The hidden danger of extreme workouts - Military Health, military health and wellness, military physical fitness - Military Times

The hidden danger of extreme workouts

More, better, faster.

C’mon, you can do it. Forget those old-school runs, sit-ups and squats.

Try a power snatch, a set of hollow rocks or a few “hot-chick muscle ups.”

By now, you’ve probably heard a lot about CrossFit, P90X, Insanity and other high-rep, high-intensity training regimens — or you’re one of the many devotees who e-mailed us testimonials about their favorite workouts when we announced this story.

You can find them everywhere. Many on-base gyms have CrossFit trainers on staff, and most military towns now have a gym dedicated to the CrossFit exercise methodology. Units are adopting CrossFit as their PT program — because it gets results.

“During the time that I have been using CrossFit on a regular basis, I have been and am currently in the best shape of my life” at age 33, wrote Army Capt. Robert Pettigrew, and that sentiment was echoed in many similar e-mails.

But as the popularity of CrossFit and other high-intensity fitness programs has grown, so have concerns about their safety.

Some troops are reporting injuries serious enough to land them in the hospital, and the military wants to take a formal look at all of the so-called “high-intensity training” programs and their impact on force fitness and readiness.

Dozens of military doctors and fitness experts attended a conference in September at the Uniformed Services University of the Health Sciences outside Washington, D.C., to talk about programs such as CrossFit, P90X, Insanity and other off-the-shelf commercial exercise programs.

“The reason we’re here is because of all the anecdotal reports of injuries,” said Col. (Dr.) Francis O’Connor, associate professor of military and emergency medicine at the university.

Problems can range from torn ligaments to a condition known as exertional rhabdomyolysis, which may cause kidney failure.

It can put you in the hospital and even kill you if not properly treated, O’Connor said.

‘Rhabdo’

Experts are quick to point out that most fitness routines pose far less risk for acute injury than team sports such as basketball or football.

But there are risks, nonetheless — in particular, rhabdomyolsis, a serious condition in which muscles are overworked to the point of breakdown and release dangerous toxins into the bloodstream that can overwhelm your kidneys. A key factor is lack of rest or recovery time during workouts, which intensifies stress on muscles.

It can be brutally painful. Just ask Hospital Corpsman 3rd Class Brett Boland.

A 25-year-old stationed at Camp Pendleton, Calif., Boland was hoping to enter the elite ranks of special operations and heard about a CrossFit workout group that his buddies said might get him in better shape.

Before he started, another corpsman leading the workout casually warned him to take it easy.

“He said, ‘Just don’t push yourself beyond your limits. I don’t want anyone getting rhabdo,’” Boland recalled. “I didn’t know what he was talking about. I’d never heard that word before.”

But after one 42-minute workout emphasizing upper-body strength, Boland was almost immediately struck by pain so acute he could hardly move.

“My muscles felt like they were ripping as I tried to stretch my arms out,” he recalled.

Three days later, he saw blood in his urine and went to a doctor. Diagnosed with rhabdomyolsis in his chest and arms, Boland spent three days in the hospital on painkillers and a saline intravenous drip to help wash out the lactic acid that had built up in his muscles.

He was on medical hold for eight months, and it took him more than a year to regain the strength in his arms and return to normal exercise. During recovery, he suffered stress fractures in his ankles because running was one of the only ways he could stay in shape.

“It was like I was literally just breaking down, so I put spec ops on the back burner for a while just trying to heal myself,” he said.

CrossFit — a California-based company that licenses the program to gyms that use the CrossFit trademark — has itself acknowledged the risk of “rhadbo” for years.

In 2005, CrossFit founder and CEO Greg Glassman wrote in the CrossFit Journal:

“Countless bad-asses from sporting and special operations communities, long regarded as bulletproof, have been burned at the stake of ego and intensity. As it turns out, the burning is rhabdo.

“We now find ourselves obligated not just to explain CrossFit’s potency but to warn of its potential lethality. ... With CrossFit we are dealing with what is known as exertional rhabdomyolysis. It can disable, maim, and even kill.”

And those most at risk for injury are not necessarily those who are most out of shape.

“People who are most susceptible are people who are moderately fit and have built up some muscle mass,” said Coast Guard Lt. Cmdr. Chris Bonner, a CrossFit instructor. “Someone who is unfit or untrained wouldn’t be susceptible because they don’t have the ability to do that type of intensity.”

Military guidelines

Glassman addressed safety concerns in an e-mail to Military Times.

“CrossFit is safer, more efficient, and more effective than the physical training it replaces,” he wrote.

But the Pentagon is worried that there is insufficient evidence to back up such assertions.

“There’s no research on these programs,” physiology professor William Kraemer said at the Sept. 13 USUHS conference.

The potential direction of future research was among the key topics discussed there, including:

• Issuing guidance to commanders thinking of implementing CrossFit as a unit’s formal PT program.

• Limiting CrossFit-style workouts to troops who have high fitness test scores and demonstrate the abilty to handle such an aggressive workout.

• Creating an evaluation process for commercial exercise programs.

• Requiring CrossFit trainers at on-base gyms to obtain additional training beyond CrossFit’s Level 1 certification.

It likely will take up to a year before any new guidelines or policies are issued.

Off-the-shelf commercial fitness programs have been around for years, dating back to Joe Weider’s bodybuilding programs popular in the 1970s and marketed by, among others, Arnold Schwarzenegger.

But this latest round has proven particularly popular in the military.

“They know combat is intense, and they know this workout is intense. It takes a lot of elements that the war fighter can identify with,” Kraemer said.