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Adventure : Fitness

What We Don't Know About Exercise

If we were to tell you that studies now show that running anything beyond 20 miles a week could kill you, you’d cut back from your 50-, 60-, 80-mile-a-week habit straightaway, right? Yeah. Sure you would.

For years, athletes, particularly those of you known to scientists as EEs (Extreme or Endurance Exercisers)—marathoners, ultrarunners, triathletes—have tended to eat whatever you damn well please, under the assumption that all calories being more or less equal, if you’re burning 3,500 a day, you can have that bacon double cheeseburger and the vanilla shake no problemo. Turns out, not only has that been magical thinking dietetically, but even more disheartening, all those extra miles may have been doing you more harm than good—if your only goal is to live as long a life as possible.

And it may not even have everything to do with what you’re eating or how much. (Though it certainly has an effect.) The issue may be in how hard you’re pushing yourself. “People on the far level of exertion may be putting themselves at risk for mortality,” says Dr. Paul D. Thompson, an 11-time Boston Marathon finisher and director of cardiology at Connecticut’s Hartford Hospital.

What got lost in all the hype over last month’s Wall Street Journal story, “Why Runners Can’t Eat Whatever They Want,” was the real issue buried inside it: that the atherosclerotic risk EEs may be subjecting themselves to has less to do with diet and more to do with what they’re overdoing. The theory is, says Dr. Thompson, “If something’s good for you, more is better. So, the more exercise, the less heart disease.” Well, everybody’s susceptible—no matter how much you exercise.

Like an ultramarathoner’s gonna cut back on their mileage. Then again, maybe they should—if longevity is their primary concern (it isn’t). Picking up on Ralph Paffenbarger’s landmark Harvard Alumni Health Study, which took a longitudinal look at the exercise routines and rates of cardiovascular disease of 17,000 Harvard alum, other researchers have shown that “the benefit of exercise becomes less and less as you exercise more,” says Dr. Thompson. “To the point where there may be no benefit at all.

What’s misleading about the Missouri Medicine study cited in the WSJ, wherein researchers found that 50 men who had run at least one marathon a year for 25 years had higher levels of coronary-artery plaque than a control group of sedentary men, was that these EEs likely “had, for one, a very unhealthy diet,” says Dr. Aaron Baggish, associate director for the Cardiovascular Performance Program at Boston’s Massachusetts General Hospital. “They also led an unhealthy life in their 20s and 30s. And they were at high risk for hereditary heart disease before they even started running.”

As contradictory as that may appear—which is worse, eating whatever you want because you exercise all you want, or simply exercising all you want?—it’s likely evidence for conducting a study on EEs who have no significant cardio issues prior to late-age exercising and who’ve always eaten a balanced diet.

And lost in all the schadenfreude among the sedentary, who finally got to thumb their noses at the EEs, is that, while exercise is good for you (and way better than sitting on your ass and praising yourself for it), “Marathon running puts extreme stress on the body,” says Dr. David Katz, director of Yale University’s Yale-Griffin Prevention Research Center. “That’s exercising too much.”

“The difference between running 75 miles a week and 100 is not that significant,” adds Dr. Thompson. “When you go out to these extreme levels of health, you’re doing it for something other than just exercise.”

Which, for many an EE, is exactly the point.

“The take-home message is that exercise is good for you,” says Dr. Thompson, who adds that another ongoing study of Tour de France riders shows that they’re living longer and seemingly without much damage to their hearts. “It could be there’s less benefit once you get over some threshold. We just don’t know yet what that threshold is.”

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Why Is a CrossFit Gym Suing Scientists?

CrossFit’s reputation as a workout with a pitbull personality is moving from the gym to the courtroom. A Columbus, Ohio, CrossFit gym is suing the scientists behind a 2013 study, alleging the reseachers fabricated data that 16 percent of people in a program at the gym dropped out due to injury or overuse.

The fight is the latest skirmish in an escalating debate over the potential hazards of CrossFit, a routine that melds weightlifting and calisthenics into a 10- to 20-minute swirl of muscle-burning intensity. The move presents an unusual, and troubling, dilemma for the world of academic research, where disputes are usually sorted out between scientists or by university overseers.

But Mitch Potterf, owner of the Fit Club, said he’s resorting to legal action after the scientists and the journal that published the study were unresponsive to his complaints that the study was inaccurate. "I don't like people lying about me,” Potterf said.

Since its inception in the mid-1990s, CrossFit has mushroomed into a fitness craze crossed with a social movement. As many as 8,900 gyms have sprung up worldwide. The CrossFit Games, featuring ripped athletes in dueling workouts, was televised on ESPN. While few scientific studies of CrossFit have been published, several, including the disputed one, found people made considerable fitness gains by following the routines.

But along with the popularity has come concerns that the intense workouts and the technical difficulty of some of the movements could lead to injuries. CrossFit has been associated with cases of rhabdomyolysis, a rare condition in which muscle trauma can cause kidney damage. And some experts, including a panel of military and sports researchers, cautioned that high-intensity routines like CrossFit could lead to injuries.

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CrossFit’s corporate headquarters and its devoted fans have responded with a ferocity that mirrors the workout. The company’s chief scientist—also the father of founder Greg Glassman—rebutted the military report with a 92-page critique. A company spokesman has dismissed some scientists as “experts” in quotes, and accused the chief professional association for exercise scientists, the American College of Sports Medicine, of having an anti-CrossFit bias.

But this is the first time it’s come to a lawsuit from a CrossFit-affiliated business. The suit raises this question: Is it a case of an innocent businessman ambushed by scientists peddling fraudulent data? Or is it a company trying to bully researchers when it doesn’t like the results?

This much is clear: Michael Smith, a graduate student working under Prof. Steven Devor, an Ohio State exercise physiologist, approached Potterf about studying members of his gym as a way to gauge how CrossFit changed people’s fitness. The researchers put 54 gym members through a battery of tests, then did the same tests following ten weeks of workouts. When the study was published, it stated that nine people dropped out due to “overuse or injury.”

But Potterf said nobody got injured from the workouts—that people missed the final testing for a variety of reasons such as busy schedules. Potterf said he never spoke with the scientists about injuries, and he doesn’t know where they got the data. The lawsuit says the gym has suffered more than $25,000 in damages. “The case is about a guy who starts a gym from scratch and works like crazy to put every ounce of blood sweat and tears into it, and then suffers harm by some unscrupulous doctors," said Kenneth Donchatz, Potterf’s attorney, who is also a member of the gym and took part in the study.

Smith didn’t respond to an e-mail seeking comment. Devor referred questions to his attorney and attorneys for Ohio State University. A university spokesman said he couldn’t comment. The National Strength and Conditioning Association, whose journal published the study and who is also being sued, declined to comment.

But in an e-mail before the lawsuit, Smith said he collected the injury information from Potterf. When people didn’t return for the second test, Smith asked Potterf what happened. “(T)he gym owner went on to tell me how one participant was a wimp, one of them couldn’t stick with the program because of their knee, one because of their back, one was too fat, etc. … All of the explanations he gave to me matched up with overuse/overtraining issues, so that is the wording we used in the manuscript,” Smith wrote.

In an interview before the lawsuit, Devor defended the study, and chalked the criticism up to an overreaction to a single paragraph in the study. “CrossFit has a bit of history that if you speak out against them they are going to attack you. And I have been attacked,” he said. “It’s all just such silliness.”

It’s not clear whether this case will ripple into the broader world of sports science. Courts have generally shied away from getting involved in scientific disputes, said David S. Korzenik, a New York attorney. He has represented consumer magazines facing complaints from companies unhappy with product reviews, and teaches media law at the Benjamin N. Cardozo Law School.

Some companies have tried to get around this by claiming scientists faked their data, Korzenik said. But the lawyer, who represents plaintiffs in these cases, said such claims are usually little more than legal tactics. Still, just the threat of a lawsuit could have a chilling effect on scientists worried about legal action if study results aren’t complementary to CrossFit. “If a particular product manufacturer or product group brings a lawsuit against publishers of studies, then in the future people will become more chastened about taking any time to look into this,” he said.

Lawsuits alleging damage from research in peer-reviewed academic journals are rare, said Williams S. Bailey, a University of Washington law professor whose book about science and the law is scheduled to be released this summer.

This case could come down to a question of whether the research was up to snuff or not, Bailey said. The way the injury data was gathered sounded potentially “shaky” to him, but a court would have to decide if it amounted to scientific malpractice. Either way, he said, the gym can’t lose. It wins the case, or the lawsuit sends a message to other researchers to beware of CrossFit.

A CrossFit spokesman, Russell Berger, said scientists don’t have anything to worry about, as long as they don’t make up information. "The lesson here for anybody whose paying attention isn’t ‘Don’t research CrossFit.’ The lesson is. ‘Don’t do bad science and lie about your results.’”

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What Athletes Need to Know About Prescription Painkillers

Last fall, the FDA approved a powerful new painkiller that states across the country argue could increase heroin and prescription drug abuse. Now, officials in Vermont, Massachusetts, and elsewhere are working to limit or even ban Zohydro, which has approximately five times the amount of hydrocodone contained in other pills on the market. The drug was approved despite the recommendations of a panel of experts put together by the FDA.

Over the last 20 years, prescription drug overdoses have increased threefold—today, more people die of opioid overdoses than from car crashes— and officials argue that the introduction of a time-release painkiller that could easily be abused could have serious consequences.

While the states duke it out over regulations, it’s important that athletes—who are often prescribed necessary painkillers to deal with injury or recover from procedures—take care to make sure they are using their prescriptions correctly, and limiting their own addiction risk.

The good news: “Most doctors undertreat pain, rather than over treat pain,” says Dr. Linn Goldberg, a professor and head of the Division of Health Promotion & Sports Medicine at Oregon Health & Science University. According to Goldberg, doctors trained in pain management will often prescribe enough medicine to treat the pain, but also give patients a little wiggle room to increase their dosage if necessary, with directions like, take 1-2 pills every 4-6 hours.

But sticking to that range is “critically important,” Goldberg says. “Overdosing or taking other medications that increase the narcotic effect kills. It can depress the respiratory center of our brain, located in the brain stem.”

Unlike antibiotics, there’s no reason to stick to prescription medicine once pain has abated. Though doctors do prescribe prescription painkillers for long-term pain management, that doesn’t usually apply to sports injuries. “Typically an injury or surgery has a finite course and medications should not be prescribed beyond the typical recovery period,” Goldberg says. “That is why we place refills on medications or have the patient discuss the need for more pain medications.”

It’s also okay to talk to your doctor about which drugs are best for you—and to request less medication for pain. Certain drugs are more addictive than others—opioids and narcotics specifically—and the FDA classifies drugs into “schedules” based on their addictive qualities. Schedule II narcotics, for example, have a higher likelihood of addiction, and include morphine and codeine. Last year, the FDA also recommended that hydrocodone products—which include vicodin—be reclassified as schedule II drugs, increasing control over them.

No matter your prescription, it’s important to look out for signs that you’ve been taking too much, like impaired judgment, sleepiness or confusion. “What is critical is that when taking opioids, not to drink alcohol and not to take other medications that will depress the respiratory center or ones that are additive to the harmful effects, such as sedatives,” he says.

But when in doubt about side affects, dosage amounts, or even if you should be prescribed a certain drug, always consult your doctor.

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Active Cities: Seattle

Join Seattle’s active set for runs, rides, paddles, and more in one of North America’s most scenic cities. 

Trail Run

Discovery Park: Just ten minutes northwest from downtown, Discovery Park’s 534 acres make you feel like you’re tucked away in the mountains. The 11-mile trail system passes through pine forest, rainforest, and a grassy meadow overlooking Puget Sound and Seattle itself.

Run

Washington Park Arboretum: For runs of a few miles, you’d be hard-pressed to beat the Arboretum, with its mix of paved and dirt paths that wind from E Madison to Foster Island in Lake Washington. Need more mileage? Head across the Montlake Cut and hook up with the Burke Gilman Trail, a 27-mile paved bike and pedestrian trail that runs west, along Lake Union and the Shipping Canal, or north, toward Kenmore. 

Road Bike

Mercer Island Loop: This classic ride for downtown cyclists begins by pedaling about three miles out to Mercer Island on the I-90 Trail bike path. Once you reach the end, turn left or right to follow the smooth, rolling road that circumnavigates the island for roughly 13.5 miles.

Kayak or SUP

Lake Union: Bordered by Gas Works Park on the north, downtown Seattle on the south, and large steel bridges to the west and east, Lake Union is the city’s protected watersports pool. Rent paddleboards or kayaks by the hour at Moss Bay, on the south end of Lake Union (it’s closest to downtown). If you want to fuel up on one of the best breakfast burritos in town, rent from Agua Verde Paddle Club and Café, near the University of Washington.

Explore

Cougar Mountain Regional Wildland Park: It’s only a 20-minute drive east of downtown, but this 3,100-acre park, which tops out at 1,595 feet, offers sweeping views of Seattle to the west, and of the Cascade Mountains to the east. It also offers more than 38 miles of trails leading to creeks, waterfalls, mountaintops, and marshes.

Work Out

Seattle Athletic Club: This downtown gym doesn’t go in for the most cutting-edge equipment and expensive decor. It just aims to give you what you need for a solid session on the machines or some serious laps in the pool. Day passes can be had for as little as $15.

Gear Up

REI: The company’s flagship store, just north of downtown Seattle, is where the outdoor industry giant got its start. This is a tourist attraction in its own right as well. If you’re using the city as a launching point for adventures throughout the northwest, you’ll find what you need here. And don’t forget to visit REI’s basement level for killer deals on gently used merchandise.

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Active Cities: New York City

It's a concrete jungle, but sneaking in a workout is easier than you think. Here's an athlete's guide to the Big Apple. 

Trail Run

Central Park: Yes, it's cliché. But the 1.5-mile cinder track around the reservoir is arguably the greatest urban run in the world, with majestic skyscraper views at every step.

Road Run

Hudson River Greenway: The five-mile stretch of smooth asphalt from Battery Park to 59th Street offers incredible people watching and a light breeze off the water to keep you cool.

Swim

The Sports Center at Chelsea Piers: The 25-yard pool has a wall of windows that look out on the World Trade Center. $50 per day for pool and gym access; chelseapiers.com

Road Ride

Palisades Parkway: Starting just south of the George Washington Bridge, the 36-mile out-and-back through Fort Lee Historic Park up to the artsy suburb of Nyack is a rolling, tree-lined ride that climbs 1,400 feet.

Explore

Governors Island: Run or bike the 2.2-mile waterfront around the 172-acre former military base and take in views of New York Harbor. Bike rentals from $15; bikenewyorkcity.com

Stay

Element Times Square by Westin: Take advantage of discounted parking for hybrid and electric vehicles at this modern hotel. Once settled, you can head out on one of the hotel's free loaner bikes. From $134; elementtimessquare.com

Work Out

Circuit of Change: This catchall fitness studio near Union Square starts its workouts with yoga, then transitions into a full-body cardio circuit, abdominal exercises, and kickboxing. From $20 per session.

Gear Up

Paragon Sports: Whether you want to scale a mountain, train for an Ironman, or find a surfboard, this is the one place that has everything—and has for decades.

Citi Bike: With 332 stations and more than 6,000 bikes spread across Manhattan and Brooklyn, the city's bike-share program is the largest and most convenient in the country. $10 per day, $25 per week; citibikenyc.com

What the Locals Have to Say

Local Pros: Rebeccah and Laurel Wassner, triathletes, Manhattan

"In the summer, we head to the Red Hook pool in Brooklyn—a ten-minute taxi ride from the financial district. It's a huge 40-meter outdoor pool with lane lines, a rarity in the city. For long runs, we'll start at city hall and link the Brooklyn, Manhattan, and Williamsburg Bridges. As a nine-plus-mile out-and-back, it's a killer."

Local Joe: Rufus Lusk, film producer and director, Brooklyn 

"I literally moved to be closer to Brooklyn Boulders climbing gym. At night there are really good climbers, and it's fun to work on hard routes. On Tuesday and Thursday mornings, the gym opens at seven, and there's hardly anyone there."

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