Ask the Coach: Rhabdo

From the Members:

“I think you guys need to address the CFGC community about the Rhabdo media frenzy with some cool hard facts.”


From Coach Dennis:

The whole “CrossFit is Dangerous and Can Kill You” thing has been proliferated in the media moreso than ever over the past week or so.  Listening to and reading these reports can understandably lead to a bit of apprehension and concern for those of you that come down to CFGC and attack our workouts with all your might week in and week out.  So, what’s the deal…are these reports legit?…do the risks of doing CrossFit outweight the benefits? 

In a word, NO! Many within (and outside of) the CrossFit community have already expressed their opinions, thoughts and anecdotal experience to defend this program that we all love so much and shed light on the fact that the claims made by these reports are largely false, unsubstantiated and complete nonsense.  That said, it is only fair to offer an unbiased, honest look at the situation to answer the question and determine whether there is any legitimacy to the claims made in these reports that CrossFis is in fact dangerous and potentially life-threatening.  

For this, I am recruiting the help of a colleague of mine by the name of Dr. Mike Ray.  Mike is a practicing Emergency Physician, CrossFit trainer and member of the Level 1 Seminar Staff.  Upon reading the article titledCrossFit’s Dirty Little Secret – highlighting the potential risk of rhabdomyolysis by participating in CrossFit workouts – Mike provided us with a comprehensive rebuttal and analysis of the real risks associated with CrossFit in his article titled “Secret Rhabdo”.  (click for the full article)

It is a lengthy article, and well worth the read, but to highlight some of Mike’s key points:

  • The title of the article is misleading.  Rhabdo is anything but a secret, at least in the CrossFit community.  I believe CrossFit has done more to educate the general public and its trainers about rhabdo than any other organization, including many related to communities that also carry an association with rhabdo.
  • He refers to rhabdo as “extremely rare”, but I would counter that while uncommon, it is also likely to be under-reported and under-diagnosed.  It is also not that rare: as an emergency physician I see several cases per year from patients who have been hiking in the Grand Canyon which is near where I work, and several cases per year from other causes.
  • Mr. Robertson states exertional rhabdomyolysis “should never happen.”  I disagree.  I want to be clear: every case of rhabdo is unfortunate, and I wish we could develop athletes and never see it happen.  We should all act to mitigate the risk, but to eliminate the risk is only possible by eliminating the stimulus, which would mean a loss of all the benefits associated with exercise, especially intense exercise.
  • Some might argue that if training at a level beyond light circuit training or modest distance walking elevates the risk of rhabdo beyond the miniscule (to, perhaps, the merely very small), this training should be reserved for professional athletes.  Do we really want to restrict the power of being a true athlete to only the elite?  Do we want to declare those benefits off limits?  Do we tell the numerous athletes at my gym who are stronger and fitter in their 40s, 50s and beyond than they were in their 20s that this is all reckless and foolish?  Do we send them to other training programs whose approach to rhabdo is to deny and ignore it so everyone can feel how “safe” they are?  Do we send them to training programs that we know are minimally effective so they might genuinely be safe from rhabdo, even though we know it increases their risk of diabetes, hypertension, heart disease, obesity and depression plus deprives them of the sense of vitality they have from training as a true athlete?
  • The Dirty Little Secret article addresses rhabdo, but of course there are other risks associated with training.  If you choose to train hard for competition, your chance of sustaining orthopedic injury is actually pretty high.  There are no professional athletes in any sport that have not had some kind of injury, and many live with pain and anywhere from mild to considerable disability as a result of their training.  CrossFit is certainly not immune from this, though CrossFit’s preference for functional movement and variance makes injury rates lower than they might otherwise be.
  • We can mitigate the risk and severity of rhabdo by training smart.  Every athlete and trainer should educate themselves about this.  Scale appropriately, hydrate appropriately, minimize or avoid high-risk movements, and above all, listen to your body.
  • Similarly, we consider everyone an athlete.  We understand the give and take of training and recognize the reality that we all live with risk regardless of what we do. Rhabdomyolysis has always been there; CrossFit has had the courage to bring it into the light.  The way to deal with that risk is to understand it and to manage it, not to deny it or completely avoid it.  To shun that risk all together is to deny ourselves the opportunity to realize much of the potential that is within us.

Well said, Mike!