CrossFit is a high intensity strength and conditioning
program that has increasingly grown in popularity since it came about in the early
2000s. There are now CrossFit gyms all across the country and several right here
in the Denver area. While the annual CrossFit Games might be well-known, the occurrence
of rhabdomyolysis induced through CrossFit exercise typically is not.
Rhabdomyolysis refers to the breakdown of striated muscle,
which then releases intracellular contents into the interstitial fluid and
circulation (Vanholder et al. 2000). Strenuous exercise can be one cause of rhabdomyolysis
and can be indicated through varying levels of creatine kinase. One mechanisms
by which this happens it through an excess of free calcium, which then results
in continuous muscle contraction. This can eventually deplete the cell and in
extreme cases lead to cell death (Vanholder et al. 2000). Additionally, extreme
exercise leads to an increased production in free oxygen radicals, which can
promote tissue damage and inflammation (Vanholder et al. 2000).
There have been several cases of patients diagnosed with
rhabdomyolysis following their participation in a CrossFit exercise program and
a subsequent recovery after discontinuing CrossFit training (Rathi, M., 2014
& Meyer, M., Sundaram S., Schafhalter-Zoppoth, I., 2018).
So, as future healthcare providers, can we ethically endorse
CrossFit as a means to achieve physical health?
In my opinion, CrossFit cannot be ethically endorsed due to
the biomedical principle of non-malfeasance. Since an association between rhabdomyolysis
and CrossFit has been identified, endorsing this rigorous program could
potentially do your patient harm. As a future healthcare provider, I think it
is important that we stay up to date on the current fads that our patients will
most likely be exposed. This way we will be able to give evidence-based advice
allowing us to provide the highest quality of care.
References:
Meyer M, Sundaram S, Schafhalter-Zoppoth I. (2018). Exertional
and CrossFit-Induced Rhabdomyolysis. Clinical
Journal of Sport Medicine: Official Journal of the Canadian Academy of
Sport Medicine, 28(6):e92-e94. DOI: 10.1097/jsm.0000000000000480.
Rathi, M. (2014). Two Cases of CrossFit®-Induced
Rhabdomyolysis: A Rising Concern. International Journal of Medical
Students, 2(3), 132-134. https://doi.org/10.5195/ijms.2014.102
Vanholder, R., Sever, M. S., Erek, E., & Lameire, N.
(2000). Rhabdomyolysis. Journal of the
American Society of Nephrology, 11(8), 1553- 1561.
Savanna,
ReplyDeleteI also agree that Crossfit should not be ethically endorsed because of the intensity and disadvantages it has. I believe only specific individuals such as athletes who are demanding with themselves and exceed the limits of their body in training should do Crossfit. There have been numerous studies that have shown that the average citizen usually has at least three injuries in their joints, muscle, or tendons within the first year of Crossfit (Tafuri et al., 2019). Physicians have a duty of providing beneficence and non-malfeasance to their patients, and by endorsing Crossfit, they are potentially causing harm because of the strenuous activity. Instead, physicians should advocate for the moderation of different exercises and increase the energy output to live a healthy and balanced life.
Reference
TAFURI, S., SALATINO, G., NAPOLETANO, P. L., MONNO, A., & NOTARNICOLA, A. (2019). The risk of injuries among CrossFit athletes: an Italian observational retrospective survey. Journal of Sports Medicine & Physical Fitness, 59(9), 1544–1550. https://doi-org.dml.regis.edu/10.23736/S0022-4707.18.09240-X
This is so interesting, I never knew this about crossfit! My sister actually just joined a CrossFit gym in Boone, NC and she loves it. She actually struggles with Binge Eating Disorder and has struggled with her weight and her appearance her whole life. In very recent years she has tried to address her unhealthy relationship with food and with herself by channeling some of her frustration into exercise. Before CrossFit she was paying a personal trainer to teach her different work out since she is completely new to the gym and embarrassed to try and figure things out on her own, but that was so expensive! It helped her a lot but eventually she had to stop because of the financial burden so she started going to the gym on her own and repeating those same work outs but it was really boring, she felt very alone/visible going to the gym by herself and it was hard for her to continue to find motivation. Eventually someone invited her to CrossFit and it has seriously changed her life! It is one of the most social ways that you can work out and the unique variety of work outs constantly challenges her body in new ways and keeps things interesting.
ReplyDeleteI know I sound like a CrossFit advertisement right now, but what I am trying to get at is that my sister is one of the almost 40% of American adults who are obese and one of the 40 million American adults with anxiety. Crossfit has helped her substantially with both of these problems and in a much healthier way than any prescriptions that she has ever tried. I definitely do agree that there are risks to this work out regiment, but I think that encouraging physical exercise of any kind is really important for us to do as physicians, especially if other aspects of the exercise (i.e.-social aspects) can benefit our patients. We just have to be sure to inform them of the known risks and encourage them to do their own research. As long as they have all the information, they can make an autonomous decision for what exercise plan (or lack thereof) will work best for them.