The Myth of Safe Exercise

I wanted to take a few minutes to discuss inherent risk as it relates to physical activity and our chosen exercise modality. A question I have to answer a lot is – “Is ‘X’ fitness regimen safe?” The answer to every fitness routine, exercise modality and training regimen is no.

No exercise that is effective is 100% safe.

We could end the blog post there. But let’s dive deeper.

The reason I’m taking the time to write this that there are a lot of safety myths floating around gyms, office spaces and homes everywhere. You’ve heard (or said) a few like these, I’d bet:

“All runner’s eventually get hurt.” “Yoga makes you too flexible.” “Powerlifting is bad for your back.” And the inevitable, “CrossFit is dangerous.”

Blanket statements about the inherent dangers of certain movements miss the nuance of life at large. Sure, you could live in a padded bubble wrapped room your whole life to insure against the threat of acute injury, but what kind of life is that?

The immediate retort to seeing the forest for the trees is, “Yeah but the incidence of injury is actually higher in some sports.” Which is true to an extent. Professional football players, for example have a statistically significant risk of certain disorders like early onset depression, memory loss and dementia due to the effects of Chronic Traumatic Encephalopathy (CTE) from a lifetime of trauma exposure to the brain (eg. concussions).

Specific examples like this are the exception, not the rule. Certainly there are TYPES of injuries that have higher incidence rates in sport specific activities, but the standard for analyzing injury incidence rates (injury rate per 1000 hours) are actually pretty close across most fitness regimens (as seen in the below chart from Strength and Conditioning Research).

Similar studies have been compiled looking at NCAA injury rates. While there are some interesting notes on injury rates with regards to the timing during the season and specific injury types (ACL tears in Women’s Basketball, Lateral Ankle Sprains in Men’s Basketball, etc), generally speaking most sports have similar injury rates.

Specifically looking at CrossFit, the Barbell Physio did a great summary on injury rates and using the best data available* the research shows an injury rate of 2.1-3.1 injuries per 1000 training hours (Hak 2013, Moran 2017, Montalvo 2017) as compared to running which has a research range of 2.5 – 12.1 (Van Mechelen 1992). *(We’ve chosen to ignore the much maligned and disproven NSCA Study).

You can start to see my point. No matter what your chosen activity, there is some inherent risk. And my approach to movement in general is “do what you like.” Because I am not going to sit around a try to tell you your favorite regimen is 0.4 injuries per 1000 hours worse than mine.

I mean, c’mon people. We can spend our time better than that.

We also know that strength training (and really any weight bearing moderate activity) is protective against long term disability and osteoporosis in the aging population (Latham & Liu, 2013). So while there might be some risk of injury to a given activity, we also have to take into consideration the gained benefit of that activity.

Those benefits may be hard to quantify into a tidy number. How do you measure the social and emotional effect of having a supportive group of peers to train with? Or a routine that gets you out of bed and energizes you for the day? You can’t.

Which is why I’ll close with a little more common sense.

First, the fact that there is no 100% safe exercise doesn’t excuse us from taking care of ourselves, and putting into place preventative measures. What does that mean? Be smart in your training. Listen to your body. Take rest days when needed. Engage in regular Prehab, mobility, and stability drills. Eat well.

And lastly, let’s stop worrying about the minutiae of what activities are “safe(r)” and instead pour our energy into doing the things we enjoy. And leave it at that.

Yours in Health & Strength,

Dr. Scott

Stop chasing pain and wasting your time! Snag my complete Video Rehab Program The Full Body Fix and take $10 off with a subscriber only coupon and grab my Free Warm Up Manual while you’re at it!  

Last modified: October 22, 2018