Is CrossFit Training Safe with Diabetes?
Looking at the latest exercise fad
With all the exercise training fads out there, it can be hard to navigate the landscape with diabetes. The strongest exercise fad at the moment is CrossFit training. The question is whether it is safe and advisable for people with diabetes.
CrossFit training is a trademarked strength and conditioning program consisting mainly of a mix of aerobic exercise, gymnastics (body weight exercises), and Olympic weight lifting. Its programming is decentralized, but its general methodology is used by thousands of private affiliated gyms. CrossFit, Inc., licenses the name to gyms for an annual fee and certifies trainers, but the actual programs vary greatly from site to site.
Although the workouts are quite intense, a young and healthy person with diabetes should be able to engage in CrossFit training without worrying excessively about the transient rise in blood glucose levels that it may cause. To control blood glucose, simply approach it like any other intense workout, which can cause elevations in blood glucose even in people without diabetes. Insulin users will have to check their blood glucose frequently and adjust insulin doses to have adequate amounts in their bodies during and following workouts. As a side note, doing some easy cardio exercise after an intense workout can help lower blood glucose naturally in everyone. Also, exercisers will typically experience a bigger rise in the early morning compared to doing the same exact training later in the day (due to having more glucose-raising hormones and less insulin on board in the morning, pre-breakfast). Watch out for later onset hypoglycemia (low blood glucose) following any intense exercise, though.
CrossFit does have some other physical risks as well. The risk of injury from some of its exercises outweighs their benefits when they are performed with poor form in timed workouts (although there are similar risks from doing other high-intensity programs incorrectly). One concern in particular is that CrossFit's online community enables anyone to follow the program without proper guidance, increasing the risk of using improper form or technique that leads to injury. I personally know of at least one young man who caused significant damage to the cartilage in both of his knees doing it inappropriately. When undertaken correctly, CrossFit is not inherently bad or ineffective, but especially when you're staring such a program, you may do too much because you can't tell the difference between simply getting a good workout and training to failure.
By way of example, a young woman who was a physical therapist and a regular CrossFit participant awoke the morning after a particularly grueling session consisting of hundreds of reps of arm exercises and found she could not bend her elbows. She was shortly thereafter diagnosed in the emergency room with rhabdomyolysis (rhabdo for short), a condition in which damaged skeletal muscle tissue breaks down rapidly. Many other reports of rhabdo related to CrossFit training have surfaced. Strenuous exercise is a known—albeit rare—cause of rhabdo, which can cause kidney failure when the breakdown products of damaged muscle cells (myoglobin) are released into the bloodstream. Severe symptoms like muscle pain, vomiting, and confusion are indicative of greater muscle damage and possible kidney failure. Severe muscle pain and dark colored urine require immediate medical treatment.
One last point is that for older individuals who have been mostly sedentary, starting out with CrossFit training is not advisable for many reasons. It's important to initiate being more active at a more moderate workout level and progress over time to harder workouts. Starting out too hard can lead to joint and other overuse injuries and can also be demotivating (since it is not necessarily fun). An excessive exercise intensity, getting injured, and not having fun are three primary reasons why people drop out of their new exercise programs. Finally, if you have been sedentary and have diabetes, it's advisable to see your doctor for a checkup before you do any really intense exercise. If you choose a more moderate workout level (as advised), however, you can get started being more active today!
As a leading expert on diabetes and exercise, I recently put my extensive knowledge to use in founding a new information web site called Diabetes Motion (www.diabetesmotion.com), the mission of which is to provide practical guidance about blood glucose management to anyone who wants or needs to be active with diabetes as an added variable. Please visit that site and my own (www.shericolberg.com) for more useful information about being active with diabetes.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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