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  • Dr. Logan Lynch, PT, DPT

CrossFit: Most Common Injuries, and Who Is At Risk

Let me start this blog post by saying my purpose is NOT to tell you that CrossFit is bad and that you shouldn't do it because of the risk of injury.....I am sure you have heard that way too many times, right? In fact, it has been shown that the rate of injury in CrossFit is comparable to Olympic weightlifting, distance running, track and field, rugby, football, ice hockey, soccer, or gymnastics (1).


There are many benefits to CrossFit and it is very apparent that there is a strong sense of community amongst CrossFit gyms. So the purpose of this post is to provide education about the most common injuries that occur and what are the risk factors that have been reported in the literature for these injuries that make them more likely - so that YOU as an avid CrossFit member can be aware and take the necessary precautions *cough cough* WORK ON MOBILITY *cough cough* to prevent these injuries from happening :)


So how many people actually get injured?


An article published in the Journal of Sports Science & Medicine showed that 50 out 192 CrossFit athletes had sustained 62 injuries in the preceding 6 months - representing a rate of 2.3 injuries per 1000 training hours (3). A similar study reported 3.1 injuries per 1000 training hours (5). Overall, a range of about 19.4% - 31% of CrossFit athletes have been reported to sustain an injury while performing their sport (3).


Most Common Injuries


The shoulders have consistently been reported as the most injured part of the body amongst CrossFit athletes, followed by the knee and low back (3). Another study found that shoulders were most commonly injured, and lower back was second (2). This study found the most common injuries to be muscle strains (41%), overload injuries (26.2%) - meaning that your body did not have enough control to handle the weight used, contusions (17.3%) - which is fancy word for a deep bruise, and fractures/dislocations (5.6%).


In a study that solely focused on beginner CrossFit athletes, the low back was the most commonly injured body region, followed by knees and elbows (4). This may indicate that the area of the body that is most commonly injured may differ between beginners and more experienced athletes.



Risk Factors


There are some risk factors that have been looked at in multiple studies, but the results vary. Some studies have found that one of the risk factors for injury in CrossFit are increased number of years participating in the sport. However, a more recent study published in 2020 examined a group of 168 NEW participants in the CrossFit style workout and found an injury rate of 9.5 injuries per 1000 hours of exposure, which is much higher than the rate in experienced athletes (4).


It has also been shown that an increased number of weekly training hours leads to more injury. The more exposed you are and the longer you do it, the higher the risk of injury. This could be due to the increased complexity and difficulty of movements that are being performed by more experienced athletes. One study found that athletes who practiced longer than 12 months were 82.2% more likely to have an injury (2).


There is also an increased risk for competitors vs. non-competitors. Competitors had 93.7% higher odds of being injured. The risk of injury was shown to increase if you participate in physical activity outside of CrossFit (3), but was contradicted by another study that showed no difference (2). Taller athletes who weigh more also showed an increased risk of injury in one particular study (3).


What does this mean?


CrossFit can be very beneficial to achieve our weekly requirements for vigorous exercise, and the community that is formed is unlike any other. But there are movements that are very challenging and can lead to injury if not carefully performed with adequate strength, stability, control, and power (just like lots of other sports and activities).


CrossFit gets a lot of criticism for being "dangerous" and causing harm, so a lot of these athletes are told they should stop doing it anytime they have pain or sustain an injury. But the truth is - these athletes LOVE what they do. They are not going to give it up, so as physical therapists we need to help these athletes do it in the safest way possible so they can stay protected and be able to do it for a long time ahead - as well as improve their performance while doing it!


Knowing what the most common injuries are can help YOU as the athlete have a focus for WHERE you can focus your mobility work (or stability if that is the problem) so that you can prevent these injuries from happening and continue to do what you love.




References:


1. 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.


2. Costa, T. S. D., Louzada, C. T. N., Miyashita, G. K., Silva, P. H. J. D., Sungaila, H. Y. F., Lara, P. H. S., … Arliani, G. G. (2019). CrossFit®: Injury prevalence and main risk factors. Clinics, 74.


3. Montalvo, A. M. (2017). Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit. Journal of Sports Science and Medicine, 16, 53–59.


4. Larsen, R. T., Hessner, A. L., Ishøi, L., Langberg, H., & Christensen, J. (2020). Injuries in Novice Participants during an Eight-Week Start up CrossFit Program—A Prospective Cohort Study. Sports, 8(2), 21.


5. Hak, P.T., Hodzovic, E. and Hickey, B. (2013) The nature and prevalence of injury during CrossFit training. Journal of Strength & Conditioning Research, Epub ahead of print.

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