Note: I have written about CrossFit injuries a few times on my website, and I have offered some tips to start any workout program safely. Since patients ask me fairly often about injury concerns with CrossFit, I discussed it in my latest sports medicine newspaper column.
Normally I don’t discuss exercise programs in my sports medicine column, focusing instead on injuries in mainstream sports. Any activity that holds a competition crowning an athlete as the “World’s Fittest Man,” especially one with over 45,000 fans on hand to watch, millions watching on ESPN, and hundreds of thousands competing for a chance of making the finals themselves deserves attention in the sports section of a newspaper.
60 Minutes recently aired a profile of CrossFit, and the fitness phenomenon’s creator Greg Glassman. In the story, correspondent Sharyn Alfonsi interviewed Glassman to discover the secrets behind the “largest gym chain in history,” with over 12,000 gyms – or “boxes” – worldwide.
The appeal of CrossFit
CrossFit workouts mix endurance training, Olympic and powerlifting and gymnastics movements. The sessions are performed at high intensity over short periods of time with little rest between exercises. Participants usually compete against each other and against the clock. Most start CrossFit to lose weight or get in better shape, but they often stick with it because of the competition and camaraderie with others.
Experienced and novice athletes push their bodies to the limits, and they push each other to overcome fatigue and go further. Occasionally that push to keep going can lead to injury.
The risk for injury is one of the aspects for which CrossFit has generated some scrutiny. Media outlets have started to question whether CrossFit has an unacceptably high injury rate.
Little data on CrossFit injuries
Partly because CrossFit has only recently exploded in popularity, few research studies exist to provide much insight into injury risks. In 2013, researchers at Ohio State published the results of a study largely showing positive benefits of CrossFit in terms of improvements in body composition and maximal aerobic capacity.
The study, published in the Journal of Strength and Conditioning Research, also mentioned that nine of the 11 people who dropped out of the program did so due to overuse or injury. According to ESPN’s Mark Fainaru-Wada, CrossFit HQ filed a lawsuit against the researchers and the National Strength and Conditioning Association disputing the injury claims.
It is possible that fear of legal action could dissuade researchers from studying CrossFit injuries in the future. Some data on injuries in CrossFit does exist, and it reveals rates comparable to other sports and exercise.
In 2014, Benjamin M. Weisenthal and other researchers at the University of Rochester surveyed 386 CrossFit participants to identify patterns of injury. They found an injury rate of 19.4%. The shoulder, lower back and knee were the most commonly injured body parts. Most of the injuries were felt to be mild and did not lead to a long absence from training.
Underlying risk factors for injury
Fainaru-Wada interviewed Dr. Joe Powers and Kyle Aune of the American Sports Medicine Institute, who have been studying CrossFit injuries. They have found that about 35% of the athletes claimed overexertion to cause their injuries. Roughly 20% blamed improper technique, while about 7% claimed fatigue as the underlying factor.
It makes sense that any group fitness where athletes race to perform a certain number of reps in a set time can lead to poor technique. And certainly having friends there screaming to push harder could lead someone to overdo it.
Injury risks with all strenuous exercise
To be fair, these risks exist with any strenuous activity. Much like injuries can occur in all high-impact sports, people can get hurt running, lifting weights or doing more traditional forms of exercise.
Honestly I’m in favor of any exercise program that motivates people to perform regular physical activity and adopt healthier lifestyles. If someone told me he wanted to start CrossFit and asked my advice, I’d say that he should check with his medical doctor, learn proper techniques, start slowly and increase safely, and see a doctor if he develops pain or other symptoms.
Having said that, if that same person instead asked about starting a running program, I would offer that same advice.
Injuries can occur in any form of intense physical activity, but if CrossFit or other workout programs are done as safely as possible, the benefits usually outweigh the risks.
Note: A modified version of this post appears as my sports medicine column in the May 15, 2015 issue of The Post and Courier.
Weisenthal BM, Beck CA, Maloney MD, DeHaven KE, Giordano BD. Injury rate and patterns among CrossFit athletes. The Orthopaedic Journal of Sports Medicine, 2(4); 2014.
King of CrossFit. Sharyn Alfonsi. 60 Minutes. cbsnews.com. May 10, 2015.
CrossFit’s big growth fuels concerns. By Mark Fainaru-Wada. ESPN.com. July 27, 2014.