With the CrossFit Games all wrapped up for this year at the time of writing this, some of you reading this may be inspired be these phenomenal athletes (I know I always am). Early on in the sport's development, there was definitely a stigma or a outside, inexperienced viewer who would think that this sport is dangerous. In fact, there is still some reproach by some (including in the medical field) who feel that this sport leads to significant injury or early bodily breakdown compared to other sports.
I am here to say that, like all other sports, there is SOME presence and risk of injury but much less than you would think. People who compete in this sport, especially at the highest levels, are the seriously the fittest and most versatile people in sports and are able to tackle most or all challenges thrown at them. Being smart about your training, having the appropriate guidance, and knowing what you are doing will get you where you need to go.
If you wish to limit potential injuries (just like with all forms of exercise), there are certain tips I tend to advise my athletes to follow. But before we get into that, let’s take a deeper look at this phenomenon known as CrossFit, shall we?
WHAT EXACTLY IS CROSSFIT? AND WHY DO INJURIES OCCUR?
Developed in 2000, CrossFit has become an extremely popular varied discipline workout program used all over the world. Promoted as both a physical exercise philosophy and a competitive fitness sport, CrossFit incorporates elements from several exercise worlds, including high-intensity interval training, Olympic weightlifting, plyometrics, powerlifting, gymnastics, kettlebell lifting, calisthenics, and strongman training.
Many of those participating in CrossFit already know that it is very effective for fat loss, strength gain and overall conditioning of the body. However, injuries in CrossFit do pop up…but not as frequently as you may think. Compared to other sports we regularly enjoy like football, soccer, and ice hockey, CrossFit injuries fall much more in line with other weightlifting and gymnastics sports, including rugby.
For example, according to the Journal of Human Kinetics, examining the injury risk between sports, it found that the injury rate for football was 140 instances for every 1000 exposure hours to the sport experienced. The same goes for ice hockey and soccer which were 78 and 4.22/5.21 (male/female), respectively, for every 1000 hours exposed to the sport. Meanwhile, those who participate in CrossFit face an injury risk of 3.1 injuries for every 1000 hours of exposure to the activity which is similar to Olympic weightlifting as explained earlier (3.3/1000 hours). Much less than soccer or hockey!
Why do injuries even occur in CrossFit? Some say it’s because of the way CrossFit is structured, where participants can easily get caught up in its competitive nature. Its popularity stems from the way it mixes traditional exercises (e.g. barbell lifts, gymnastic moves, push-ups) into a combination of maneuvers known as the Workout of the Day, also known as WOD.
These WODs can be as long as an hour or as little as five seconds, but they’re nearly always fast and can be grueling. Athletes race to finish a set number of reps “for time” or perform as many rounds as possible of a combination of exercises. That scoring aspect, added with the fact that the whole field competes at the same time, creates a frenzy that can push athletes to sacrifice technique, and potentially lead to injury.
So what are some ways one can safely participate in CrossFit, mitigating the chance of injury? Below I discuss the 6 proven tips I’ve seen that help my clients with CrossFit injury prevention.
Make Sure You Warm Up Properly
Whether you are a competitive athlete or working out for the first time in years, it doesn’t matter; warming up is critical if you want to reach your fitness goals. And this definitely holds true in CrossFit. During a typical workout, a CrossFitter will perform any combination of lifting, jumping, running and gymnastics movements. That’s a lot for one day of training!
I always tell my clients that a warm-up is an opportunity to maximize their body’s potential to perform those movements. It is also an effective way of decreasing the risk of injury, as it’s an opportunity to prime your nervous system, enhance mobility, and awaken motor patterns similar to the movements you will perform during the workout.
By the end of your warm-up, your body should be able to meet the demands of the specific CrossFit workout. The good news? A great warm-up doesn’t take a long time. If you’ve worked out at a CrossFit gym, you’ll know that a typical class is 60 minutes. About 45 minutes of that is for lifting and the WOD. This means you’ll only need 10-15 minutes as an estimated time frame for a good warm up.
Know Your Limits and Listen to Your Body
CrossFit WODs are designed to test your limits. While it’s great to challenge yourself, never lose sight of what’s realistic for you. In that gym, despite everyone else around you, you are still competing or training against who you were yesterday vs who you are today. Your body will let you know when it’s had enough. Pay attention to these signals, and you’ll lower your chances of getting injured during CrossFit. Otherwise, you may run the risk of setting yourself back with potential for weeks or even months of decreased performance or even taking a break from training to recover from injury.
If at any point during your workout you feel like something isn’t right or you feel pain, you should take a break or modify the exercise based on the coach who is teaching the class. From there, if pain continues to persist, modify your performance further to cut out exercises or movements that cause pain WHILE seeking help from a trusted medical professional who understands the sport of CrossFit and the demands it can place on you.
Pain and elevated levels of discomfort are two of the many things that our bodies can use to signal that something is wrong. It can be easy to ignore these based on all of the athletes who I see coming to me after weeks and months dealing with it. The longer you wait though, the longer it takes to fully recover along the missed weeks and months you could have been training and performing better (if treated earlier).
Prioritize Gradual Gains Rather Than Giant Leaps
CrossFit is known for its success stories and personal breakthroughs. However, major gains don’t come with one workout. Go for gradual, incremental gains each week and keep building on them. Lifting too much or jumping too high can lead to breakdown in form which can result in pain or injury. Approach every WOD with common sense. It’s always important to remember that you need to build a strong foundation that you can steadily build upon.
One of the best ways to make sure that you’re focusing on gradual gains throughout your CrossFit and fitness journey is to keep a journal of your workouts which highlights what you did, how long you did it for, and a notes section. This notes section can be a great way to track how your body was feeling during, shortly after, and the days following a workout. Using an extensive journal that highlights your previous workouts can be a great way to identify things that you’re struggling with and help you stay accountable with a focus on progressive gains over time instead of trying to push your body leaps and bounds further than it's been before.
Focus on Form and Technique Before Intensity
Common injuries stemming from CrossFit that I have worked with many times over include lower back pain and strains, anterior (front) knee pain, tennis elbow, Achilles tendonitis, labral tears, and rotator cuff injury. Almost all these injuries are preventable and can be mitigated by mastering form and technique rather than intensity in most cases. Over time, just like a machine, our bodies and its components will wear out but we want them to stay as healthy as possible throughout to keep us within the CrossFit world for as long and as healthily as possible.
For example, a common injury I see happening to Cross-Fitters is to the wrist, the culprit usually being improper form used during push activities and during the catch for Olympic movements. When performing a push activity that can be as simple as a push up or as complex as a snatch, having the right form is paramount. Additionally, having the strength and stability through your hands and wrists, all the way up to the shoulders, are vital. I find that when working with an athlete who has wrist pain they are either lacking mobility or control in their shoulders or thoracic spine causing them to force wrist extension to get the bar back further and more in line with their center of gravity or they are failing to perform accessory work for their hands and wrists.
Lifting heavy weights on a heavy bar is one thing but being able to stabilize the wrist and hand without having to rely on your ligaments and the static tension of our tendons is another. We have many small muscles in our hand and forearms that help with the stabilization of these joints. By performing regular accessory work for your hands and wrists this will help to prevent missing reps on bigger lifts and also to prevent risk of wrist sprains and strains.
Another common injury is to the shoulder, which occurs due to a variety of reasons within CrossFit but the most common and easiest one I see occur is similar to what was mentioned above. Many of the movements experienced in CrossFit including the Snatch, Clean and Jerk, Push Presses, handstand push-ups, and even muscle ups require gross movement from multiple joints for its accurate completion. Some athletes contort or find ways, especially in high volume WODs, to be able to get through the workout without having to gas their arms or body completely.
By doing so, we can sometimes overlook the stress we are putting on structures like the labrum which provides internal static stability to the shoulder and the rotator cuff and bicep tendon which provide dynamic stability to the shoulder. Based on the function of these two aspects, I am sure you can guess what I am referring to in what is missing…stability.
I have worked with many CrossFit athletes who experience both shoulder and elbow pain due to an imbalance that develops from continual gross shoulder activity while a neglect or insufficient accessory exercise occurs. Ensuring you have regular accessory shoulder work will not only help stabilize the shoulder and prevent pain and injury but will also keep you in the sport longer.
I always like to use a lot of car references when explaining things about the body as our bodies are like biological machines to a degree. Think of your stabilizers of any part of your body like the nuts and bolts to your car. If one or a multiple of them are loose or if your alignment is off due to an imbalance in the way the wheels are facing, how much shorter of a period of time do you think it would be that something else would break down than if those nuts and bolts were solid tight and the wheels were in balance?
Seek Treatment or Information about Aches & Pains Sooner Than Later
The next thing you can do to prevent future CrossFit injuries is to make sure that you get treatment for existing pain and injuries before they get worse. If you don’t take the necessary steps to seek treatment for injuries you’ve already sustained, you can not only lengthen the time it takes to fully recover but you could also set yourself up for more injuries down the road. Additionally, if you come in sooner and are dealing with much less pain, then there is an opportunity for you to still train while you are recovering rather than to potentially have you shut down for a period of time.
As I’ve mentioned before, CrossFit workouts can be a great way to stay in shape and reach those wellness goals. But you also need to make sure that you’re recovering from CrossFit workouts appropriately as well. Especially when pain and injury are involved. Physical therapy is a great treatment option for those who have recently experienced an injury. Whether you’re a beginner or advanced athlete, a Doctor of Physical Therapy with a significant knowledge background of CrossFit can help athletes and individuals of all skill levels recover from injury, alleviate pain, and reduce the likelihood of future injuries. I myself have participated in CrossFit workouts and regularly perform the movements to train for Triathlons, so I understand the full benefits of it.
Don’t Get Carried Away by Competition
Lastly, I’ve had to remind dozens of clients not to fall victim to becoming overly competitive while engaging in CrossFit. Yes, competition is a wonderful motivator, but it can cause athletes to lift too much, run too fast or jump too high during the WOD. While it’s great to be inspired, stay focused on your personal goals rather than posting about your latest successes on social media with lackluster form. Remember, you’re competing against yourself rather than those around you.
I hope speaking about this topic was helpful for you. If you are a CrossFit athlete and find that you are dealing with pain or injury, please feel free to reach out to us at Ascent Physical Therapy at (516) 387-4669 or email me at firstname.lastname@example.org. Also, you can click the link HERE to fill out a webform to learn more about how we can help you.
Keep up the good work!
References:Klimek, C., Ashbeck, C., Brook, A. J., & Durall, C. (2018). Are Injuries More Common With CrossFit Training Than Other Forms of Exercise?, Journal of Sport Rehabilitation, 27(3), 295-299. Retrieved Mar 28, 2022, from https://journals.humankinetics.com/view/journals/jsr/27/3/article-p295.xml