This is being worked into a more formal, less first-person document. But I wanted to share a story and perspective.
I want to take a moment
and talk about the way we work as Crossfit athletes, about our goals, and ask
some hard questions about what could be done for these athletes to push even
harder, to higher levels. I would also like to discuss, or at least broach the
subject of the notion that some of this might constitute “doping.”
It should come as no
surprise to people that the Crossfit “Metcon” – metabolic conditioning – is
perhaps one of the most demanding activities we ask of athletes in sport today.
It is this tough because it is designed to be tough; Greg Glassman talks about
the multiple energy pathways available to athletes: the anaerobic phosphagen and
glycolytic cycle, and the aerobic oxidative phosphorylation cycle. Glassman
says in numerous lectures that the goal of Crossfit is to increase an athlete’s
“work capacity across broad time and modal domains.” That is to say, to take an
athlete and extend their ability to work – and by work, Glassman uses a very
specific definition, a unit of power achieved, whether it’s moving one hundred
pounds two feet, or twenty pounds five hundred feet, it’s a measurable,
objective, consistent unit of work – across domains that they are inherently
not suited to doing.
So yesterday after I came
home from my workout, my triceps and my upper pectorals and my deltoids had for
all intents and purposes quit working; it was not a function of pain or
stiffness, really, they were just numb, and this is something we commonly get
from eccentric muscle contractions. The workout in question had been lots of
overhead walking lunges with a 45-lb plate and hand-release pushups and I think
the count wound up being on the order of 150 of each.
As I came in the door, I
grabbed a pint of chocolate milk which is my recovery beverage, and inhaled it
as quickly as I could and felt just a little bit better. I then realized
quickly that it wasn’t going to be enough and I had a second pint, so that’s
about a litre of chocolate milk, and about 800 calories, fifty grams of sugar.
Almost immediately, lay
down on the carpet in the entrance to my apartment because my legs were
exhausted and my arms couldn’t really hold me up, and I was not strong enough
to undress and get in bed or go stand in the shower. And so I sat on my side
for a moment on the carpet, and it hurt less to turn over and I fell asleep on
my face on the carpet, in the living room.
Apparently I started
dozing and my wife noticed and said, go get in bed, and I went, and did that.
Over about an hour or
ninety minutes, I stayed in bed and tried to recover a bit but ultimately the
numbness – it’s not a numbness, if you’ve ever done this sort of exercise, it’s
not a numbness so much as a lack of action in the muscle; you don’t get the
feedback that the muscle has been pushed out when you extend it. When you
contract the muscle, it feels like the limb moves, but you don’t actually feel
like the muscle has done anything. It’s almost as if there’s a neurological
disconnect, things still sort of work, and there’s not a lot of pain involved,
but things are very weak and there’s very little ability to bear any weight.
Two hours into this, I
realized that I needed to be pushing fluids, that I was quite possibly in
shock, and that I wasn’t physically capable of putting fluids or calories into
my body rapidly enough to compensate for the – I hesitate to use the word
damage – but the work that I had accomplished: the calories burned, the muscle
tissues torn down, the water lost through sweat and urination, the blood flow
change from my extremeties to then digesting this milk ‘meal’, to ostensibly some
blood pooling then on my back in bed. I realized I was in a very bad way in
terms of being able to recover in that kind of a position, in that kind of
condition.
I needed to be upright,
walking around, breathing properly, getting circulation, massaging those
muscles – we talk about myofascial release and certainly mental stimulus, even
if it was something as simple as conversation or reading might have made me
more alert. But effectively what happened was the workout was so thoroughly
grueling that afterwards I was left physically unable to replenish or nourish,
or effectively repair what I had done to myself.
And so the thought
occurred to me, why is it that there is a social and indeed a legal stigma to a
medical doctor giving someone like me in a condition like that IV fluids? If I
had gone to an emergency room in shock and had just run a marathon for the
first time, they’d have given me a liter of saline and possibly a liter of
dextrose, and sat and watched me. The difference is here, this workout I do
sometimes six days a week.
I find myself wondering
what it is that’s actually wrong with the notion of using something like IV
fluids to recover when you have worked your body beyond the point when you can
ingest water through your face to the point you are healthy again. The second
thought that occurred was, what specifically is wrong with palliative care,
with analgesic care at this point? We know that somebody who has gone and
exercised this hard, and gone through this much activity, is in pain, is at least having a little bit of mental difficulty
from the event, and is most likely having an amount of shock. And it occurred
to me, what would be wrong with, in that condition, giving me, as a patient, a
litre of saline, a litre of dextrose, and a grain of Demerol or some small
token dosage of dilaudid.
Now the major difference
here between me and a trauma patient from a car accident who might indeed have
the same exact injuries – torn muscle fibers, dehydrated, in shock, disoriented
– the difference is that I did it to myself. And when somebody has it done to
them, it’s okay to treat them with full medical rigor. So I find myself
wondering, why it is we have this stigma, and I wonder if there’s room in
society at some point with the medical profession to offer as part of what
we’re starting to see as “concierge medicine” and agreement where the doctor
understands an athlete is trying to be the best athlete they can be and push
those physical boundaries we’re finding we can now push past – that you are working
to be the fittest that you can possibly be – and I know that you are capable of
out-working your body’s ability to absorb oxygen or water, so what I want you
to do is I am going to let you free-breathe oxygen and I’m going to give you IV
fluids and dextrose because your body needs
those carbs and if you’re having minor muscle cramps I’m going to give you a
little bit of an analgesic and you’re in the same condition as somebody who
might have, for example, crush syndrome.
I really wonder, why there
would be such a stigma with that. Because it seems to me the two are very
similar. I have to wonder. When we look at the reasons, specifically with
Crossfit, and I hate to pick on Crossfit as an example of people who are doing
things that are “Forging Elite Fitness” and all these sad clichés that we throw
around because there are elite athletes in every sport. But in Crossfit in
particular, we have athletes who can consistently induce – not that they’ve
shoved a finger down their throat – but they can work hard enough that they
vomit because they cannot absorb oxygen rapidly enough through their lungs. We
have athletes who have learned to work through the mental pain and anguish that
says “your muscles are quitting,” and they get rhabdomyalosis. We have athletes
who exceed their body’s abilities to replenish water through their mouths, and
they pass out from dehydration and wind up in infirmary tents being treated by
medical professionals.
So why is it, then, there
would be such a stigma with treating athletes who work hard enough to tax all
their biological systems, and effectively, augment those systems with
technology? When we create a protein supplement and allow an athlete to get 500
grams of whey protein in 250ml of water, that’s not something they’d normally
be able to do; we’re able to do all kinds of things technologically for
athletes, and yet we draw the line at the needle. And for me, that seems like
an arbitrary place to draw a line and I am sure that the vast majority of the
community disagrees with me, but I would be interested in hearing cogent
disagreement.
Why is it not okay to IV
rehydrate an athlete who has exceeded their body’s ability to rehydrate? Why is
it not okay to take an athlete and put oxygen on them after an event? Why is it
not okay to given an athlete dilaudid who has done enough eccentric muscle
contractions that they have burned 25 or 100 grams of muscle fiber and they are
in pain, when it is okay for anybody
else who has sustained those same injuries involuntarily through trauma?
