CrossFit sees athletes push themselves to complete a large range of high intensity exercise. As with any high-intensity exercise program, there is always a risk of injury, and so whilst there are a large range of benefits to CrossFit, some participants find that they are battling against high injury rates, and often turn to physical therapy for help.
In this article, we will go through some of the potential dangers of CrossFit, common injuries we see, and how you can best continue CrossFit injury free.
Does CrossFit increase your risk for injury?
As with any exercise program, CrossFit does have a risk of injury, but is this risk higher than other sports? A 2017 study showed that the incidence of injury in athletes undertaking CrossFit is comparable to those participating in other sports and recreational exercise (https://pubmed.ncbi.nlm.nih.gov/28085123/). So it appears that it may not be CrossFit itself that’s causing people increased injury rates, so what is it?
A large reason people get injured in CrossFit is simply by pushing themselves too hard, too early. Overloading is one of the most common reasons for injury in sports and exercise, and CrossFit is no exception. Due to the high intensity of a CrossFit workout, there is increased load placed on athletes’ muscles and joints, which leads to an increased injury rate. To counter this, athletes must ensure they are training themselves at an individual level. Still pushing themselves, but working at weights that are appropriate to their strength and power, and workouts appropriate to their functional fitness. They must also ensure their training program gives their body adequate time to rest and recover. Muscles need rest in order to resupply worked areas with nutrients, oxygen, and special cells called fibroblasts which allow for tissue healing following damage caused by workouts. This period also allows for muscular hypertrophy, which increases muscle size and strength. If the body is not allowed this time to recover, damage caused to the muscles will not have adequate time and resources to heal, which can lead to injury.
Types of injuries
Five of the most common CrossFit injuries we see as a result from this include the following:
Rotator Cuff Strain/Tear:
The Rotator Cuff is a group of four muscles, with a primary role of stabilising the shoulder joint, as well as rotating and supporting the shoulder through movement in all directions. As these muscles are small, yet often placed under heavy load through the many types of weights training CrossFit offers, they can be easily overloaded and are responsible for many shoulder injuries.
Wrist Strains:
CrossFit involves many snap-focused, power lifting exercises such as the clean and press, that load the wrist at end of range. As the wrist is a smaller joint that is often undertrained, it can struggle with the sheer force being put through it.
Achilles Tendinopathy:
The Achilles tendon is heavily involved in many explosive movements such as jumping, hopping, sprinting and various gymnastics movements. As plyometrics based training is a large part of CrossFit, the Achilles tendon may become irritated, especially if footwear that does not support the ankle is worn.
Patella Tendinopathy:
Like the Achilles tendon, the patella tendon is also involved in plyometric movements such as hopping and jumping. A key feature of these tendon injuries is pain gradually improving as exercise goes on, and can worsen as the connecting muscle becomes tight and overworked. This is just one of many knee injuries we see.
Lower back injuries:
Lower back injuries commonly involve muscle strains, or disc herniations that occur where there is increased load being placed on the spine. This is often seen through overuse, muscle imbalance, or improper form, where lower back muscles are forced to compensate for surrounding muscles not activating correctly.
Injury prevention tips
Whilst we may not be able to completely remove the risk of injury, there are certainly a range of strategies we can use to help lower your injury risk.
Warm Up!
I cannot stress this enough, a good warm up is imperative to a safe CrossFit workout. A warm up should begin with 5-10minutes of light exercise, that gradually increases to a moderate intensity. Great examples include jogging, jumping squats, lunges, star jumps and push ups to name a few. Once you’ve got your muscles warm, dynamic stretching throughout the entire body should follow, which will help stretch your muscles as they move through their entire range of motion. This will help prepare your muscles for the stress they will be placed under during the workout, and will also help improve performance!
Get Help From a Coach
Asking a coach for assistance can be extremely beneficial to help correct any improper form. We know that poor technique can sometimes lead to injury, and this can be extremely hard to fix yourself, especially if you’re not 100% on how to do a particular exercise. Asking a coach to watch and give cues to help with your form is a great way to improve.
Start Light
A constant mistake we see is people going into the gym, grabbing the biggest weights they can lift and beginning their workout. This does not allow your muscles adequate time to warm up, and puts them under huge stress, increasing your risk of injury. It can also cause poor form habits as you struggle to get your required muscles activating! For example, if you are looking to squat, and build your way up to 100kg, start using even just the bar, and slowly add 10-15kg each set!
Switch on Your Core!
This is especially important in activities such as deadlifts that target the lower back. Your core must be activated in order to support the spine through movement under load. If you’re not feeling it, try to add some specific core work into your workout to get it firing.
Modify Your Squat
Squatting is something many people struggle with as they try to find that ‘perfect form’. However, squatting will differ for everyone due to the biomechanics of how our hips and knees are anatomically structured! If you find you’re struggling to get low, try adding some heel raises under your feet. If you can’t get your glutes to activate, try wrapping a band around your thighs to force them to switch on. If you are struggling with this, have a chat to your coach or physiotherapist to see how they can help
Rest
If you are constantly feeling stiff and sore, take a look at your training volume. Are you training too often, for too long, or too hard? Your body needs rest to recover, so make sure you schedule in some rest.
Warm Up Your Shoulders/Rotator Cuff
As mentioned earlier, the rotator cuff muscles in the shoulder are extremely prone to injury. This means they are especially important to warm up prior to a workout. Make sure you implement some form of external/internal rotation work into your warm up, in addition to some shoulder specific strengthening in your weekly routine to help prevent a shoulder injury.
Cool Down
Whilst you’re at the end of the workout and you’d love to chat with mates or get out the gym ASAP, please remember to cool down! Light activity followed by static stretching allows the muscles to gradually return to a resting state without tightening, and will help greatly with your recovery.
Risk factors
A 2019 study showed that there were two predominant risk factors for injury in CrossFit training: Previous injury was the first, showing that participants were more likely to reinjure themselves. The other was training duration, showing that athletes who had been in the program >12months were 82.6% more likely to sustain an injury than those in their first 12 months. The study also showed there was no correlation with injury and other potential risk factors such as age, weight, gender, height, or practice of other sports. (https://www.researchgate.net/publication/337615219_CrossFitR_Injury_prevalence_and_main_risk_factors)
Treatments, therapies, and care for preventing injuries
If you do get injured, physical therapy can provide a range of treatment options to help you. As muscular and overloading injuries are often the cause, soft tissue work can be a good way to help desensitise the surrounding nervous system to reduce your pain. We will then look to see if improper form is the cause of your injury, and if so work with you in the gym, and give you tips on how to change functional movement to correct your form. Our primary goal will be to allow you to continue lower level workouts, whilst progressively overloading you to promote healthy movement and get you back to full capacity, building towards those fitness goals as soon as possible. We will then continue to work with you, and devise and complete an individualised strength and conditioning training program, to help prevent future injuries.
Returning to training
Depending on your injury, your physiotherapist will help determine whether you need to rest completely, or modify your training load in your recovery period. Some injuries such as lighter strains may only take a few weeks to manage, whereas others may take a few months. The best thing to do if you have an injury is talk to your coaches and trainers, or a medical professional such as a physiotherapist, who will help to improve your strength and conditioning throughout your injury, and get you back to training pain free as soon as possible.
