in The Soviet Union for olympic athletes in the 1970's to improve speed and power. A video is worth a thousand words, to see the CrossFit version of these activities, see below:
Even from the most modest heights this exercise could be a nightmare for an osteoporotic grandmother wanting to "get in shape" given the increased risk of compression fracture in the spine, hip fracture, or joint damage on arthritic lower extremity joints. If a physical therapist were to prescribe these exercises to a Medicare patient and they subsequently broke a bone, at
best you'd never see another patient from the referral source, and at worst you'd be sued by the patient. I would hope CrossFit trainers receive training that would make them aware of some of these contraindications, but I have no way to verify that, and I probably wouldn't bet on it.
For those 40-50 year olds wanting to give these workouts a try, I would advise you to remember a few things.
- Most of the athletes you see doing these exercises are in the prime of their lives (20 to mid-30 somethings). Their joints and discs are in very different places than someone 20 years older. What is a challenging workout for them, could be pathological to an older, less fit individual.
- Plyometrics were designed originally for olympic athletes. These are individuals that are professional athletes. A tenth of a second in a sprint event, or an extra inch or two of vertical jump can be the difference between being on a medal podium or watching from the bleachers. For them, these exercises are required to excel in their respective sports. Therefore, the risks of plyometric exercises are an acceptable part of their training regimens.
- Risk you ask? These exercises have a much higher risk/ reward ratio than doing traditional exercises on weight machines or with controlled free weights or bands. Simply put, plyometrics do have the potential to provide great power and strength increases for an individual. But they are also some of the most risky activities to include in a work out program due to their explosive nature. They put extremely high loads on tendons and muscles, which greatly increases the chance of muscle/ tendon strains or worse, rupture. And that's only the contractile tissues! They also place incredible loads on passive structures like ligaments, bones, fascia, cartilage, and discs to name a few. These activities can easily land you in an orthopedist's office, even with the best of form.
- Pro and college teams usually only include these activities in the off season workouts due to the increased time muscles need to recuperate from these workouts. Performing plyometrics during the regular season would overload muscles and tendons and put athletes at increased risk for injury. That should hopefully get your attention as to how serious these exercises are, especially if you are reading this in the capacity of a weekend warrior.
- If you are not a relatively fit individual, be very cautious entering into one of these programs. Make sure you have excellent instruction, know the risks involved, ask yourself if you need to take these risks, and know your medical history. If you have any kind of joint, disc, or bone density pathology, check with your physician or physical therapist before you proceed.
- Exercise is needed in most individuals lives to be happy and healthy individuals. Fortunately, to gain the health benefits from resistive exercises, you are not required to perform exotic exercises that involve jumping off boxes or lifting up tires. Moderate resistance exercises performed 3 x week is adequate to gain strength in a 4-6 week period. Moderate intensity resistive exercise has also been shown to improve bone density in many studies. Use common sense when choosing your workout plan.
A wise physician once told one of my patients "All things physical, are not therapy." Keep that in mind as you weigh your exercise choices. Be smart and remember, exercise is supposed to help you stay healthy, not hurt you!
