The Long Run

T.J. Murphy:

A story I recently wrote to help clarify how CrossFit can be a useful part of the toolbox for lifelong runners.

Originally posted on Unbreakable Runner: CrossFit Endurance for Running:

In a recent article posted on Active by my former colleague, star author and longtime friend, Matt Fitzgerald, Matt takes up the issue of injury prevention for runners, using an initial mention of Unbreakable Runner to make his point.

He writes, “In their book, MacKenzie and Murphy take it as a given that runners who run more get injured more. However, recent research suggests the opposite is true.”

The first study Fitzgerald cites was a web survey of 668 marathon finishers. Sixty-eight of the respondents reported an injury that hindered their training for at least two weeks. From the data, researchers concluded that runners should put in no less than 18 miles per week before a marathon “to reduce their risk of running-related injury.”

Fitzgerald also refers to a 2014 study that looked at 517 runners with a 9-month follow-up. Researchers focused on overall mileage, speed and frequency of runs…

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Why Squats are Good For Runners

Originally posted on Unbreakable Runner: CrossFit Endurance for Running:

Two examples of how CrossFit Endurance can produce runners who are into high-performance and injury resistance: Valerie Hunt (left) and Jennifer Yeargain Fisher.

Two examples of how CrossFit Endurance can produce runners who are into high-performance and injury resistance: Valerie Hunt (left) and Jennifer Yeargain Fisher, both from Austin, Texas.

Last year, Runner’s World put forward the following questions to explore:

Is CrossFit a good supplement to running? A replacement for running? A small study conducted in Alabama provides some useful real-world information on what happens physiologically during a CrossFit workout.

In the article, Scott Douglas discusses an ACSM study conducted with nine subjects performing a CrossFit workout known as “Cindy”: It’s a 20-minute AMRAP—As Many Rounds As Possible—of the following circuit: 5 pull-ups, 10 push-ups and 15 bodyweight squats (also called air squats).

It’s a quick read—378 words—and comes to the following conclusions:

This study suggests that this CrossFit workout gives reasonably fit adults who are accustomed to that mode of training a decent 20-minute workout. That’s not the same, however…

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Minimalistic Shoes and Restoring Your Feet

From Lava Magazine.

Are Minimalistic Shoes a Sham?

by T.J. Murphy

Using progressive exposure to usage of minimalistic shoes, this runner reclaimed arches and better mechanics.

Using progressive exposure to usage of minimalistic shoes, this runner reclaimed arches and better mechanics.

Was the Vibram verdict wrong? Two doctors say that flat, minimalistic shoes can bring your feet back to life in a natural, omnipotent way.

Is the minimalistic shoe dead? It seems to be a popular headline these days, particularly since Vibram USA, the company that makes the five-fingered super-minimal shoes, lost in a class-action lawsuit this past May to the tune of $3.75 million. When the news of the settlement hit, I read various Facebook posts on how this was finally the coffin door slamming shut on minimalism.

The lawsuit suggested Vibram made false marketing claims in regard to strengthening the feet and rewarding the user health and injury-prevention benefits.

The court case was a flashpoint in the running-shoe-store narrative that has become common over the last few years. Here’s how it usually goes down: A runner or triathlete reads Born To Run, and becomes inspired by Barefoot Ted and the Tarahumara Indians portrayed in Christopher McDougall’s bestselling running-thriller. Fired up, the runner chucks his dual-density-EVA running shoes—with the stiff heel counter and a “stability” bridge baked into the arch of the shoe—and buys a pair of Vibrams, Nike Frees or Inov-8s, ostensibly moving from a 12mm heel-to-toe drop in their shoes to a 3mm drop or even zero drop heel-to-toe differential. And zap! Their Achilles tendon becomes inflamed, and a sidelining injury is introduced before the shoes are even broken in.

The Vibram lawsuit seemed to be thunder strike of angst from runners and triathletes who suffered this kind of outcome during their minimalist foray.

Is it true though? Are minimalist shoes a sham?

There’s at least one runner/podiatrist who doesn’t think so. Dr. Nick Campitelli fiercely believes that a slow transition to a minimalistic shoe will do the exact sort of thing that Vibram was accused of falsely suggesting: Strengthen the foot. According to Campitelli, a long-term transition from a motion-control or stability shoe to a flat, bare-minimum shoe will unleash the powers of the human foot and erase the various atrophies that may have occurred from years of wearing shoes that act like a cast on the foot.

Read more at Lava Magazine.

5 Rules You Must Know Before Taking a Fish Oil Supplement

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(Originally published on Stack.com)

In the late 1980s, some of the first field tests of high-grade fish oil supplements took place with athletes in California. Dr. Barry Sears, Ph.D, a former staff scientist at MIT and a medical researcher specializing in the hormonal effects of food and the prevention of cardiovascular disease, worked with Garrett Giemont, then the strength coach for the Los Angeles Rams, and Skip Kenney and Richard Quick, who coached the swim teams at Stanford University.

Sears reviewed biochemistry studies performed by Sune K. Bergström, Bengt I. Samuelsson and John R. Vane that earned the Nobel Prize for Medicine in 1982. The Swedish scientists had explored the powerful physiological effects of inflammation and the role in the immune system of certain eicosanoids known as prostaglandins, which are considered an “autocrine” type of hormone. Rather than being produced by and released from specific sites in the body—like the pancreas—prostaglandins are produced within cells throughout the body.

“Think of eicosanoids as your biological Internet,” Sears says. Like a signaling crew of the central nervous system, they exert extraordinary influence in regard to cellular inflammation.

The upshot for the competitive athlete? Lower levels of inflammation mean increased blood flow, enabling more oxygen transfer. Recovery times improve, endurance improves and health increases. Sears’s first field experiments were conducted circa 1990, but more recent research supports his conclusions. Studies in the American Journal of Clinical Nutrition and the European Journal of Applied Physiology report that fish oil supplementation increases blood flow up to 36 percent during exercise and lowers the levels of inflammatory markers.

In his early work with the Los Angeles Rams and the Stanford swim team, Sears studied how taking long-chain omega-3 fatty acids (i.e., the good stuff in fish oil) might help athletes by “modulating” eicosonoids. In other words, Sears believed that fish oil would help the athletes reduce their cellular inflammation levels.

As Sears communicated to Giemont, Kenney and Quick, a reduction in cellular inflammation should lead to a slew of performance benefits, including strength gains, more endurance, less pain and speedier recovery.

During his early work with the Stanford athletes, Sears said he found a crucial lever necessary to achieve the hormonal control intended with fish oil supplementation—diet. For example, swimmers with exceptionally high carbohydrate intake levels, which spiked insulin, did not achieve consistent results from the fish oil.

“I went into the bowels of the MIT library and found the data that showed us what was going on,” Sears said. “If you have high levels of insulin, you’ll drive the anti-inflammatory eicosanoids into becoming inflammatory. So unless I controlled the diet I would not be able to control inflammation.”

Thus, in combination with fish oil supplementation, Sears advised athletes to eat a moderate level of carbohydrates balanced by moderate amounts of protein and fat. As he reported in his book, The Omega RX Zone, the football players, accustomed to eating more meat and protein, were generally more open to this diet than the swimmers. As reported in 1993 by Swim magazine, the Stanford swimmers who took fish oil supplements and followed a diet with moderate (as opposed to high) carb intake accounted for seven gold medals in the 1992 Olympics. From Kenney and Quick’s point of view, the diet and fish oil made a critical difference for their athletes.

Also affirming the potent effects of fish oil was Doug Smith, a six-time Pro-Bowl offensive lineman for the Rams, who reportedly told Garrett, “Coach, I’ve got to quit taking this stuff, because I am getting stronger in the middle of the season, and that just doesn’t happen.” Assured that the fish oil supplements contained no PEDs, just omega-3 fatty acids, Smith continued the regimen.

Sears has worked with world-class athletes ever since, including swimmer Dara Torres, who won two gold medals in 2000 at the age of 34 and three silver medals at the 2008 Olympics at 41. More recently, Sears advised Team Cervélo, a UCI Tour de France cycling squad, which had implemented an aggressive anti-doping program, on anti-inflammation protocols.

“When you’re talking about an endurance event, whether it’s the Ironman, an ultramarathon or the Tour de France, it’s about who can produce the most energy,” Sears says.

Fish Oil Rules

The following are Dr. Sears’s pointers for athletes wishing to increase their performance and recovery through fish oil supplementation.

1. Control your insulin. Make sure each meal and each snack has moderate amounts of protein, carbohydrate and fat. Excessively high carbohydrate concentrations—like what you get if you eat a massive bowl of pasta—will spike your insulin level and raise your cellular inflammation level. Moderation is the key word. “It’s basically your grandmother’s diet,” says Dr. Sears.

2. Get a fasting cholesterol blood test to determine how much fish oil to take. Look at your triglyceride/HDL ratio. HDL is the so-called “good cholesterol.” In adults, this ratio should be less than 2. Per Sears’s protocol, if the TG/HDL ratio is less than 2, supplement with 2.5 grams of long-chain omega-3 fatty acids each day; if the ratio is higher than 2, supplement with five grams of good fish oil for 30 days, then reduce the dosage to 2.5 grams per day.

3. Supplement with 10 mg of GLA per day. GLA is gamma linolenic acid. Sears says that supplementing with fish oil can decrease natural production of GLA, an important building block for the production of “good” eicosanoids. Another way to make up for the deficit is to eat 2 bowls of slow-cooked oatmeal every week.

4. Check the TG/HDL ratio every six months. The goal, Dr. Sears says, is to keep this ratio between 1 and 2 for optimal inflammation modulation.

5. Use high-grade fish oil. Do your research when selecting fish oil. Poorly filtered fish oil may contain contaminants like PCBs. Dr. Sears suggests the following criteria, which he defines as “Weapons Grade” fish oil:

Total long-chain omega-3 should be more than 60 percent of total fatty acids
Mercury = less than 10 parts per billion
PCBs = less than 5 parts per billion
Dioxins = less than 1 part per trillion

T.J. Murphy is a veteran journalist, CrossFitter, and author of the best-selling CrossFit book Inside the Box: How CrossFit® Shredded the Rules, Stripped Down the Gym, and Rebuilt My Body. Inside the Box is now available in your local bookstore, CrossFit gym, and from these online retailers. Please order Inside the Box today.Inside the Box a book about CrossFit by T.J. Murphy ITB 72dpi 400x600

3 Keys to Preventing Rhabdomyolysis

(Originally published on Stack.com)

On March 10, the Associated Press reported that William Lowe, a former University of Iowa football player, filed a lawsuit against the university accusing the coaching staff of negligence. According to the AP report, Lowe alleges he was the victim of injuries sustained from a high-intensity off-season workout supervised by Hawkeye coaches and trainers on Jan. 20, 2011.

Lowe was one of 13 Iowa football players hospitalized and diagnosed with external rhabdomyolysis, a severe condition of the liver due to the release of muscle fiber contents into the bloodstream. Rhabdomyolysis has an assortment of causes, from car accidents to severe hydration. It can also be caused by extreme amounts of exercise, like an Ironman triathlon. Warning signs are extreme muscle soreness and dark-colored urine, caused by a substance known as myoglobinuria.

The reported culprit in the Hawkeyes football story was a Squat workout that lasted nearly 20 minutes: 100 Back Squats with a load equaling 50% of a one-rep max. In the lawsuit, Lowe is pursuing monetary damages for physical and mental anguish, contending that, “the injuries and damages [he] sustained . . . arose from the same general types of danger that [he] should have avoided through safe and proper athletic training and supervision.”

When the original story broke in 2011, rhabdomyolysis became the subject of much reporting and analysis in the mainstream sports media. As Iowa head football coach Kirk Ferentz acknowledged in a 2013 interview, the Squat workout had been performed several times in previous years with no adverse consequences, and it was only in the aftermath of the 2011 incident that they heard of the disorder.

“That whole incident is unfortunate in a lot of regards,” Ferentz said. “If you look back, no one really knew what rhabdo was at that point.”

“It can kill you.”

Indeed, college football is not what has been most frequently associated with rhabdomyolysis in the media. That dubious honor most certainly goes to the popular strength and conditioning program known as CrossFit. One of the first articles in the national press that identified rhabdomyolysis as a potential hazard of CrossFit appeared in The New York Times in 2005. In that article, CrossFit founder Greg Glassman spoke about the dangers of rhabdo. “It can kill you,” he said. “I’ve always been completely honest about that.”

In a more recent story, “CrossFit’s Dirty Little Secret,” Eric Robertson, an assistant professor of physical therapy, rekindled the controversy—in light of CrossFit’s spectacular growth over the last 5 years—trying to make the case that a future epidemic of CrossFit-created rhabdo cases will be the downfall of the program. He wrote, “My prediction: in a few years, the peer-reviewed scientific literature will be ripe with articles about CrossFit and rhabdomyolysis. Health providers will be there to scoop up the pieces, but who is there to protect those people unknowingly at risk?”

Robertson’s assertion prompted a fact-check by Mitra Hooshmand, Ph.D., a neuroscientist who publishes the blog, ScientiFit.com. Hooshmand, who says she is not associated with CrossFit, reviewed the medical literature and concluded that rhabdo is not exclusive to CrossFit: “The populations affected by exercise-induced Rhabdo and reported in peer-reviewed journal articles and case studies range anywhere from teenage athletes to professional football players, fire-fighters, Army and Air Force personnel, bodybuilders and swimmers. Therefore, it appears that exercise-induced Rhabdo can afflict individuals in almost any form of intense exercise.”

Hooshmand also ran the available numbers to see whether claims about the rate of rhabdo incidents in CrossFit, Robertson’s or otherwise, have any evidence to support them. “Let’s do the math,” she writes, calculating from the known cases of rhabdo over the first 10 years of CrossFit’s existence. “[It] equates to less than 1 case per year, accounting for 0.00000036% of the U.S. population averaged over those 10 years.” Hooshmand also says the Centers for Disease Control and Prevention does not appear to be keeping stats on rhabdo, “suggesting the condition is either extremely rare or poorly documented.”

Dr. Leon Chang, an MD specializing in anesthesiology, is a co-owner of CrossFit Elysium in San Diego. Chang has a unique point of view on the controversy, given his combination of CrossFit knowledge and time spent in the hospital helping to treat victims of the disorder. “As far as rhabdo, I am mildly concerned as an owner,” he says. “In general, rhabdo is very rare in the CrossFit population. If you look at youth sports, like high school football, distance running and such, you’ll see there are far more cases of rhabdo or generalized injury from over-exertion in those activities compared to CrossFit. Unfortunately, due to CrossFit’s reputation for intensity, coupled with a laissez-faire attitude on the part of some in the community and playful jokes like Pukey the Clown and Uncle Rhabdo, cases of rhabdo in CrossFit get blown out of proportion.”

Chang says exercise-induced rhabdo bears little resemblance to the condition caused by something like a car crash. “I have seen and taken care of many patients in the hospital with rhabdo,” Chang says. “When serious, it truly is a life-threatening condition—the cases I’ve seen in the hospital make the CrossFit examples pale by comparison.”

Chang disagrees with the fundamental point that critics like Robertson try to make—that unknowing newbies entering a CrossFit box are a high risk. “The new athlete is essentially not at risk for rhabdo. In a nutshell, they simply are incapable of pushing themselves hard enough to cause muscle breakdown and real injury. Lack of cardiovascular conditioning, strength and mental willpower will kick in and cause them to slow down way before they are at risk for rhabdo, which is a protective mechanism. Similarly, an athlete who has ‘trained up’ appropriately has developed their capacity in step-wise fashion: They can handle what they can do, because they practiced and developed the ability to get to where they are. So they’re a safe population as well.”

“This is a recipe for rhabdo.”

Who is at risk then? Which athletes participating in CrossFit are potentially in danger? The answer, according to Chang, is former athletes who are out of shape. He says, “An ex-military individual or former CrossFitter are perfect examples. These people have pushed hard before and they have the mental toughness to keep going when their bodies say stop. Unfortunately, they are physically de-conditioned and no longer equipped to handle such high intensity. This is a recipe for rhabdo, and for those people, we watch them very carefully, and make sure they don’t push too hard on their first few workouts.”

This may have been the case in the Iowa Hawkeyes football episode. As the Cedar Rapids Gazette reported, the Squat session (which apparently was followed by Sled Drags), was one of the first workouts in the off-season training schedule, right after winter break. As a father of one of the hospitalized football players acknowledged in a press conference, concerning how much training his son had performed over the break, “I could tell you he didn’t do anything except eat a lot and lie around, and then this was kind of the first day back.”

John Welbourne is a nine-year veteran of the NFL and creator of CrossFit Football. He commented on the Iowa football affair in a blog post, suggesting that a number of factors may have contributed to the incident in which so many athletes suffered rhabdo at once—but most likely it was just too much, too soon for players who showed up out of shape. “Had [the coaches] prepared their athletes for a workout consisting of 100 Back Squats at 240 pounds and a 100-Yard Sled Drag done as quick as possible? I guess not, as rhabdo usually follows a dramatic increase in volume. The problem is, these athletes might not have been ready to handle this workload, and the coaches should have realized it. Many times as a coach you design something that looks great on paper only to change it dramatically once the workout starts.”

Welbourne also openly wondered whether the workout was on a Wednesday, Thursday or Friday morning—following a “dollar drink night,” which is not uncommon in a university town at the beginning of the semester. A night of drinking could have set the stage for rhabdo via dehydration, he wrote. (Jan. 20, 2011 was a Thursday.)

Keys to prevention

Whether it’s a first week of CrossFit training or an early season football practice, how can athletes and coaches reduce the risk of rhabdomyolysis?

Gradual exposure to high-intensity training. In a 2005 CrossFit Journal article, Glassman explored the nature of the five CrossFit-induced rhabdo cases that had been reported to date. To reduce risk, Glassman advocated “On-Ramp” beginner programs for anyone new to CrossFit, even those coming from more standard physical fitness programs where workout intensity was relatively low. “Elite CrossFitters are performing 18,000 foot-pounds of work per minute for three or four minutes (that’s nearly half of one horsepower!),” Glassman wrote. “This is what our top tier athletes are doing in workouts like ‘Fran.’ Without deliberately training for maximum expression of effective work against a wide-ranging time domain, it is virtually impossible to deliver power output as high as our athletes do.”

“Hydrate or Die.” In an article written for the CrossFit Journal, Eugene Allen enumerates some of the other known causes for inducing rhabdo, including heavy alcohol consumption. Allen suggests dehydration is the most prominent threat for athletes. For the athlete, hydrating before a workout, especially in hot weather, is a preventative measure. “The Camelbak tag line ‘Hydrate or die’ is more meaningful in light of some understanding of rhabdo,” he says.

Beware of eccentric movements. Dr. Chang says that with respect to rhabdo, an emphasis on eccentric movements, with high repetitions, is particularly dangerous. “Any movement with a pronounced eccentric component can potentially cause rhabdo, out of proportion when compared to other movements,” he says. “An eccentric movement is when the muscle is ‘loaded’ and under tension but is not contracting. So for example, when one deadlifts, the pull from the floor is concentric. Once at the top, lowering the weight under control to the ground is an eccentric load. Hamstrings lengthen, back muscles tighten up, but no contraction occurs.” Some exercises have a pronounced eccentric phase, and a good CrossFit coach will be aware of the danger and temper the volume levels for beginners.

“The classic offenders are Kettlebell Swings and Jumping Pull-Ups,” Chang adds. “In the Kettlebell Swing, controlling the bell on the way down represents a very long, loaded eccentric phase. For the Jumping Pull-Up, what often happens is the individual does the Pull-Up, but then slowly lowers themselves back down, which represents eccentric work for the forearms and lats.”

T.J. Murphy is a veteran journalist, CrossFitter, and author of the best-selling book Inside the Box: How CrossFit® Shredded the Rules, Stripped Down the Gym, and Rebuilt My Body. Inside the Box is now available in your local bookstore, CrossFit gym, and from these online retailers. Please order Inside the Box today.Inside the Box a book about CrossFit by T.J. Murphy ITB 72dpi 400x600

What Happened When a 300-Pounder Tried CrossFit

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Photo by Jay Kay (jayknickerbockerphotography.com)

(originally published on Stack.com)

The first time he walked into a CrossFit box about a year ago, 30-year-old Travis Brumbaugh was a chain-smoking sales manager whose weight hovered around 300 pounds. “I was doing all of the wrong things,” he says.

Brumbaugh wore size 44 pants and frequently worked 12-hour days. To counter the stress of his job, he ate pretty much anything and everything, and his weight skyrocketed as a result. After trying and failing numerous diets, he was on pace to become one of the 25.8 million Americans suffering from Type 2 Diabetes. And though he’d recently trimmed down to about 285 pounds thanks to a set of P90X DVDs, he’d fallen off the wagon and his weight was climbing back up when, in a last-ditch effort, he joined CrossFit 428 in Tampa, Fla.

With a body type that could be categorized as morbidly obese, Brumbaugh was not even close to being prepared to handle the intense workouts performed by elite athletes at the CrossFit Games. Trainer Hope Keddington knew she’d have to scale back the movements and workouts to a level Brumbaugh could safely handle. “He was very overweight and he wanted to come in every day,” Keddington says. “I tend to be blunt. I told him, ‘If you can do it, I am all for it. But it’s going to be hard.’”

Keddington, who coached the 5:30 a.m. class, was an Olympic lifter in college, and she had seen many newcomers set unrealistic goals, grow frustrated and give up. She convinced Brumbaugh to try a three-days-per-week approach, which would give him sufficient time to recover from each workout. The workouts were challenging, and Brumbaugh started off slowly, but he kept coming back consistently. He liked Keddington’s coaching and the team atmosphere of the gym and its members. Eventually he saw results.

“It felt like an overnight thing,” Brumbaugh says. “In the fourth month, it was like the fat just started falling off me.”

After 10 months, Brumbaugh had lost over 60 pounds and burned 10 inches off his waist size, from 44 to 34. Attending the 5 a.m. classes, he upped his attendance to four, and eventually to five days per week. Today, “he only misses workouts on the rarest of occasions,” Keddington says. “He’s the poster child for what CrossFit can do for you.”

Last November, Brumbaugh competed in the entry level section of an inter-gym competition. He hit a personal record on the Snatch, lifting 135 pounds, as well as a PR for Pull-Ups. “He did 10 of them,” Keddington says proudly. “All unbroken.”

(Read the rest of the story on Stack.com)

T.J. Murphy is a veteran journalist, CrossFitter, and author of the best-selling book Inside the Box: How CrossFit® Shredded the Rules, Stripped Down the Gym, and Rebuilt My Body. Inside the Box is now available in your local bookstore, CrossFit gym, and from these online retailers. Please order Inside the Box today.Inside the Box a book about CrossFit by T.J. Murphy ITB 72dpi 400x600