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Thursday, October 27, 2016

Sports Injury Management/Prevention 'Pearls'



The conclusion...
PATELLA TENDONITIS,PT
how to treat,manage and prevent
part 2 of 2

 Compliance. That's key to executing any prevention and management program especially when you THINK you don't need to until you NEED to!However, my techniques are SO easy  and simple to do, it would be hard NOT to comply! Not only that, they work, IF you work them! My years of treating knee issues has proven this to be true time and time again.

PREVENTION & MANAGEMENT. At 30 deg. of knee flexion [non weight bearing ie sitting in chair] knee capsular pressure is low. However, full flexion(bending) or extension(straightening) increases pressure.
 That's why with most knee injuries the 'sweet' spot' most comfortable is 30 deg. I mention this because the following technique requires that sweet spot. Let us begin...

The leg extension machine [fig. 1] is one of my fave in my arsenal of treating and preventing PT. Even better if you can set the moving arm of the machine at 30 deg. [fig.2]
                                                                                                                         
Fig 1

 [Fig 2] arm set at 30 deg.
Next, place both legs onto arm of extension[Fig 3a & 3b] Set the weight moderate, no more than 40#. If this causes discomfort, decrease weight. It is not uncommon to feel some MILD discomfort; in fact, its very normal.  

Fig 3a


 Fig 3b


Next, extend legs fully [fig 3b] then lower weight with ONE leg[Fig 4]. Extend again, but lower with other leg. Before you lower leg, though, be sure you are able to sustain extension with that one leg for at least 2 seconds before lowering it. Do 10 per leg. 1 set is all that is needed. Calibrate weight according to comfort level. This is NOT a quadriceps strength training program, but a tendon strength training program!

 Fig 4
WHY THIS TECHNIQUE WORKS: I learned some time ago during my studies that when a tissue inflames it scares. When it 
scares, the scaring is laid down on the tissue in a 'random' fashion like a box of spilled match sticks. This causes restrictions in the tendon that increases discomfort. Also, almost forgot to mention, there is a bursa (fluid filled sac) that rest between the tibia and tendon [fig 5.].
This can be a secondary symptom of PT which can be just as painful. It used to be, and still is called 'jumpers knee' because it was common in basketball players.

But now, ANY athlete can get it except swimmers because they don't have to deal with the same forces in water that exists when playing on land. 
What this technique is is an eccentric technique we use in therapy to get the scare tissue to align with the direction of the injured tissue! thus, allowing healing to take place. 

The tendon is inflamed from an offending activity of excessive loading.  These loads surpass the tensile capacity of the tendon, thus inflammation, combined with little restoration and recovery time, and NO prevention,is a perfect storm for tendonitis.
Fig 5



CRYOMASSAGE COMBINED WITH CRYOSTRETCH.
 'Old school is STILL the BEST school!'

Lastly, one of the most popular modalities for treating injuries is ice. However, when it comes to PT even the application of the ice is important! The idea of this technique is to put the tendon in a 'stretched' position. When you sit, the tendon is elongated. This is the best position for icing(see below). You only need to move the ice in a circular pattern for no more than 2-5 minutes. 'Thats all?' you say? 'What about the 20 minutes'? This is true if the tissue you are icing is deep under layer layers of fat and other tissue; it takes time, 20 or more minutes for the cold to have its affect. The patella tendon is very near the surface, thus less ice time



Sunday, October 23, 2016

Sports Injury/Prevention 'Pearls'
 from 
2x MENS JOURNAL TOP 100 TRAINERS IN AMERICA

What REALLY is patella tendonitis?
The definition, prevention, treatment and management
PART 1 of  2




Patella tendonitis ('itis' means inflammation) is a very common injury that can ruin just about, well, EVERYTHING!:running, stairs, squatting, kneeling on a floor. The patella [fig. 1], is covered with a fibrous connective tissue which is an extension of the patella tendon, above the knee cap. [fig.2]. Attached to it are the powerful quadriceps muscle group. Combined, they provide a very powerful mechanism that helps in 'deceleration' of knee flexion e.g. when the foot fits the ground. The patella is actually vibrating very fast due to the intense contraction of the quadriceps  to keep the patella in place. Awesome.
Fig 1
 Fig 2
THE PROBLEM: However, over a short time, without preventive strategies, the tendon[fig. 3] can suffer minor tears. The tendon does have a blood supply. When the tendon tears, it inflames and at first seems somewhat innocuous until you start reaching for ice packs, knee straps, knee braces, topical agents, limping etc.
Fig 3
WHY: Remember when I mentioned the quadriceps muscle and its powerful contraction that exerts this awesome force, technically 'limp torque', through the patella? Well every time you take a step this exerts an eccentric load on the patella. Think of this moment as 'putting on the brakes'. Well brakes do wear out. In this case, the patella tendon is the brake! Now add hundreds of cycles of running, squatting, jumping{really the landing] the tendon ultimately suffers classic overuse symptoms.

CAUTION: The scope of this topic is confined to the patella tendon and one of many conditions that can exists with overuse. There are multitudes of differential diagnosis that should be ruled out or you risk implementing a treatment protocol that is contract-indicated(shouldn't do!). So unless you have been properly diagnosed, whether its through WEB MD or an actual health care professional! don't perform the strategies I will be outlining in the coming blogs on this topic. The good news though that if you live in the area I would be glad to perform an assessment to determine if you have 'true' patella tendonitis.


COMING UP later in the week!..
PART 2
 A few simple methods to prevent and manage patella tendonitis that will surprise you!
Don't miss it!

Monday, October 17, 2016


FEET DON'T FAIL ME NOW!

Ladies and gentleman, introducing 'your' feet. I just wanted to shift gears and address the hygiene of ...the feet. Yes. The feet. I 'm always giving out training and stretching advice, yet, I didn't want to talk about that stuff today. When I was getting out of the shower yesterday, and I began my post shower ritual of feet maintenance, I was contemplating what to blog about. Boom! Now before you go off and call me a diva or metro-sexual let me explain: Feet are sensitive and are prone to not only structural(ligament, tendon and bone) wear and tear, but skin wear and tear. So I thought I'd share my strategy on taking better care of your 'dogs'!:

  • TEA TREE OIL: this has several other herbal oils in it that provide anti-fungal properties. Great for preventing toe fungus and athletes foot. I use after every shower. Works great!
  • SPT PAIN RELIEF: This is an 'outlier' and has NOTHING to do with foot maintenance. However, anyone involved in sports, or weight training should have this. In my, almost 3 decades in the treatment, prevention and management of sport related injuries SPT hs proven to be  the most effective topical for acute and chronic 'itis'es ie. tendonitis, joint capsulitis , and bursitis I've come across, and there have been many. But the results are quite impressive, so impressive I had to share it with you!
  • CALLOUS CREAM & FILE: after a shower or bath I file my hard callouses,( which can get uncomfortable and at times form blisters) then apply cream. Magical!
  • NAIL CLIPPERS: self explanatory, but if you clip the big toe nail to short you risk getting   'paronychia' which is the inflammation of the cuticle where the nail grows into the cuticle. Ouch! Sometimes this has to be treated with antibiotics.
That's it. Hope you found these feet tips helpful!

Thursday, October 6, 2016



 TRAIN DIFFERENT: Raw & UnLeaSHEd!!
Learn by watching

I will be showcasing my years(almost 30) of creating training circuits and combinations called MFC, 'my fave combo'.Very effective and challenging.
I hope you enjoy them as much as I enjoyed teaching them. 
NOTE: ALL footage is unedited and are recorded during actual training sessions.

Friday, July 1, 2016




"DUDE look like a lady"
Ladies! worried about getting 'bulky' from weight training? That's so 80's!

I don't wanna look all bulky and s#$t"' I hear ya mam!' Most women are afraid of weight training because of the fear of looking 'dude' like: bulky or muscular. Well, that can happen if you are not properly trained. This became more prominent 'side effect' with Crossfit-mania.;the initiation of Olympic lifts created the classic 'girth' look of a powerlifter for most females.

I am here to tell you that in order to avoid that is to reduce the reliance on compound movements like those Olympic lifts that can cause that undesired look of bulky. Weigh training is an excellent method for creating a lean physique. Muscle is metabolically active when we are just sitting! So it is imperative to gain some muscle and you can do that without jeopardizing the feminine physique. 

Training should comprise multiple training environments that engage all 3 planes of motion. Those motions can be created with medicine matrixes, kettlebell series, sports performance drills involving agility(see 'BreathTakrz), anaerobic/metabolic circuits, holistic sets, boxing combine with resistance training etc I mean the list is endless. The point I am making is engage all movement that involves, lifting, throwing, jumping,running, timed circuits,pulling, flipping,...and I promise you you will not look BULKY, but fit with a hint of muscularity without sacrificing the physical features that enhance the feminine physique.

Wednesday, June 15, 2016




WTF!?...WHY YOU RUNNING IN THIS HEAT? AND DEFINING DEHYDRATION

Come on people!... This just in:FLASH: you cannot lose fat running in 100 deg heat!!
Man, does it drive me crazy seeing people running in this oppressive heat! There is nothing but BAD that comes of this and I will explain in brief, yet, vivid details what is happening to the blood....as you boil it by driving up core temperatures to dangerous levels. Folks, heat does not  burn off fat!!! It boils at 360 degrees!

The purpose of sweating is to cool the body. It does this by dilating the blood vessels just under the skin so the blood can get to the surface to cool off. That 'blush' you see on most people is the blood cooling the surface via evaporation. This is very important to prevent overheating which can lead to heat stroke where you stop sweating, but are hot to the touch. This is NOT GOOD. Most of the water from sweating comes from the blood. Lets say you are out for a run and your sweating like crazy. The heart begins to pump harder to cool the other organs but as you begin to exercise vigorously the blood gets warm which ultimately starts the sweating mechanism.


Now the sweat collecting on the skin now gets cooled through evaporation. So as soon as sweat hits the skin surface the blood gets cooled; you feel this  when there is no humidity and the sweat can evaporate pretty easy. However, when the humidity is high the evaporation rate slows down due to the excess moisture already in the air making it harder for the sweat, now sitting on the body, to evaporate. Get the picture?!

So lets say that you keep running, pretty soon the blood gets 'sludgy' because you continue to sweat as more water is drawn from the blood in an attempt to cool the body. Nevertheless, the body core is increasing and as the blood goes to the lungs to pick up oxygen, it does not deliver it to the muscles efficiently enough. Next thing you know you are feeling  clumsy and disoriented. STOP. This is 'true' dehydration! To ensure that blood gets to the muscles in your dehydrated state the flow of blood to the skin decreases and sweating diminishes in order to conserve water. This drives up the body core temp which leads to the dreaded heat exhaustion or heat stroke.

Unfortunately, this chain of events happens often during August when football teams, especially,gather to begin preseason training. Often kids come to these preseason practices overweight and outta shape. So they will attempt to cut weight by 'layering' clothes to increase sweat output thinking it will cause weight loss. True: weight loss in water form NOT fat form!! Sadly, the result has been death in some cases.

My recommendation to prevent the deleterious of effect of training in the heat is simple. DON'T RUN WHEN IT IS 95+ DEGREES AND THE HUMIDITY IS HIGH! Duh!! There is NO evidence to support this training method. N-O-N-E. Now before you think I am an alarmist I want to stress I am talking about the brutal heat wave washing over the city these past few weeks. Otherwise, unless you will be competing in arid conditions and you must acclimate,then by all means go for it. For most of us though it is senseless. Swim laps in a pool if you want to do cardio!  if you have read my other blogs, I under rate running as the only method of weight loss. Instead, go to an air conditioned gym and pump some iron to maintain good core posture and lower extremity stability.


*SKIPS TIPS FOR STAYING COOL!

UPDATE TRAINING WEAR: Cotton is dead!!! Buy dri-fit. Dri-fit is a 'wicking' fabric that keeps the body cool. I am still amazed at the number of clients that still wear cotton. We take notice when we see they are struggling through a session especially if it is their 4 one. I will often take note of what they have on. Often times it is layered!! two cotton shirts and it is soaked with sweat! Remember we want the body cooled by the sweat via evaporation. Dri-fit facilitates that and can be found in any sport goods store ie. Dicks, Dunhams, ect.

ACCLIMATE! ACCLIMATE! ACCLIMATE!: I only use air conditioning at home. No matter how hot it is I don't turn on the AC in my car, unless my darling wife is with me! Don't spend too much time insulated from this climate then boldly go out and train in it! I am suggesting you try not using the car AC ALL the time.  I encourage our young athletes to do this because I know they are inside all day in AC.  My son has been doing this since he started playing sports and he is glad he does. He often sees his lacrosse teammates having a hard time adjusting due to this 'insulation' effect and understands the benefit and adaptive effects of acclimating. You to should 'feel' the heat and when you do this you will be surprised how cool 85 degrees is from 102 degrees. ACCLIMATE!!!

HYPERHYDRATION AND EUHYDRATION: The first term, hyperhydration is consuming liquids before training. I suggest 1 hour before training to consume a 160z gatorade type drink.  Drink, euhydrate, throughtout your training every 15 minutes or depending on conditions. This is highly recommended especially if you will be training more than 90 minutes. If you read my previous blog then you know what to consume after training! If you are training less than one hour then water is sufficient. There is water in food too, so you are getting your share hydration there especially if your training diet is solid.

WATER FOR DOUSING: I have what I call a 'hot head'bottle for clients who need to cool off quick. We have a water spicket on our building. We simply have our client fill it (water bottle) and douse their heads with it. Great relief. Sometimes better than the cold water for instant cooling! This method increases cooling due to evaporation. So if you are running take enough to consume and douse!!

SAFETY ROUTE: If you go out at least make the destination a 'cooling station' or safety route. It can be the library for instance where you can literally chill and get water or my fave, a 7-11store  where its always a brisk 50 deg in the summer time! Damnn its chilly in there..and don't get me started on the Slurpee's..

DON'T GO OUT: Common sense is under rated so I m not going to say much here.
*if you are experienced this may not matter to you. More for the neophyte.

Follow these tips and you will find the challenge of running in this heat not  so insurmountable. However, my recommendation is to redesign your training day to stay inside or go early in a.m. or later p.m. 







Thursday, May 26, 2016

TRAINING SORENESS: 
  SIDE EFFECT OR 
  OBJECTIVE?  
A long time ago , I was asked this question "I have been working out for a while and I am not getting sore anymore. What can I do to get that soreness?"I responded 'Soreness is a side effect, not an objective.' His training was boring and he had simply platueaed so I suggested a few training ideas. Two weeks later I saw him again and he said he was really sore and wanted to know how to get rid of the soreness! 

Training soreness is simply minor muscle damage at the microscopic level. If you were to look at a muscle fiber after an intense training session you would see strands of fiber that look like frayed rope. The muscle, of course, heals and during the healing process that takes approximately 48 hours; you wake up with a mild soreness like you've been through a MMA bout! Well, maybe not that severe, but you get the idea. We call this DOMS: delayed onset of muscle soreness. Is DOMS an objective? No! it is a side effect of training. When you introduce a 'new' stress into your training program, expect it. 

The remedy for this is to take a 'chilly' shower to reduce the inflammation that occurs from training. I know this doesn't sound inviting but it is effective. Another approach is a massage to loosen the scaring that occurs from the muscle damage. The scaring takes place during the repair process and causes that stiffness you feel as you try to regain functional normalcy! I highly recommend you get back to training at a mild to moderate intensity when you have DOMS to encourage mobility. This 'stretches' the muscle and reduces the DOMS symptoms. The recovery process should only take a day or two at the most then you can return to your normal training intensity.

Tuesday, May 24, 2016



BE PREPARED!
The one piece of equipment I have but hope to never use

I have an AED,automatic external defibrillator, and a first aid kit. S%^t can happen and get real real quick!being a sports medicine professional on the field and in the clinic, you NEVER want to be Unprepared. I was taught during my clinical internships that just because its uncommon doesn't mean it CAN'T happen! I had  these experiences during my clinical years and as a business owner, but I was PREPARED.

My intent is not to get too heavy and serious on this topic its just as I was checking first aid supplies and the battery and pads on the AED, I was inspired to write this. That's all. I hope to never have to use my AED but as they say better to have it and not need it, than to need it and NOT have it"  

Monday, May 16, 2016

 WHY THE 'WARM UP' IS IMPORTANT

AT BSI we, of course, stress the 'warm-up' before we start our training. IF you are not a client, our training is multifaceted; meaning the sessions involve multiple stations of power, coordination and stamina demands This is how I have been training clients for the past 28 years. Our warm up, like our training is functional based. This is based on my years in the treatment, assessment and management of sport related injuries. Besides the 'loosening' up feeling you get from warming up, did you know there are interesting things happening in the blood and to the nervous system when you do this? Check it out

You ever wonder why you get winded the first few moments of a work out? Most likely because you did not warm up! The blood contains, fat, plasma, red cells, white cells, natural killer cells, sugars  etc; it is an impressive concoction that it is truly  awesome when you consider the function of each blood component. Anyhow, there is what is called hemoglobin, (HG) that circulates in the blood. The HG carries oxygen, (O2) throughout the blood stream. Now this is where the warm up gets interesting: When you begin to do the, treadmill, Versa climber, Xbike, jump rope, etc the HG 'gives up' its O2 so it, the O2, can get shuttled to the muscle where it gets used to prepare the muscle for the intense work ahead.  If the HG does not give up its O2 then there is no oxygenated blood for the muscle and you feel yourself breathing harder than normal. When you jump right into an activity the muscles are actually 'starved' of O2 because the muscles have not warmed up enough.  

Another interesting thing happens in the muscles during a warm up. The nervous system sends volley of impulses to [afferent] and away [efferent] from the brain all day. When you begin to warm up, these impulses speed up and andrenaline begins to flow, the muscle and bone joint nerve endings prepare to distribute loads that are then transmitted to the tendon which is attached to bone then the session begins!Of course I have simplified things a bit, but basically that is what is happening. So if you want to reduce your risk of injury: WARM UP THE BSI WAY!!!!!

Perhaps the most important feature of a warmed up muscle is its capacity to burn fat more efficiently than a cold muscle. Fat is released during stress. The stress of sudden intense exercises deluges the blood stream with fatty acids. A cold muscle won't 'burn' the fat and therefore that fat ends up in places it is not wanted: the arteries!

So in summary, just know a warm-up is important because:

  • Provides O2 to muscle 
  • Enhances coordination
  • Reduces risk of injury 
  • Speeds up combustion of fatty acids and glucose




Tuesday, May 10, 2016



DISEASE OF EXCELLENCE
Train! Train! Train! Speed. Power. Quickness....Ouch!!

We are trained professionals in the science of sports performance and injury prevention. Sometimes things go wrong and injuries happen. It is no doubt that all sports has its own inherent quality to provoke an injury. From the muscle tear to the dreaded ACL tear, the body does have its limitations. My mentor put it bluntly when I did my first clinical internship many years ago while performing my first shoulder exam of a professional baseball player. He said: "Skip. The body is NOT made for sport!"I thought, 'how true.'

Injuries happen at all levels of competition no mater how 'talented' you are. The stress and frequency of training should increase as you become stronger. The amplitude, loads, intensity etc should all become more demanding BUT, this must be calibrated properly to reduce the risk of injury.    The bodies tissue i.e. ligaments, tendons, cartilage and muscle have certain tensile capacities that breach or tear when training loads are chronically excessive.

Disease of excellence then are injuries that occur from intense demands on a complex movement system: the human body. When you watch sports that require quick decision making, speed, acceleration, deceleration, jumping, colliding, agility there are complex neurological relay systems that happen so fast its incomprehensible.  Muscles are firing at incredible speeds. Volitional responses occur within milliseconds.  But when it goes wrong you may "wonder how does a high level professional athlete let alone a little league, high school or college athlete get hurt?"  There are several factors that result in injury: 1. Poor or outdated training methodology, 2. Ignoring signs and symptoms, 3. Date injury management techniques, and 4. Lack of or no training periodization.

Poor or outdated training methodology.  Whether you know it or not, training and conditioning is a science. Often times it appears that all you are doing is just working hard with no real purpose besides sweating! However, our training program is designed to provide optimal intensity that will provoke a training stimulus to make you stronger and enhance calorie combustion. Unfortunately, their are armatures who think that training has not evolved at all and are still doing the same training methods done when they were in high school!  Little do they know that those dated techniques predispose them to injuries,  decrease in power output and the dreaded training plateau!

Ignoring signs and symptoms. I'm guilty of it too. You feel a little 'something' in the shoulder, ankle or knee but you brush it off as a training 'pain'. Then it gets worse. So what do you do? Stop the offending exercise until the pain goes away then with a logic that is truly dizzying you go BACK to the thing that hurt you in the first place!! This is the same guy/gal who is compelled by the body building or boot camp mentality that the pain is normal...Huh?! Look. Its not normal. Muscle soreness is normal. NOT pain that last more than two weeks! Such training programs need a serious overhaul, which is what we specialize in. When I evaluate an injury caused by training I always have the subject demonstrate 'their' technique. 99% of the time the technique is either flawed or out dated. Our training programs are challenging, innovative and progressive but never flawed or out dated. Like we  say with a grain of truth 'don't try this at home'!!



Dated injury management techniques. Epsom salts. Magnets. Oxygenated waters. The list is endless.   So are placebos! IF YOU BELIEVE IT WORKS, IT WILL WORK!! Nevertheless, it does not address the CAUSE!  We encourage our clients to inform us when they suffer what I like to call 'snags'(minor soft tissue injury) caused by a workout that was too aggressive. We simply 're-calibrate' the training session to promote recovery via specific rehab techniques that we design.  We have vast experience in the treatment, management and treatment of orthopedic sport related injuries. The key is managing the intensity and duration of the workload. But more importantly getting an accurate assessment of the problem before proceed to the point of no return!

No training periodization. Periodization simply means altering training frequency, duration and intensity throughout the year. Most don't do this and by combining all of the above scenarios this is a   'perfect storm' for an injury to occur. It is easy to periodize your training simply by adjusting variables that are in your control such as training days, active recovery and regulating training durations.

We recommend that if you are involved in ANY high volme/amplitude type training  it is a good idea to mix up the frequency of your training week. So if you train 4 days a week and take classes 2 days a week thats' 6 training days. We suggest you do what is called a two day split: Train 2 days in a row-REST third day-train another 2 days-REST for two days. If this sounds sacrilegious to YOU then this blog is for you!

Hopefully, this gives you insight on how to prevent injuries and still maintain a intense training environment. Injuries will happen when you push your body to the limit. The key is knowing how to manage those injuries, prevent them in the first place and more importantly knowing when you need to upgrade your current training regiment.


"Muscles soreness is a side effect. Not an objective"
-Skip Bunton

Saturday, May 7, 2016

               
 BSI 'Throw back' classic
(circ 2012)

FINAL WORD ON CROSSFIT
A few weeks ago a very unfortunate incident took place in a CF affiliates facility. From what I gathered from the story a member was performing the Snatch. a high level Olympic lift. Apparently, during the descent the bar velocity took him into extension, and he did not recover in time and the young man suffered an SCI, spinal cord injury. At time of this blog I do not know the condition of this unfortunate soul, but the BSL staff wishes him all the support he is going to need in the future. I have worked with SCI and it is a long and challenging road to a 'new' way of functioning in the world. Not just physically, but emotionally. It has collateral impact on those close to him. So again I send him my sincere prayers for his arduous journey ahead.

Now lets begin.....

I LIKE the CF business model
 Mr.Glassman, founder and creator of CF has some salient features of his business model that I like and are commendable: 1. He does not take a percentage from affiliate profits. And he could. He leaves a lot of money of on the table by doing this. 2. He has resisted being bought out because he truly believes he can change the world, and he has started to.  Then that is where I stop being a fan of  CF.  Granted, he cannot be responsible for every affiliate but he can introduce wider scope of training layers to reduce preventable injuries and increase affiliates knowledge base the importance of training periodization and alternate high intensity environments in his workshops. Predictable training schemes lead to plateaus and injuries.

The founder, Greg Glassman
Before I began this article I perused several articles of the founder, Greg Glassman, I did not find any evidence of formal education. However, in 1974 at 18 he became a gymnastics coach at the local YMCA in Santa Cruz, CA. Then he started training celebrity/athlete clientele finding success with high intensity workout. He realized that bodybuilding and endurance programs were lacking. 1995 he is hired by Santa Cruz police department. The rest is history. I mention his background to share with you that he really had no formal preparation. He just 'altered'  intensity by omitting the rest period that most bodybuilders take and added weight training to endurance runners.


TABATA METHOD
Now, I wanted to wait till the dust settled to say a few words about this. CF has come under fire since its inception. The premise, not new, is to move through circuits of techniques in a structured amount of time and pre-established rep range. Nothing new there. Technically called a metabolic circuit or Anaerobic training and is a common and established practice in sports performance and general fitness. The research as far back as the 70's shows this. Just look at Olympic athlete training programs.  Nevertheless, Mr. Tabata research is note worthy but not ground breaking. He spent two years in Norway and a year in the United States at Washington Univ. in St. Louis. (this is the same university doing ground breaking with in SCI creating unique muscle stimulation units helping the paralyzed walk). He says he learned a number of analysis techniques there. At the time the head coach of a speed skating team in Japan had developed a training technique where the athletes would exercise in short bursts of high intensity and Tabata was asked to analyze the effectiveness of this program. The name of the coach was Mr. Koichi. My Tabata's own admission it was the coaches idea, not his.

BEFORE THE CRAZE
 This approach of short burst of work with limited rest is called interval work and has been around for as long as I can remember. The problem was, at the time, and even now, that training anaerobically is difficult. Heart rates push the needle at max levels. It was a very common practice with high performing athletes. If you were an athlete or are an athlete then you know about 'suicides' and combination training if you played any sport.

The techniques that CF employs are not new. What vexing are the people who 'thought' they knew how to train, find it revolutionary. I can say this, the marketing is the only thing revolutionary about it. The techniques are classic: Olympic lifts, plyometerics, ergometer [rowing], medicine ball and repeat under specified time with some gymnastic stunts that why novel are not always practical. When I was in graduate school they were simply called 'metabolic circuits'. It was a way to achieve an intensity of fitness without spending hours in the gym, a.k.a bodybuilders. Speaking of bodybuilders, Glassman made a comment that 'their' routines were lacking. This is true to an extent. Bodybuilders are not know for their cardio conditioning! However, the professional bodybuilders and even a few novice bodybuilders were doing 'holistic' sets which are simply doing reps to exhaustion per body part and then sprint on treadmill for 30-45 sec. Body building required hours working just about EVERY body part, so time in the gym was like having another job!

EDUCATION V. GOOD EXPERIENCE
The first responsibility of an author is to reference your work. I have read several of the CF Journal writings and he does not reference. Most published works are peer reviewed or 'juried' review. This means that others in the profession read and challenge the validity of the research work. This can be daunting and humbling but it helps refine your ideas, theories and application.  In fact some of the things he says are theory when clinically and in peer reviewed journals have been explained.  

When Glassman talks of injuries its absolutely clear he has no experience or limited education in understanding injury predisposition, functional movement, prevention and management.  I have read many of his articles and have been unable to determine any validity to his approach. In fact in one article done by one 'his' coaches she talks about PNF (proprioceptive neuromuscular facilitation) a technique I have used many times in the clinic. However, what she describes is a simple 'muscle energy'  technique called simply contract-relax as she explains how this improves range. PNF requires manual resistance (someone to apply manual resistance through a range of motion. There are multiple techniques)

 I know with the Internet you can 'school' yourself, but I also have seen ACL reconstructions, and why I am very good at rehabilitation and understanding ACL surgery and its implications, you would not want me doing your ACL reconstruction!. The amount of clinical hours, internships, constant education to stay abreast of current trends in training and conditioning cannot be substituted for 2 day certification. What CF has done is create a culture whereby ANYBODY who thinks they know training just because 'they love to train and they have passion to help others' can get certified with techniques they barely know in a weekend!. Even with that instruction they lack the knowledge to progress a technique or modify it to get the same result with reduced risk.

 DON'T HURT'EM HAMMER!
"If all you got is a hammer than every problem's a nail". CF admits that you are going to get hurt. GREAT! Sign me up. This culture of hardcore, where getting hurt appears to be a badge of honor, is amateurish and dated. Any program is designed to engage multiple training approaches in all levels and intensity. Paramount is the engaging of coordination patterns as new techniques are learned.  Look. You can't argue with results. CF gets results, BUT so do other programs that are just as intense but safer. I have trained former CF and they come in knowing the Olympic lifts, kettle techniques, etc but as soon as I tweak their lift or change tempo by adding another variable to alter anaerobic environments, they realize that they may not be in the best shape. Especially when it comes to learning a new movement pattern.  Also, when these athletes are injured in a CF environment there is no option! What do you do when you suspect knee, hip or shoulder (on the rise due to excessive kips)? Their affiliates will admit there will be injuries and since the unfortunate spinal injury incident, they have blogged about the risk of getting hurt with their program. I just don't subscribe to this lack of accountability. A trainer is hired to not only train but be knowledgeable enough to know when a client has a potential to get hurt.

You can re-calibrate the lift so it reduces the risk of injury yet not sacrifice intensity. Or when a client is injured you should know how to remedy that injury within the boundaries of your knowledge base. Yet, suffering a SCI is unheard of. Every training program should have preventive techniques built in and if injury does occur, you should have a management plan. Could this SCI could have been prevented? Who knows? I know this though. When we are doing advanced lifts, the frequency is not high and we have complimentary lifts to prevent excessive ranges of motion and velocities. Our programs have rigorous elements of multi-planar movements to ensure proper neuromuscular firing, and to exploit weaknesses especially in eccentric postures where a majority of injuries happen.

IT ALL ADDS UP
'I just felt something', 'It just started after the last session', 'I noticed on the 'catch' but then it goes a way, 'Oh this started a year ago but I thought it would get better'.These are common, not all inclusive, complaints when I have evaluated someone who has done CF or CF 'like' workouts. It all adds up. We call these cumulative stress risers. It occurs when tensile capacity of musclotendinous units are comprised by high velocity, abnormal external stresses. This occurs in all levels of lifting and always occurs when one plane of motion is neglected due to excessive loading of other planes.
The clinical term is Hierarchy of Loads. This hierarchy is based off the transmission of forces to certain active and passive anatomical restraint tissues:
SMALL loads: Muscle>Cartilage
MODERATE LOADS: Muscle>cartilage>Tendon
LARGE LOADS: Tendon >BONE
A majority of load induced tissue trauma is caused from abnormal stresses. When I was doing my sports medicine internships, I was told by my instructors "that the body is not made for sport." This is true and can be applied in weight training scenarios. ANY technique will cause tissue damage if amplitude of resistance frequency is high ie. daily high intensities, lack of periodization, poor restoration, limited training scope, lack ability/knowledge to insert a preventive technique into an aggressive program.The CF model seems to ignore this.

Moreover,  there are legions of CF that have gotten results. The reason they get results is because of the high frequency of training days, but there is a cost and that cost is injury and training plateaus. We see former CF members who have suffered injury or are plateaued and want a different challenge. Interestingly enough, when we introduce other patterns of movement, they struggle. The struggle is where that 'plane' of motion has been compromised and it is also the location of injury. In sports performance and sports injury management we can predict injury when teaching technique. We can almost anticipate a tissue 'breach'.


SO?
Judge for yourself. This is not an indictment of Glassman, but a warning and cautionary tale. Glassman has a legion of followers. He has done an extraordinary job of promoting fitness with this method. He deserves the success. But before you judge, be sure that the training of a CF trainer is for you. The training techniques and programs can be intensified by any incompetent trainer to make you 'feel' like you're  getting a good workout. However, be sure you tried other established training facilities that can achieve the same result with reduce injury risk,  provide a greater selection of training modalities,and  can manage your old or current injury. Training is arduous anyway. To get the physique you want takes much work and training time, but DO NOT be lulled into thinking that CF is the only way. It is NOT.

Regarding training athletes, seek out a real professional that is not going to just address power using Olympic lifts, rings and medicine ball. All training is science and the Glassman science is sketchy and elaborates on established sports performance science by giving his 'opinion' on how athletes should train for optimal performance. There are in-depth training methods that go way beyond WOD!


FINALLY

When you're at the top, every body takes a shot at ya. I have not been at the top like CF but for 26 years I have had some things, not so nice, said about my way of training: its controversial and different but it works. So I empathize with Mr. Glassman. The success of CF is undeniable. And in all fairness Mr. Glassman  can't  directly be held responsible for incompetent trainers getting certified under his programs. However, he can revise his program to include a basic preventive/management of training related injuries into the certification process. CF is popular. The techniques are good old school techniques. The intensity is definitely not for everyone and the risk of injury is high. If you have a pre-exsisting injury then proceed with caution;I am not impressed at all with their lack of training modifications or calibration. Any program you enroll in should have a progressive element of ALL the features of fitness established many years ago:
Duration. Intensity. Scope. Complexity. All of these factors can and should be altered to be commensurate with your increasing strength, balance, stability and postural coordination/reaction. I'm sure Glassman knows this: it just needs to be pervasive with his program affiliates.
In the greater scheme of things CF has had its share of criticism. I don't want to be in that pool, however, the techniques are safe but if that's the only tool you got, it will dull pretty quick! CF needs to elevate its training scope beyond the formulaic template it has set out, and make certification more rigorous. Besides I like the competition of a worthy opponent!


ADDENDUM 
Other Metabolic Circuits:
  • Peter Coe regimen

A type of high-intensity interval training with short recovery periods was used in the 1970s by the athletics coach Peter Coe when setting sessions for his son Sebastian Coe. Inspired by the principles propounded by the German coach and university professor Woldemar Gerschler and the Swedish physiologist Per-Olof Astrand, Coe set sessions involving repeated fast 200 metre runs with only 30 seconds recovery between each fast run.[6]
  • Tabata regimen

A version of HIIT was based on a 1996 study[7][8] by Professor Izumi Tabata (田畑 泉) et al. initially involving Olympic speedskaters,[9] uses 20 seconds of ultra-intense exercise (at an intensity of about 170% of VO2max) followed by 10 seconds of rest, repeated continuously for 4 minutes (8 cycles). The exercise was performed on a mechanically braked cycle ergometer. Tabata called this the IE1 protocol.[10] In the original study, athletes using this method trained 4 times per week, plus another day of steady-state training, and obtained gains similar to a group of athletes who did steady state training (70% VO2max) 5 times per week. The steady state group had a higher VO2max at the end (from 52 to 57 mL/(kg•min), but the Tabata group had started lower and gained more overall (from 48 to 55 mL/(kg•min). Also, only the Tabata group had gained anaerobic capacity benefits.
  • Gibala regimen

Professor Martin Gibala and his team at McMaster University in Canada have been researching high-intensity exercise for several years. Their 2009 study on students[11] uses 3 minutes for warming up, then 60 seconds of intense exercise (at 95% of VO2max) followed by 75 seconds of rest, repeated for 8–12 cycles. Subjects using this method trained 3 times per week, and obtained gains similar to what would be expected from subjects who did steady state (50–70% VO2max) training five times per week. While still a demanding form of training, this exercise protocol could be used by the general public with nothing more than an average exercise bike.
Gibala's group published a less intense version of their regimen in a 2011 paper in Medicine & Science in Sports & Exercise. This was intended as a gentler option for sedentary people who had done no exercise for over a year. It included 3 minutes of warm-up, 10 repetitions of 60-second bursts at 60% peak power (80- 95% of heart rate reserve) each followed by 60 seconds of recovery, and then a 5-minute cool-down.[12][13]
  • Timmons regimen

Jamie Timmons, professor of systems biology at the University of Loughborough, is a proponent of a few short bursts of flat-out intensity. In a BBC Horizon programme in February 2012, he put Michael J. Mosley on an exercise bike regimen consisting of three sets of about 2 minutes of gentle pedalling followed by 20 second bursts of cycling at maximum effort. This was done three times a week for a total of 3 minutes of intense exercise per week, plus some warm-up and recovery time. Measurable health benefits were reported, including significantly improved insulin sensitivity.[13]

common CF techniques

Body Weight Exercises


Air squat
Athlete moves from the standing position to a squatting position with the hips below the knees, and back to standing. One-legged air squats are referred to as pistols.

Back extension
Using a GHD machine, the athlete moves from an L-shaped position with the head directly below the pelvis to an extended horizontal position by rolling the back and bringing the head up last.

Box jump
From a standing position on the floor, the athlete jumps and lands with both feet on top of a box, and fully extends before returning to the floor. Typical box heights in inches are 15", 20", 24", and 30".

Burpee
Beginning in a standing position, the athlete drops to the floor with the feet extending backward, contacts the floor with the chest, and then pulls the legs forward, landing in a squatting position before standing up, ending the movement with a small jump.

Handstand push-up
Beginning in a handstand, with the arms straight and (usually) the heels gently resting against a wall, the athlete bends the arms until the head touches the ground, and then pushes back up into a handstand position.

Hip Extension
Using a GHD machine, the athlete moves from an L-shaped position with the head directly below the pelvis to an extended horizontal position by keeping the spine straight and rotating at the hip.

Jump rope
The most common variation in CrossFit is the "double under" in which the jump rope makes two revolutions for each jump.

Knees-to-elbows
Hanging from a bar, starting in an extended position, the athlete raises the knees until they make contact with the elbows.

L-sit
With the body supported on gymnastics rings or parallettes, the athlete holds the feet at or above the level of the hips with the legs straight. This is typically held for a set amount of time.

Lunge
Athlete takes a large step forward, bends the forward knee until the back knee makes contact with the ground, and rises.

Muscle-up
Hanging from gymnastics rings or a bar, the athlete pulls up and over the rings or bar, ending with the arms straight and the hands below the hips. Variations include strict muscle-ups and kipping muscle-ups, in which momentum is created to complete the movement.

Pull-up
Starting from a hanging position with straight arms, the athlete pulls up until the chin is over the bar. Variations include: strict, in which no swinging is allowed; kipping, in which momentum is used to help complete the movement; weighted, in which extra weight is hung from the athlete; chest-to-bar, in which the ending point of the movement is higher, and the chest makes contact with the bar; jumping, in which the legs are used to help propel the athlete upwards; assisted, in which an elastic band allows the movement to be completed with less than full body weight.

Push-up
Starting in a plank position with the arms straight, the athlete lowers until the chest makes contact with the ground, keeping the body straight throughout, and making sure the elbows track straight back instead of out, then pushes back up into the plank position. Variations include weighted push-ups and ring push-ups, in which the hands are supported just above the ground by gymnastics rings.

Ring dip
Starting with the body supported on the rings with straight vertical arms, the athlete bends the arms, lowering the body until the shoulder drops below the elbow, and then straightens the arms. To scale this movement, an athlete may do assisted dips using an elastic band or holding positions of the dip to increase stability and strength.

Rope climb
Starting from the ground, the athlete climbs a rope and touches a point at a designated height, often 15 feet. Variations include no feet, and L-sit, in which the feet are held above the level of the hips during the climb.

Sit-up
Athlete moves from a supine position, with the shoulders on the ground, to a sitting position with the shoulders over the hips. The feet are sometimes anchored. An "ab-mat" is sometimes placed under the lower back.

Toes-to-bar
Hanging from a bar in an extended position, the athlete brings the feet upward until they make contact with the bar.

Distance movements


Rowing
Many workouts include rowing machine distances from 500 meters to 2000 meters, or rowing "for calories".

Running
Typical distances range from 100 meters to 1 mile. Shuttle runs back and forth between marks 10 meters apart are also common.

Swimming
Some affiliate gyms include aquatic distance exercises within workouts.

Movements with weights


Clean
Barbell is (or dumbbells are) lifted from the ground to a "rack position" in front of the athlete's neck. Athlete ends in a standing position. In a squat clean the athlete receives the bar in a squatting position and stands to finish the lift. In a power clean, the athlete receives the bar in any position that is above a parallel squat.

Deadlift
Barbell is lifted from the ground, making sure to drive with the legs and glutes, until the athlete reaches an upright standing position.

Kettlebell swing
A kettlebell is swung from between the legs to eye level (Russian) or overhead (American). The kettlebell swing can be used both as an aerobic and anaerobic exercise.

Press
Barbell is moved from the "rack position" to the overhead position. In a strict press (also called a shoulder press), or military press (in which the feet are together), the lower body remains stationary. In a push press, the bar is "jumped" off the body using a "dip and drive" motion. A push jerk is like a push press, but with a re-bend of the knees to allow the athlete to drop under the bar and receive it with straight arms. A split jerk is like a push jerk, but one leg goes forward and the other backward when the athlete drops under the bar.

Snatch
Barbell is raised from the floor to the overhead position in one motion. In a squat snatch the athlete receives the bar in a squatting position and stands to finish the lift. In a power snatch, the athlete receives the bar in a partial squat.

Squat
Barbell is supported on upper back (back squat), in the rack position (front squat), or in the overhead position (overhead squat). From a standing position with a wider-than-shoulder-width stance, the athlete bends the knees until the hips are below the knees, and then stands, keeping the heels on the floor.

Sumo deadlift high pull
With a wide stance, a barbell or kettlebell is lifted from the ground to a position just under the chin.

Thruster
A combination of a front squat and a push press: starting with the barbell in the rack position, the athlete squats (hips below knees) and then stands, driving the barbell overhead.

Tire flip
A large tire, lying on its side, is flipped over by lifting one edge.

Wallball
Holding a medicine ball below the chin while facing a wall at arm's length, the athlete squats (hips below knees) and stands, throwing the medicine ball in order to make contact with an overhead target on the wall.