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Old 07-28-2011, 11:43 AM   #261
Shane Skowron
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Re: Gillian Mounsey Article

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Originally Posted by Mark Ritchie View Post
So no, we don't know much from the forums at all in terms of statistics or percentages. We can't even really know which exercises REALLY are at risk, since our dataset isn't complete. We only know what people report. For all we know, non-reported cases on other exercises could have higher rates.
Question. Do the percentages really matter?

I mean, if activity A was known to cause 800 cases of condition and 1% rate x but activity B had 10,000 cases and a 3% rate, does that mean that what activity A is doing is acceptable?


See what Jamie posted below. I'm sure broken ribs, broken wrists, and concussions are far more common in other sports. But does that make it acceptable for a rec league to have it?

Quote:
Originally Posted by Jamie Gowens View Post
The females started getting hurt because of the males' competitive exuberance. Seriously hurt, broken ribs and wrists, concussions, etc.

What did the city do?

Instituted a "halo" for the pitcher. If a line drive is hit within the "halo", regardless of intent or lack thereof, the batter is ejected from the game.
Instituted a "no crash" rule. If a female is in the baseline and male runs into her, he's out. Intentional or not, he's out. If he's THAT competitive about it, he can slide, but he can't crash into the female in the baseline.
Composite bats are now against the league rules. Bring a composite bat into the batter's box, you'll be ejected for the season.

The league took measures to protect the participants. Not unreasonable measures, just common sense measures.

Wait but the city is not liable man!! People should be held responsible for their actions!!
 
Old 07-28-2011, 11:54 AM   #262
Mark Ritchie
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Re: Gillian Mounsey Article

Well, this may be more spitting in the wind...

If CF HQ wanted to really be evidence based, they would collect standardized injury data from affiliates, and make it a required part of the renewal process. Random audits of the data reporting would help to keep the false reporting of data in check. That is really the only way to track and understand injury rates for rhabdo or anything else.

However, that would only tell you the rates in CrossFit affiliates. Not for CrossFit as a whole (since there are lots of people doing it on their own).

My opinion is that CF HQ really should be collecting this data. Another organization I'm involved in (The National Outdoor Leadership School) and others started a data collection effort. They require all of their instructors to record and report injuries, including time of injury, context, etc. They then shared this data with Outward Bound and others, and it has had a hugely positive impact on reducing injuries by spotting trends that one could not spot otherwise. For example, they saw lots of injuries at a certain time of day across classes and terrain variations. By directing instructors to remind students to hydrate and eat around that time, they saw injury rates drop.

CF HQ could do the same. Every year, collect the data as affiliates renew. Standardize the reporting, and make good data reporting a part of getting your renewal. Analyze the data, and then work on figuring out the actual causal relationships. Let the data drive the decisions and training.

Not likely, but if they were serious about it, that is what they would have to do.

The research could even be done as a stratified random sample, without HQ having to do it, and there is a comprehensive list of CF affiliates, so anyone with enough time could design and carry out the study.

Hmm....
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Old 07-28-2011, 12:09 PM   #263
Mark Ritchie
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Re: Gillian Mounsey Article

Shane, you are asking a good question, but need to pull it apart a bit more. What you are talking about is discussed a lot in risk management and specifically in outdoor/adventure education.

Percentages matter in that they indicate the chance of an event occuring.

They tell us nothing about the severity of the event.

What we want to know is the probability and the severity. That is how you calculate risk. A low probability event with severe consequences is very different than a high probability event with low consequences.

So I agree, we don't want severe consequences (e.g. rhabdo), but at the same time, we don't really know the probability. So the percentages do matter.

What we should know is both the probability and severity of rhabdo and other injuries, and what factors are involved.

That way you can design programs that avoid injuries. That's why you need to know the percentages. We've only got one half of the equation (severity) and not the other (probability).

So we don't know. We've got some good stories, and enough information that a good trainer or aware athlete can be aware of the potential severity. But that is about it.

And honestly, we really should know this information.
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Old 07-28-2011, 12:16 PM   #264
Aushion Chatman
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Re: Gillian Mounsey Article

Mark if you start talking about Risk Mitigation I'm out of here...

I don't think anyone is ever going to detail a study on CF injury in totality in a meaningful way. It would really have to be driven by the CF Games and it would only be when the "sport" of CF is big enough to warrant that kind of scrutiny...

Otherwise why would anyone pay for this to happen...CF INC is a growing company in a bad economy...why would they start self-reporting things no one (well except on a message board) is asking for.
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Old 07-28-2011, 12:27 PM   #265
Mark Ritchie
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Re: Gillian Mounsey Article

No risk mitigation from me! Risk can be managed, not mitigated.

Actually, I think collecting data from the CF Games would be pretty worthless, especially since their goals, intensity and conditioning are not the norm.

Collecting and being transparent about this data can be an advantage. NOLS and other credible outdoor/adventure education organizations publish their injury rates. It was hard to get people convinced to start doing that, but the people behind that initiative at NOLS did it, and have seen how tremendously beneficial it can be.

But you're right. Probably too scary to consider for HQ.

But it would be very very useful for a trainer to know what the most likely injuries really are, and what steps could be taken to avoid them.
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Old 07-28-2011, 12:30 PM   #266
Shane Skowron
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Re: Gillian Mounsey Article

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Originally Posted by Mark Ritchie View Post
Shane, you are asking a good question, but need to pull it apart a bit more. What you are talking about is discussed a lot in risk management and specifically in outdoor/adventure education.

Percentages matter in that they indicate the chance of an event occuring.

They tell us nothing about the severity of the event.

What we want to know is the probability and the severity. That is how you calculate risk. A low probability event with severe consequences is very different than a high probability event with low consequences.

So I agree, we don't want severe consequences (e.g. rhabdo), but at the same time, we don't really know the probability. So the percentages do matter.

What we should know is both the probability and severity of rhabdo and other injuries, and what factors are involved.

That way you can design programs that avoid injuries. That's why you need to know the percentages. We've only got one half of the equation (severity) and not the other (probability).

So we don't know. We've got some good stories, and enough information that a good trainer or aware athlete can be aware of the potential severity. But that is about it.

And honestly, we really should know this information.

As a risk manager, are you ever asked to give estimates without hard data? Non-sarcastic question.
If yes, what would you say in this case?

Last edited by Shane Skowron : 07-28-2011 at 12:32 PM. Reason: manager not mitigator
 
Old 07-28-2011, 12:36 PM   #267
Ryan Sheehan
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Re: Gillian Mounsey Article

One missing ingredient, and the culprit in many cases involving crossfit injuries is hubris, either on the part of the exerciser or the coach. The personality traits of a person that a) finds crossfit enjoyable and b) has the money to subscribe to a crossfit gym are often the same ones that cause a person to push it to or past his limits. The few crossfit gyms I've been a part of have been largely inhabited by A type personilites. This includes me as well. Hell, look at the GIANT egos on the 26 pages of this thread who assume that their prescription for exercise is the answer and if cfhq would hear their cries we would all be better for it.

It seems to me that in many cases, the enthusiasm for exercise outpacing the capacity for exercise is how people get hurt. Many of us have hurt ourselves doing movements in crossfit that were not well thought out, but prior to injury acheived a heightened level of fitness as a result of them. As Tamara said, she will make mistakes and she hopes to learn from them. Unfortunately in exercise and resistance training, these mistakes occasionally come in the form of injury or overtraining. Even more unfortunately for us affiliate owners, sometimes these lessons come in the form of injury to another person. Injury is bad enough, but injury without a lesson learned is unacceptable. Throughout life my most lasting lessons have been what NOT to do.

Because my post-injury goals did not line up with the programming of the crossfit gym I went to, I opened my own crossfit gym. That doesnt mean the old gym is not a good place, it's just a good place for people with better shoulders than me. I like to get wrapped up in my ego and think that my brand of exercise is the best and I focus on the right things and minimize the wrong ones. The fact is, someone may get hurt one day on my programming and someone may not get as strong or as fast as they could on a different program. When I notice that, I will adapt.

I see both sides of the argument, some of the movements in crossfit will hurt you, or you will hurt yourself doing them. On the other side of the coin, it is insulting to the people doing the right thing with their programming and progressing slowly to attain the strength and ability to do the high rep movements without as much risk, to be lumped in with every other schmoe with an L1 cert. Duration of instruction in a classroom does not validate an education. It's the continuing education people do outside of their gym, coupled with encouraging their gym members to think for themselves that make an outstanding gym. I think that people besmirching the validity of the level 1 causes some trainers to guard their information like there was some invaulable mysticism devined upon them to make them pass muster. The level1 is a jumping off point. That's where crossfit has more specific certs to continue your education. There are other organizations that may even be better for continuing ed (RKC, USAW, COLLEGE)

There are constructive ways to make crossfit better in your community. This thread is not one of them. It's the same 8 people moaning on and on. You're the same 8 people in every thread just being the contrarian. For goodness sake, it's like an argument between radical muslims and christian fundamentalists. Dont listen, just wait for your turn to talk. There's no war between exercise philosophies. If there is a war to be declared it is against a gluttonous and slothful lifestyle. Enjoy crossfit if it's what you enjoy but be smart about it. If you only like parts of it, do those parts in your olympic gym and call it Emilyfit or Shanefit. If you don't like it don't do it. But realize that when your passion causes you to repeat the same motions over and over in a fatigued state, there is a chance that it will one day turn on you. It happens to pitchers, swimmers, triathletes, and even weightlifters. It's hard to be the best version of yourself without some input from your ego, but unchecked ego without moderation and humility will often cook up a recipe for disaster.

And stop calling gyms boxes. It's obnoxious.

Before you ask, my affiliate is called CrossFitSAV. It's not on the main page. I dont know why. I've never looked before because I've never had reason to, but I will be inquiring as to why it isn't.
 
Old 07-28-2011, 12:55 PM   #268
Eric A. Brown
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Re: Gillian Mounsey Article

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Why are you so opposed to someone trying to make something BETTER?

I don't care what the sport or organization is. I would still look at the risk/reward analysis. As a USAW coach, if my weightlifters kept getting injured, it would be a really good idea for me to take a look at my programming and coaching techniques, would it not? As an intelligent person, I would do that. I don't know why you think what I'm saying only applies to CrossFit.

You have your standards for what constitutes too much risk in your gym, and I have mine.
And, of course, there is the vast amount of money that is made putting on a powerlifting meet or weightlifting meet. Or not. Most people that put on meets, except at maybe the national or world level, do so just to give back to their sport. I have helped run meets that have lost a few bucks year after year. So what? When I was first coming up people put on meets for me and were not exactly rolling in the green.

With the amount of money that Crossift makes from a single endorsement deal they could afford a real risk analysis and comprehensive study that many other actual sports cannot.

Agree with you completely about the risk:benefit ratio.

The number one rule of anyone calling themselves a coach is to keep people injury-free. Sure, it happens, but it is not supposed to. And it is certainly not something that any responsible adult should ever glorify.

From a practical standpoint alone, as a coach, if my athletes get hurt they lose training time or train less effectively. My goal is to get as much out of the little time I have with them. If I am busy trying to figure out how to train someone around an injury that could have been prevented, my stupidity has wasted my time and possibly their chances at their next event. My athletes deserve better than that.
 
Old 07-28-2011, 01:00 PM   #269
Jamie Gowens
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Re: Gillian Mounsey Article

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Originally Posted by Eric A. Brown View Post

The number one rule of anyone calling themselves a coach is to keep people injury-free. Sure, it happens, but it is not supposed to. And it is certainly not something that any responsible adult should ever glorify.

From a practical standpoint alone, as a coach, if my athletes get hurt they lose training time or train less effectively. My goal is to get as much out of the little time I have with them. If I am busy trying to figure out how to train someone around an injury that could have been prevented, my stupidity has wasted my time and possibly their chances at their next event. My athletes deserve better than that.
This thread really could be ended right here.
 
Old 07-28-2011, 01:01 PM   #270
Mark Ritchie
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Re: Gillian Mounsey Article

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As a risk manager, are you ever asked to give estimates without hard data? Non-sarcastic question.
If yes, what would you say in this case?
That's a fair question. Yes, sometimes you are asked to make an estimate without a lot of data. But you can't make an estimate of risk without having some data (hard or soft, quantitative or qualitative). One of the prime directives of risk management is to always be seeking more reliable data and information.

For the specific case of rhabdo in CrossFit exercises, we know the mechanism of injury for rhabdo (a muscle trying to contract while being stretched, often under load). We know that GHD sit ups and negative pull ups have this same MOI, and are thus something we should be really careful with. So while at my gym we do have a GHD, it is used with care and consideration for injury, and I caution all of my clients to not "hold" a jumping pull up at the top -- e.g. don't do negatives.

So in this case, I feel I know enough from talking with other trainers, reading the CF Journal, the discussion at my level 1 cert, and other research I've done (including talking with our medical advisors) that those two exercises need to be taught carefully.

I don't know about ruptured achilles tendons from box jumps. I understand the MOI (I'm a wilderness first responder as well), and don't know enough (yet) about the specifics in terms of what is meant by "high" reps. But it is something I'm working on learning more about, and we're careful with them.

What I can't say is if there is "more" rhabdo in CF than in other fitness activities (e.g. higher rates per person hours). Spinning causes rhabdo!? That was a new one to me -- and indicates to me that there might be a lot more rhabdo out there in specific fitness activities than we know about, but that those activities don't have the scrutiny and centralized community that CF has, so we never hear about them.

We also don't know if it is CrossFit per se, or the type of driven athletes that do CrossFit that lead to the higher rates of injury. We could have a false correlation -- e.g. the real cause is athletes who don't know when to stop, but those are the people most attracted to CrossFit. So it isn't CrossFit that is the cause, but it does correlate with injuries.

Getting back to your first question, if you are a good risk manager/trainer, and you know the MOI for rhabdo, then can generalize to activities (like spinning) that you don't have data for to make an estimate.

Sorry if that was too long! But as Mark Twain said, I don't have time to make it shorter.
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