The problem with finding reliable data that conclusively establishes injury rates in CrossFit is that, frankly, there isn’t any. Depending on the study, injury rates vary from as low as 16 percent to as high as 74 percent.
Attacking the ACSM
CrossFit's publicity pitbull calls the American College of Sports Medicine a direct competitor and accuses the organization of bias. But its members disagree. “To think that the American College of Sports Medicine has it out for CrossFit is paranoid almost beyond human understanding."
When we published "Is CrossFit Killing Us?" fans of the workout went berserk, attempting to discredit us, the story, and the research. “It’s a fricking paragraph in the paper,” the study author says. “There’s no way I will ever do research with that workout again. It’s just not worth it.”
Truth About Glassman
Greg Glassman's rise has not been without controversy. "CrossFit is a workout and a company no conventional trainer or M.B.A. would ever have built. Glassman is sitting atop a firecracker of a company. And the relevant question is, as always, What's he going to do now?" INC. wrote.
In its December issue, Outside published “Is CrossFit Killing Us?” The piece set out to address, and quantify, the risk of injury associated with the popular fitness phenomenon. CrossFit entails a high-intensity regimen of complex weightlifting and ballistic bodyweight exercises, and stories of people getting hurt seemed to be everywhere. In much shorter supply, however, was hard data backing up the numerous anecdotes and testimony.
Arguably the hottest flashpoint of controversy in the story centered around a study conducted by researchers at Ohio State University and published in the November edition of the peer-reviewed Journal of Strength and Conditioning Research (JSCR). That study, which was intended to assess the efficacy of CrossFit workouts, not the rate of injury, included a stat indicating that 16 percent of the participants had dropped out due to “overuse or injury.”
The CrossFit community went berserk. While many commenters chimed in about their own injuries from workouts, many more criticized both the statistic and the study itself. Lengthy rebuttals appeared in CrossFit Journal—the organization’s newsletter. One of CrossFit’s chief PR people, Russell Berger, rang up the study director, Professor Steven Devor, and grilled him until the scientist refused to talk to him any more. The upshot was a collective pile-on attempting to discredit the study, its directors—and Outside—while spinning public opinion away from the idea that the insanely popular workout program was any more hazardous than jogging in your neighborhood.
And yet, no one was making up the stories about people getting hurt. So, what was the deal? Was CrossFit inherently dangerous? And if so, were the hordes of newbies with beach-body dreams flocking to CrossFit “boxes” aware of the risks?
I wanted to dig deeper, since lots of lively debate continues to revolve around this topic. And I started in the obvious place: By calling up Devor, the JSCR study’s author, at Ohio State University. Devor, 47, is an exercise physiologist with a PhD from the University of California at Berkeley whose past research has focused on exercise and nutrition.
Devor doesn’t argue that the 16-percent figure is a soft number, and a figure that was never intended to represent global injury rates. But he also said that CrossFit’s reaction was a misguided ambush on a study whose main findings were actually positive for CrossFit. It showed that people ranging from beginners to seasoned athletes all lost body fat and saw a jump in performance over 10 weeks of CrossFit training. The injury statistic was, literally, an afterthought. The original study didn’t mention it, but the editor at the journal publishing the study asked for the information, Devor says, and it was provided after-the-fact by the owner at the CrossFit gym.
“It’s a fricking paragraph in the paper,” he told me. “There’s no way I will ever do research with that workout again. It’s just not worth it.”
THE PROBLEM WITH finding reliable data that conclusively establishes injury rates in CrossFit is that, frankly, there isn’t any. One study, put out in November in advance of being published in JSCR, surveyed 132 people with an online questionnaire. The paper found that 74 percent reported being hurt during CrossFit—but that was over the course of a lifetime, not over a short period, like Devor’s study, which would skew the number higher. The paper notes that the figure is on par with weightlifting, gymnastics, running, or training for triathlons.
Another widely cited document is a position paper issued in 2011 by a group of civilian scientists and military experts. Concerned about reports of injury among soldiers performing high-intensity weightlifting workouts, they concluded such practices could cause more injuries, and should be treated with caution. But they were not looking at CrossFit, per se. And they were basing their position on expert opinion, like that of Michael Bergeron, a professor at the University of South Dakota’s medical school, and head of the National Youth Sports Health and Safety Institute, who helped with the paper.
“I’m just concerned about novices and unprepared people jumping into a program that’s very aggressive,” Bergeron says.
Perhaps the most comprehensive and persuasive research I came across was an as-yet unpublished survey conducted by professor Yuri Feito, a physiologist at Georgia’s Kennesaw State University. Feito queried 733 CrossFitters, and found that half of them reported some kind of CrossFit-related injury in the previous year. The problems ran the gamut, from torn blisters to a ruptured Achilles tendon and torn knee cartilage. Roughly 15 percent of the injuries were serious enough to warrant a trip to the hospital, says Feito. The most common problems were shoulder and back pains, with nearly half the people reporting at least one of those. He also found three cases of rhabdomyolysis, a rare but potentially dangerous injury caused when severe muscle damage clogs the kidneys, sometimes landing people in intensive care.
Keep in mind, the study is still waiting to go through the quality control that comes with peer review. It’s also possible that serious injuries were understated, because people who got hurt and dropped out wouldn’t see the survey on CrossFit forums.
Also notable: Feito is an admitted CrossFit fan, and a graduate student working on the project also works for CrossFit headquarters. Feito goes to a CrossFit gym five times a week, and is training for a half marathon. “When you put it in perspective, it’s not that dangerous compared to any other activity you would perform,” he says. People get hurt in other sports at similar rates, he says. And the risks need to be weighed against CrossFit’s ability to attract people who might otherwise skip exercise altogether.
THE ABILITY TO attract more and more participants is not only engrained in the CrossFit business model, but also high on their PR pro Russell Berger’s agenda. Berger, a 28-year-old former Army Ranger, has earned a wide reputation as CrossFit’s publicity pitbull. He’s active on message boards below news stories (including Outside’s) and tends to dismiss studies as bogus and fearmongering.
Fair enough, perhaps, but he also accuses the country’s leading professional organization for exercise scientists, the American College of Sports Medicine (ACSM), of having a bias against CrossFit. He sees it as a direct competitor, because it offers certification programs for athletic trainers. “We’re selling very different products in the same field, to the same people quite often,” says Berger.
This perspective stuns scientists like Devor, who, like most university sports researchers, belongs to the ACSM. “To think that the American College of Sports Medicine has it out for CrossFit is paranoid almost beyond human understanding,” he says.
When Berger pounced on Devor’s study this fall, he argued that he was merely trying to unmask shoddy science, and coming to the defense of the Columbus, Ohio CrossFit gym where the study took place. It first came to his attention when a competing gym posted a message on the Internet urging people to come there instead, because people wouldn’t get hurt. “We’re sort of a guardian that prevents a full-scale slandering of our businesses by pseudoscience,” Berger says.
The problem is, many people who speak out about injuries in CrossFit have no intention of being slanderous or even disingenuous. To ignore, or play down, the risk of injury in CrossFit is to ignore the glaringly obvious. I spoke to seven experienced exercise scientists, all familiar with CrossFit, and the opinion was pretty much unanimous: While CrossFit can be highly effective, if you do any workout full-bore, day after day, especially ones that involve performing complex weight-lifting maneuvers or calisthenics, you’re playing with fire.
"Any time you try to race the clock under a high intensity load, that increases the risk of injury,” says Michael Bergeron, the professor who helped with the military paper. “And any time you go to failure, you've crossed that threshold of the body positively responding to exercise, to the point that you can break down."
He adds that the CrossFit system ignores some of the most widely accepted fitness advice: Follow a plan that balances high intensity workouts with easier ones; divide training into different periods of several weeks or months focusing on different kinds of fitness, such as endurance or power; and tailor workouts to an athlete’s particular needs, rather than into a one-size-fits-all formula. Also, perhaps most importantly, be patient and build up slowly.
CrossFit’s culture, business model, and near vertical growth has limited room for patience or following conventional fitness advice. That’s been true all the way back to CrossFit’s scrappy origins as a punishing workout routine conceived in a Santa Cruz, California, gym by Greg Glassman, a former gymnast. An outspoken libertarian and iconoclast, Glassman first gained a following in the early 2000s among garage-gym do-it-yourselfers who downloaded the workouts from his Web site. Early on, Glassman set out to distinguish CrossFit as not just another sleek, corporate exercise routine, or big-box Nautilus workout. Take Pukie the Clown, a company mascot. In his most common form, the demented-looking, muscle-bound clown is on his knees, vomit spewing from his mouth, presumably from a trip to CrossFit hell.
To date, more than 50,000 people have gone through the company’s two-day program to begin the process of learning how to train others*, paying $1,000 each. Fanning the popularity, Reebok became the lead sponsor of the CrossFit Games in 2011, where the “Fittest on Earth” are crowned. The number of gyms, or “boxes,” has grown from 500 in 2009 to nearly 8,000 worldwide at last count, and in the process it’s flooded the country with aspiring coaches who need a weekend-certification seminar before they’re allowed to open their gym under the CrossFit mantel.
The company, owned by Glassman, made $50 million in 2012, with a goal of hitting $100 million this year. The company’s bottom line depends on its growth continuing, since most of its money comes from a steady stream of aspiring coaches at training seminars and the annual fees from boxes.
In keeping with its libertarian ethos, the company headquarters takes a hands-off approach to the gyms. Unlike a standard franchise, like McDonald’s, where the company dictates much of what each store does, a CrossFit affiliate can structure workouts just about any way it wants. In this sweat-stained free market, boxes that do a bad job will be weeded out as people go elsewhere, says Russell Berger. “You end up with 8,000 little experiments around the globe that are determining what the best practice is.”
I'M AN AMATEUR ATHLETE, competing mostly in triathlons, but I don’t do CrossFit. I wanted to see for myself what was going on “inside the box,” as it were. So I went to visit Dave Werner, owner, manager, and trainer at Level 4 CrossFit Seattle.
Werner opened Level 4 in 2002, then the first official CrossFit gym other than Glassman’s. At the time, he simply called it CrossFit North. Now 52, the former Navy Seal looks like a walking advertisement for CrossFit’s powers to transform practitioners into specimens of fitness and health. His pecs bulge beneath a t-shirt as he effortlessly cranks off pull-ups at the gym, housed in a cavernous Seattle warehouse. Werner credits CrossFit for helping him recover from a military career and a desk job that left him with a bad back, nerve damage in one leg, and an extra 50 pounds of fat.
As the number of Seattle-area boxes has grown to more than 50, three species have emerged, Werner says. Some, like him, cater to people looking for a fitness program. Others, fired up by the CrossFit Games, embrace it as a competitive sport. He worries those gyms might push people to go too far too fast. Then there are the boxes that seem to be in it just for the money.
Before subjecting someone to a full CrossFit workout, people at Werner’s gym get four one-on-one sessions where they learn how to properly lift a barbell and swing a kettlebell. Even after they enter a class, he won’t let people do certain kinds of injury-prone moves, like deadlifts or clean-and-jerks, unless he’s sure they can do them correctly.
As we talked, one of his coaches led a workout nearby. The eight participants ranged from lean athletes to middle-aged guys who could afford to lose 20 pounds. Half the participants were women, including one who was visibly pregnant. As a soundtrack of 80s rock played, they sped through a five-minute circuit tossing medicine balls high in the air and swinging kettlebells over their heads, followed by five minutes of pull-ups, squats and sit-ups. The sweatfest was punctuated by a few groans. But it was hardly the vein-popping, muscle-straining sessions found in YouTube videos of CrossFit competitions. Look around Werner’s box, and there’s no sign of Pukie the Clown.
Werner doesn’t need lab data or hard science to convince him that CrossFit workouts can be risky. And Level 4 may be one of the best examples of how conscientious owners safeguard against such problems.
The larger issue is that CrossFit, as a brand, wants to have it both ways: To market itself as the toughest, most effective, and most badass workout in the land, while also claiming it’s as safe as any other activity. But is that really possible? In the free market that CrossFit touts, there are winners and losers. And you could pay a high price—tendinitis, a blown rotator cuff, rhabdo—if you find yourself at a loser box.
“I think the name CrossFit now tells you about as much as saying ‘I’m going to go out and get a burger,’” says Werner. “It could mean grass-fed, pull out the stops, try to make a great burger. Or it could be mass-produced like McDonald’s or something. It could be some truly awful hole in the wall.”
*The original version of this article stated that more than 50,000 people have undergone CrossFit’s two-day training program become certified coaches. We regret the error.
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