CrossFit | 190108
Tuesday

190108

Workout of the Day

35

Rest Day

Post thoughts to comments.

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.

Link Between Health Spending and Life Expectancy: U.S. Is an Outlier

11

Life expectancy increased as countries spent more on health care from 1970 to 2015. The United States stands out as the greatest spender by far, but despite health-care spending in the trillions, Americans can expect to live shorter lives than citizens of countries that spend less on health. The data suggests the U.S. health-care system is increasingly inefficient at best and completely broken at worst.

Read MoreLink Between Health Spending and Life Expectancy: U.S. Is an Outlier

Comments on 190108

52 Comments

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Peter Shaw
November 20th, 2019 at 3:34 pm
Commented on: Reading the Scientific Literature: A Guide to Flawed Studies

I remember some of these tools and ideas for analyzing scientific literature being taught to me in school, but they are quickly lost if not used regularly. In undergrad we receive an overview of the basics and are sent on our way into careers in science. From there, if you are working with a group of intelligent professionals you will regularly take part in Journal Club meetings to discuss literature. These can be a great way to encourage critical thinking about science.


Unfortunately, not everyone has time for Journal Club meetings and we are all influenced and touched by science in some way, shape, or form. So it is useful to have a few tools we can use for quick analysis over coffee.


Thank you!

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Matthieu Dubreucq
October 20th, 2019 at 2:20 pm
Commented on: Reading the Scientific Literature: A Guide to Flawed Studies

Thanks for the tools to help us read a study and know if it is flawed or legitimate.

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Matthieu Dubreucq
October 20th, 2019 at 2:04 pm
Commented on: Link Between Health Spending and Life Expectancy: U.S. Is an Outlier

Let's make sure we learn from this. Canada is not far from the US and we now have the data to see that if we don't seriously look at our health as something we all have control (lifestyle choices) over we are doomed to go down the same path as the US.

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Peter Shaw
November 20th, 2019 at 3:20 pm

I agree Matt.


The healthcare system is a big ship to turn, but CrossFit is doing what it can at the ground level. The empirical evidence showing effect of CrossFit combined with proper nutrition is impossible to ignore. It won't be long before countries looking to get healthier and spend less are looking in our direction.

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Kyle Laney
December 20th, 2019 at 9:02 pm

Yes, we are spending too much money on healthcare in America. But to throw doctors under the bus is reprehensible. People need to stop expecting doctors to be magicians. A lot of the money we are spending are because people are not taking care of themselves as well as they could at younger ages and people, through the marvels of modern medicine, are growing older. So the medical system is simultaneously dealing with a more chronically sick younger population and a more acutely sick older population. Throwing doctors under the bus fixes nothing. The medical system is in no way perfect but finding ways to encourage people to live healthy lifestyles without unnecessary promotion of pseudoscience should be strongly encouraged.

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Felipe Castor
January 14th, 2019 at 6:18 pm
Commented on: Link Between Health Spending and Life Expectancy: U.S. Is an Outlier

I want to congrats the brand Crossfit. I never saw in my life a private enterprise that fights for public health in all the ways like you. I'd like to say it personally to Greg Glassman. Anyway, I hope he don't stop to fight against this obsolete system where majority people are sick and dying.

As this article shows, the inequality in health spends is the main obstacle to develop public health in US. The total spending with health is big, but it is concentrated on rich people. Here in Brazil it is not different. It is reflecting, many ways, the huge income inequality in both countries. So I call you to put more efforts to pressure for politics that assure public health to ordinary people.

It would be amazing if you start to fight for an Universal Health Care system in US.

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Chris Douglas
January 11th, 2019 at 1:20 pm
Commented on: Reading the Scientific Literature: A Guide to Flawed Studies

"In Defense of Food" by Michael Pollan provides some interesting historical context on how these types of studies came to be the norm, especially in regards to the analysis of nutrients instead of the food itself.

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Romain Grelier
January 9th, 2019 at 8:09 pm
Commented on: 190108

10km row and mobility

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Cat Scott
January 9th, 2019 at 2:30 pm
Commented on: Link Between Health Spending and Life Expectancy: U.S. Is an Outlier

It would be very useful if you could attribute the date and source for opinions as well as for the various scientific papers you are now citing. For example, Dr Angell's opinion statement in the Jan 8 EOD was published ~14 years ago in 2004.

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Greg Glassman
January 12th, 2019 at 3:44 am

Cat, don't be lazy. You found the truth. That's how fucked up things were in 2004. What's happened since? It's gotten worse. Much worse. Look up Dr. Angell's background. Her opinions will have bearing for a 100 years.

Don't pretend like we're offering science that is old and stale, long replaced by new and more valid science. The dates of everything we've offered are abundantly clear and ultimately not important.


This is science not Kim Kardashians webpage.




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Phill Kiddoo
January 9th, 2019 at 9:09 am
Commented on: 190108

20 Minute AMRAP

7 Knees to Chest Sit ups

9 Push Jerks (135/95)

Run 400m

6+16 rxd

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Jim Rix
January 9th, 2019 at 5:18 am
Commented on: 190108

Did yesterday's WOD:

21-15-9

35# DB squat clean and jerks

strict pull-ups

GHD sit-ups


14:45

Nice workout. Should sleep well tonite!


56/5'8"/160

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Raul Francis Colomer
January 8th, 2019 at 10:32 pm
Commented on: 190108

Deadlift

95lbs 5x

145 lbs x3

175 lbs x3

205 lbs x1

235lbs x1

235lbs x1

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Joshua Henriquez
January 8th, 2019 at 10:12 pm
Commented on: 190108

Because I had to learned from google university. Link work safe.

https://www.shmoop.com/pied-beauty/stanza-1-summary.html

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Steve Adams
January 8th, 2019 at 9:22 pm
Commented on: 190108

10-8-6-4-2

150lb

Bench press

Power clean

For time 12:03

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Erik Wagner
January 8th, 2019 at 9:19 pm
Commented on: 190108

Coach Glassman,


I understand the need to move forward and continue to refresh the site as well as programming. My request is to remember that there are many of us that do our WODs in our home gym and don’t have a coach to guide, scale and explain the purpose of what the WOD is all about.


I do appreciate the guidance I receive when I drop in while traveling. I’m now over 50 boxes on 3 continents and counting. It always brings a smile to my face to be embraced by the community for the hour that I am with them.

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Nicole Deaver
January 8th, 2019 at 8:32 pm
Commented on: 190108

Enjoying the rest day & that poem!

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Clarke Read
January 8th, 2019 at 8:28 pm
Commented on: Reading the Scientific Literature: A Guide to Flawed Studies

It’s deeply discouraging how often, as Feinman shows in a single case here, the most faithful interpretation of the data is not the one that ends up in the Abstract. It’s simply not feasible for anybody - even an academic - to read every paper in even a narrow field with the diligence required to render independent judgment. What share of the literature has been broadly interpreted in ways the data did not support?


One consistent theme I’ve noticed working with and talking to older academics like Feinman - the sort who did much of their work before computers made statistical analysis and reanalysis easy - is the higher bar many of them set for data analysis and discussion in papers. When data were harder to gather and analyze - more precious - there was a greater emphasis on, and expectation for, extracting all possible interpretations out of them, including those that may have unintentionally arisen via the study methodology. In this case, as Feinman notes, simply changing the independent variable (from calories to carbs across all phases) reveals a relationship with triglyceride levels more consistent than the relationship the authors focused on.


I suspect much of the “noise” in nutrition research could be cleared if this sort of comprehensive interpretation were universally applied. Very often, if a study arrives at a surprising conclusion the reason can be found in the methods or the interpretation of the data. (This points to one of the perils of meta-analyses, which Feinman critiques elsewhere…these nuances are lost when the pure quantitative results of papers are analyzed together.)


Yet coming to this conclusion requires spending a couple hours with this paper - an approach that is useful for individual studies, but not scalable. What’s the solution? I don’t know, beyond finding a few sources whose interpretation you trust and who you believe interpret the data both critically and charitably as warranted. In the meantime, when we can, it’s good practice to look for ALL the inferences that may be consistent with the data, and recognizing that the authors may not have made the correct inference themselves.


Feinman and Volek’s analysis is worth reading directly, twice if possible.

https://nutritionandmetabolism.biomedcentral.com/track/pdf/10.1186/1743-7075-3-24

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Jeff Chalfant
January 8th, 2019 at 8:26 pm
Commented on: 190108

5 rounds for time of:

400-m run

15 thrusters

10 burpees


Men: 75 lb.


Scaled to 3 rounds. 16:48. Asthma attack slowed me down even though I took the runs easy. Went unbroken on thrusters and walked the burpees to give my toe a break.

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Jeff Chalfant
January 8th, 2019 at 8:32 pm

No caffeine or food pre WOD. Felt unusually out of breath after the first run. Everyone around me is sick with a lung bug so my immune system may be on alert. Anyway I didn’t feel myself today. Still got a decent workout I guess. It still hurt!

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Clarke Read
January 8th, 2019 at 7:54 pm
Commented on: Link Between Health Spending and Life Expectancy: U.S. Is an Outlier

This is a maddeningly complex issue, but the big picture is clear - whatever the cause, (1) the U.S. is overspending on healthcare and (2) (which I find more important), health care efficiency and progress in the U.S. has at best stalled and at worst fallen.


For (1), the argument may be as simple as prices, as some have argued: (apologies for the paywall)

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05144

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.22.3.89#

https://www.newsweek.com/americans-are-paying-more-worse-healthcare-other-rich-nations-study-1283457


It also could be structural or a function of the way diseases both occur and are handled in the U.S. - the original source notes 50% of healthcare spending is consumed by 5% of the population

https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus

https://ourworldindata.org/financing-healthcare#what-was-the-consequence-of-growing-expenditure-without-insurance-expansion-in-the-us


And yet, when we look at trend data within the U.S., the picture looks arguably worse. Over the past 25 years, life expectancy has increased only 4% (75.5 to 78.6 yr) and disease burden decreased 12% while healthcare spending as a share of GDP has increased 40% ($788B, 12.8% to $3.3T, 17.9%). That does not look like progress, and as a trend, it’s unsustainable.

https://www.healthsystemtracker.org/brief/a-generation-of-healthcare-in-the-united-states-has-value-improved-in-the-last-25-years/#item-start


(While comparable countries have seen HC expenses grow as much as the U.S.’s in percentage terms, they were starting from a lower baseline and saw greater health quality improvements)


If healthcare were a product, a 4% (or 12%) improvement in quality alongside a 40% increase in real cost over 25 years would be considered a failure. There are certainly savings that can be had from structural improvements in the way healthcare is delivered, paid for and administered in the U.S., possibly major ones. But given the billions collectively spent on healthcare R&D (private + public) every year, this reflects the poor return on our investment in new treatment modalities - pharmaceutical or otherwise - over this period.


Maybe healthcare is doomed to “Eroom’s Law”, where care improvements will become progressively more expensive and there’s little we can do about it. Or maybe the majority of healthcare investment and efforts over the same period have been focused in the wrong areas, categorically. An increasing share of the healthcare and healthcare-adjacent population is arguing the latter. Even if just as a hedge, investment in this alternative is warranted given the predicted ROI of standard operating procedure.

https://en.wikipedia.org/wiki/Eroom%27s_law

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Brittney Saline
January 8th, 2019 at 7:25 pm
Commented on: Link Between Health Spending and Life Expectancy: U.S. Is an Outlier

"Studies find, for instance, that administrative costs in the health sector are higher in the US than in other countries..."


Health care in the U.S. is more about business than health.

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joshua webster
January 17th, 2019 at 1:01 am

Did you ever read the "Bitter Pill" articles that were written in TIME magazine? They are all about the subject of how much our healthcare costs when it's allowed to be managed by hospitals and "chargemasters". Really interesting stuff.

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Jeremy Meier
January 8th, 2019 at 4:45 pm
Commented on: 190108

Also.. I think they removed scaling options to give people more incentive to take their L1 and do the online scaling course. I’ve done both and you will get the tools needed to scale any workout. Just my opinion on the matter

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Kathy Glassman
January 8th, 2019 at 4:41 pm
Commented on: 190108

Pied Beauty is one of my favorites!

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Lynne Pitts
January 8th, 2019 at 7:58 pm

Mine too; great choice!

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Jeremy Meier
January 8th, 2019 at 4:21 pm
Commented on: 190108

15 Hand Over Hand Sled Pulls, 105 lbs, 15 ft

-- then --

5 rounds of:

15 Bike Erg Calories

15 GHD Hip Extensions

15 Plate Ground-to-Overheads, 45 lbs

-- then --

15 Hand Over Hand Sled Pulls, 105 lbs, 15 ft


18:31

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Ethen Stuber
January 8th, 2019 at 6:04 pm

I swear I thought that said handstand hand over hand sled pull and almost had a heart attack

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Keri Mucha
January 8th, 2019 at 2:02 pm
Commented on: Link Between Health Spending and Life Expectancy: U.S. Is an Outlier

I've been an inpatient hospital nurse for over 10 years and I can definitively say my patient population has been getting sicker. While it's discouraging to see, I feel super hopeful that all the truth CrossFit is bringing to the table will contribute to the change we so desperately need.

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Chris Sinagoga
January 8th, 2019 at 5:06 am
Commented on: Link Between Health Spending and Life Expectancy: U.S. Is an Outlier

I like the URL link to this page haha. As always, good to bring this stuff to light.

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Jeff Chalfant
January 8th, 2019 at 4:09 am
Commented on: 190108

Yay, smooth scrolling! And even faster than before!

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Skip Hanson
January 8th, 2019 at 4:22 am

Thanks Jeff! We are working hard to improve.

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Melissa Yinger
January 8th, 2019 at 3:29 am
Commented on: Reading the Scientific Literature: A Guide to Flawed Studies

Richard Feinman writes an incisive critique of modern scientific literature before offering a list of helpful guides for discerning whether a scientific study is flawed or legitimate. To preface his critique, he includes an epigraph from Shakespeare’s Macbeth, which got me thinking. I appreciate any excuse to return to Shakespeare, so I started reviewing the context of the quotation Feinman cites and the doctor’s role in the play. In doing so, I’ve discovered that Lady Macbeth, the patient to which the doctor refers, may be read as an allegory for the crisis of modern scientific literature.


At the heart of Feinman’s critique is the sense that modern science has become an echo chamber wherein popular theories are repeated ad nauseam until they become dogma. The barrier to entry into the echo chamber is a willingness to repeat the popular theory. You must “conform to the party line,” Feinman says. If you don’t repeat and confirm what others have argued–right or not–you don’t even get to join the party. Enter Lady Macbeth.


Lady Macbeth might be read as an allegory for this problematic situation in the sciences. When Lady Macbeth begins her sleepwalking with repeated ravings, Macbeth grows worried and consults a doctor. The doctor, learning of Lady Macbeth’s symptoms and determining them to be a sickness of the mind rather than the body, speaks the lines Feinman cites: “The patient must minister to himself,” to which Macbeth replies, “Throw physic to the dogs, I’ll none of it” (5.3.48-51). In other words, Macbeth is exasperated by the doctor’s inability to help him.


If you flip back a few scenes in the play to 5.1, it becomes apparent just how insidious the doctor’s inability to help is, and what is at the root of the failure. There, the doctor observes Lady Macbeth’s symptoms for the first time. “Unnatural deeds do breed unnatural troubles,” he says (5.1.70-1). “Infected minds to their deaf pillows will discharge their secrets ... My mind she has mated” (5.1.71-8). The Penguin editors gloss “mated,” as a clipped version of “checkmated” that means to imply “defeated,” i.e., Lady Macbeth’s peculiar symptoms have defeated the good doctor’s training and left him baffled. This valence is certainly present in the line, but so is the more modern meaning of “mated,” which refers back to the doctor’s reference to breeding: “Unnatural deeds do breed unnatural troubles.”


In continuing the image pattern in this way, the doctor suggests that the “unnatural troubles” that plague Lady Macbeth are reborn in his own now-corrupted mind. His mind, like hers, is unsettled. Further evidence of her infection or impregnation of him (near-interchangeable terms in the doctor’s speech) is apparent in his parroting of her language patterns. Lady Macbeth is given to rambling repetition–“To bed, to bed ... Come, come, come, come” (5.1.65), as well as her infamous, “Out, damned spot! Out, I say,” (5.1.34). The doctor’s speech remains more eloquent than Lady Macbeth’s ramblings, but his repetition of “unnatural” and later, “God, God forgive us all” (5.1.74) is suggestive. The cycle of repetition is a symptom of the sickness that upsets all order and reason for Lady Macbeth, perhaps for her doctor, and certainly for modern scientific literature.


The cure? In Macbeth’s words, we have to “raze out the written troubles of the brain” (5.1.44). Feinman offers some excellent advice for beginning that process when engaging with scientific texts.

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Tyler Hass
January 8th, 2019 at 10:25 pm

Thanks for adding context to the Macbeth quote. Some people believe the plays of William Shakespeare were written by Francis Bacon, who was a scientist among other things. If true, it wouldn't be a surprise that he would critique the state of medicine in his era. It's always fascinating to find connections between art and science. Great comment.

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Mart Gibson
January 8th, 2019 at 3:11 am
Commented on: 190108

20 minutes. Did 70 on the straight bar. Don’t have dumbells yet. I just wanted to say I did like scaling because I just started CrossFit at 53 but I am smart enough to figure what weight to use and how to substitute workouts. I am glad to have a site like this to start off with.

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Mart Gibson
January 8th, 2019 at 3:15 am

Sorry did this on the wrong day

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Jonathan Kramer
January 8th, 2019 at 5:19 pm

Mart, the important thing is that you did the work, not whether you commented on the right day. It is important for everyone to understand their own strengths, weaknesses, and injury areas and adjust as needed.

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Tim Miller
January 8th, 2019 at 2:27 am
Commented on: 190108

Dropped the dumbbells to 30 to but forgot to time. In retrospect I could have done the 35s no problem. Sometimes I let these workouts intermediate me and i doubt myself. I have to stop doing that because my self doubt is wrong 99% of the time.

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Janeilla Thomas-John
January 8th, 2019 at 2:18 am
Commented on: 190108

The pull-ups are hurting my feeling too. I’m going to run a mile and then do some yoga. 😩😂

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Janeilla Thomas-John
January 8th, 2019 at 2:18 am
Commented on: 190108

The pull-ups are hurting my feeling too. I’m going to run a mile and then do some yoga. 😩😂

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Lisa Stanley
January 8th, 2019 at 1:09 am
Commented on: 190108

I’m going to do yoga. All these pull-ups are hurting my feelings. :)

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John Clarke
January 8th, 2019 at 1:05 am
Commented on: 190108

Rest Day thoughts for those who didn't ask for it:


In retrospect, if you've really been following the main site for the last year or two or five, this is exactly where the Founder has been taking us. Think of all the media lately regarding: Off the Carbs, Off the Couch. L1 seminars for doctors. Fighting Big Soda, Food, etc. The success stories. The common theme in the above has been decades of Conventional Wisdom has made most of us fat, weak & sick and that CrossFit is the best answer to all those problems. Counter to all the bitching in Comments, it is clear the redesign necessarily emphasizes CrossFit is for anyone willing to embrace it. The new website has ALL the information a newbie needs to get started if you take a few minutes and follow the links. If something isn't there? Ask. Comments will always give the answer. If not having the scaling just given to you is enough to drive you away, then you're missing the point. There is no perfect scaling option, which I bet is part of the reason HQ stopped doing it. The appropriate scale depends 100% on our own physical/physiological tolerance for intensity at that moment. CrossFit is all about focus on nutrition to prevent or reverse chronic disease and on intense & functional movement to retain physical independence well into our later years. Although entertaining, the future of CrossFit isn't the Games. It's the husband/wife doctors running their affiliate out of the home Garage (best video of last year, IMO).


You might be wondering (if you've read this far) where I get off with this rant. I found CrossFit around 10 years ago and since then have trained in affiliates but mostly on my own. I don't post often, and wanted to thank HQ and the Community here for all you guys do. Greatly appreciated.

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Mike Andridge
January 8th, 2019 at 1:32 am

Well said John. They combined the good stuff from crossfithealth.com, so it's all on one link:)

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David Mitchell
January 8th, 2019 at 3:59 am

Right on John!!

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Alexey Logachev
January 8th, 2019 at 9:47 am

Nice thoughts, John. Very inspiring!

What is the tittle of the video that you mentioned?

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John Clarke
January 8th, 2019 at 10:45 am

https://journal.crossfit.com/article/rockett-science

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Alexey Logachev
January 8th, 2019 at 12:32 pm

Thank you very much, John, you're the best!

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Nicole Deaver
January 8th, 2019 at 1:16 pm

I agree, well said!

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Martin Loftus
January 8th, 2019 at 3:30 pm

I agree you, John, however, I still miss Bingo.

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Craig McDonald
January 8th, 2019 at 4:34 pm

Nice writing, John. Well said.

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Sara Hockett
January 8th, 2019 at 7:26 pm

Well said!!! Thank you! I also found CrissFit about 10 years ago and feel like it saved me mentally, emotionally and physically! Thank you HQ for the website and I love the app! Sara

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Kathy Glassman
January 8th, 2019 at 9:52 pm

Nailed it!

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