Why Do Injuries Seem To Occur With Crossfit?

I have been doing Crossfit for 4 months now and I have had my fair share of niggles since commencing training. I have thought about the different reasons as to why I am sore or getting injured. Also, “out there”, there is a perception that Crossfit leads to a high rate of injuries – so I thought about these too!

I have been talking about Crossfit to my patients, friends and family for about 4 months now. One of the most common comment/question I hear is “Doesn’t Crossfit lead to more injuries?”. And to a certain extent, I am going to cautiously agree.

However, just because there seems to be an increased risk of injury doesn’t mean that Crossfit is dangerous or bad for you. Like all things, risks need to be managed. For example, walking on an athletics track will decrease your risk of dying from being hit by a car if you compare it to walking on the road…however, you also decrease other benefits like seeing different landscapes, having different challenges like hills or steps, having different surfaces to walk on and increase your risk of going crazy by walking anti-clockwise (as is the normal convention on an athletics track.

So why does Crossfit seem to increase your risk of injury?

Simply put, I think it is pure volume – the amount of work, the amount of repetitions, the amount of range your body moves through, etc.

What Crossfit actually does is point out where all the asymmetries, tight spots, loose spots, weak spots, uncoordinated spots and fitness deficits are.

A short injury history example

I have been struggling with a low back/SIJ problem for the last 2 months. I have been trying to manage it properly but during the open, I went for it – probably unwisely…so I lost a month there.

I initially strain my back/pelvis doing squat cleans I believe. I struggled under fatigue and load and twisted to the left. At the time, I knew I probably strained something but it didn’t hurt straightaway and I finished the WOD (workout of the day) without any more technique errors.

However, the strain was there. Now, it is hard to diagnose your own problems and my staff and I are quite busy so it has been hard to find time to get it properly looked at. However, the thing that I have noticed has been that my left hip has tightness, only a fraction more that my right hip. On a full squat though, I can feel the torsion and control it. Add load and fatigue and I probably twist too much. In fact, I know I do.

Each time I flare my injury up has been during anything with a “squat” involved – Deadlifts, Snatch, Clean and Jerk, Wallball Shots, and all of the squats (Air, front, back, overhead). The last time was just the other day doing the WOD called “TABATA This!” – it was the Air Squats that did me in – I got through 3 rounds of 17 squats but on the last of the 3rd set, my injury twinged again and i had to stop the squats (I still completed the WOD!!).

Releasing and stretching the hip has been the best for the problem – it decreases the pain and improves my mobility. This will ultimately lead to a more symmetrical hip range compared to the right side and careful training will result in improved strength on both hips as well. I am also continuing to strengthen my back and abdominals through the WODs – I haven’t added to my training load yet but I am ready to if I need to…

So how do you prevent injuries in Crossfit?

1. Listen to the coach/trainer – I think this is the biggest area I see problems in – too many people won’t stop to change their technique. If you let a bad habit creep in, it begins to affect other areas and suddenly you have a shoulder that you can’t use properly (a very common injury it seems!)

2. Listen to your body – your body will have asymmetries in it – this is common. It is your job to get onto these as often as possible. Make sure your mobility is up to scratch. Make sure you stretch, roll out, self massage, etc and take care of your body!

3. Perfect your technique before increasing your load – it is far better to do your WOD at a lower weight with perfect technique for each repetition than to increase the weight even just a little bit and complete 1 or 2 reps with poor technique. It is often during those 1 or 2 poor reps that injuries occur. I am pretty strict with this and even I got caught out with some bad reps and strained my back.

4. Sort out your problems – Don’t “train through” your niggles. Sort them out. Go see someone and get a program of mobility and stability sorted. I am taking care of my back and hip this way. I was actually feeling pretty good and was without pain for about 1 week but it wasn’t enough – You need about 6 weeks of good, non-painful WODs before you can even think about relaxing your guard. It just goes to show that I need to take my medicine too!

So Is Crossfit Dangerous or Not?

I actually love Crossfit because it DOES point out your deficiencies. It does highlight your weaknesses. I truly believe that everyone needs to have good functional strength and I think Crossfit certainly does this better than most.

So, “NO!”, I don’t think that Crossfit is dangerous. I think it is like every other activity out there – all activities have risks – it is how you manage them that counts. Even lying in bed is dangerous – you begin to lose muscle mass after just 24 hours!

I would love to hear about what you think – post your comments below!

About Antony Lo
Antony Lo is an APA Musculoskeletal Physiotherapist based in Sydney. His website is www.MyPhysios.com.au. He specializes in the management, treatment and prevention of pain and dysfunction, particularly of the pelvis and ribcage. His sub-specialties include Crossfit and Exercise Performance Optimization, Ante-Natal and Post-Natal Care and difficult cases that have failed treatment elsewhere.

33 Responses to Why Do Injuries Seem To Occur With Crossfit?

  1. Thanks Antony as usual common sense needs to prevail with all training, but having the right back up team like a great physio and massage makes all the difference.

    • Antony Lo says:

      Agreed Louise, it is not just with Crossfit…when I have spoken to people, they put up the injury excuse as a barrier to start SOMETHING…I would be happy if they just started ANYTHING! hahahaha

  2. Mark Collins says:

    I think one of the biggest risk factors in Crossfit is our pride. It is amazing how we push to get the extra rep or beat the person next to us.

    I think the key is to get great technique, even when we are fatigued and be patient when beginning Crossfit. I have been guilty of this. I pulled my calf muscle when practicing double unders. I had terrible technique as I was jumping too high and loosing the tight core. I just kept thinking one more rep until I felt the calf tear!

    The one thing I love about crossfit is that it highlights the weak and deficient areas in our body. For me it was the tight hip flexors, weak glutes and hammies, stiff thoracic spine, weak abs….the list goes on!

    Overall I can say that my body has never felt better since doing Crossfit. To me most other Sports are higher risk, not to mention sitting in the couch and doing nothing.

    Regards
    Mark Collins
    http://www.cantonbeachphysio.com.au

    P.S: I will see you @ the regionals Anthony.

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  5. banman says:

    I did Crossfit for a year and have now backed away from it somewhat. I learned a lot from it but I certainly didn’t think everything was right for me and as a pretty inflexible mid-40s guy, I found I just didn’t have the flexibility to do quite a bit of it without doing it badly or without it hurting. I found it to be a very macho culture and whilst scaling is an option, if for example, you were to suggest doing a wod with deadlifts in at anything under BW, it would be frowned on and scoffed at. If we were to mention injuries to the coach, he’d suggest a stretch but lost interest pretty quickly in anything that persisted and was very much of the ‘work through it’ mentality. As you have alluded to though, the fundamental problem with it though is that because of the comeraderie and the constant pushing to get PBs and complete the WOD, you’re nearly always training to exhaustion. Which really is just asking for injuries in my opinion. I may feel more positive about it had I started in my 20s and had more of a competitive nature.

    • Antony Lo says:

      Totally agree banman. Think I am fortunate to be in a crossfit “box” that has a good coach. Having said that, I see people who don’t listen to him.

      To be honest, it isn’t for everyone. It is for me.

      You have to be strong enough to scale back. It is hard when those around you don’t or they push too hard.

      What ever you do, the principles of crossfit are not unique. Do lift weights, body weight exercises and cardio. Regularly learn and play new sports :)

      Cheers

      • Sapa says:

        Strength: 115#WOD: 5:28 with feet hooked to bar on a smith manhice, since I can’t do free-standing HSPUs (yet). OHS were unscaled for the first time.I was also able to accomplish my first muscle up (on a bar) last night. I could only get the first one, but it felt great to be fully above the bar for the first time.Thanks to everyone at CFE. You have all really help me change my life.

  6. banman says:

    Love your last line A-Lo. “Do lift weights, body weight exercises and cardio. Regularly learn and play new sports”. That’s what I do now with lots of variety in there, some shorter sessions, some much longer ones, all with lots of sweat and a good number of heart rate spikes to over 90% of max.

    • Antony Lo says:

      Sounds like Crossfit…without the group and bad advice :) Keep it up :)

      You can always do their workouts at home…just be sure to video yourself now and then to see how your form is. I use an app that a friend showed me – Coach’s Eye – on my iphone (iPad available too I think). It is great – slow mo, frame by frame, annotations and graphics and lets you record your voice over the top and re-record it. Quite cool!

      • banman says:

        that’s funny. I video’d myself doing deadlifts last night and was going to have a look at that. Can I be cheeky and just ask whether you’d mind casting your eye at it – 20 secs – and just tell me whether it’s reasonable or appalling form please. I appreciate that my back does have a tendency to arch over so I do try and concentrate on keeping it straight on each rep. And getting my bum back and shins more upright…it’s on

        I’m upgrading my blueberry this month so will likely go for an iphone just on the basis of that app. Looks cool. Thanks for that.

        • Antony Lo says:

          That is funny :) OK, I had a look. Overall, not bad at all.
          1. The weight looks pretty easy for you so that’s good – you aren’t over doing it.
          2. Your back does set in a slightly bent over position but it is not that bad really. If you have a look at how you stand at the end, that is the ideal position your back curve should look like in your set position
          3. Your deadlift technique looks a little off. I am not a coach but I am pretty sure you are bending your knees on the way down too early and having to “reach” the bar forwards to get past your knees. Try to keep the bar over your shoe laces the whole time, delaying the knee bend on the way down until the bar is just past your knee caps. That way, it will look like you are deadlifting in a Smith Machine!! The way you are lifting at the moment make the bar look like it is moving in a “C” type of motion instead of an “I” type of motion. I hope I am making myself clear on this point :)
          4. Your haircut is awesome – same as mine :)

          Well done – just get your technique checked by a qualified coach…from a physio point of view, the above is what I think :)

          Cheers!

          • banman says:

            Thanks a lot for that. That’s good to know. I see what you mean re the deadlift form. I need to do some hamstring exercises to stretch them a bit I think. Cheers for haircut comment. Had it like that for coming on 20 years now. Never looked back….. Have a great weekend and thanks again

          • Antony Lo says:

            Rolling/balling your posterior hip muscles will help as well. The set position is more about hip mobility and back strength than anything else :)

            Having a great weekend. About to go do a swimming WOD…

            Total for time of:
            Part A: 3 rounds of
            - 20 alternating lunges
            - 10 “pool muscle ups” – dead hang in deep end at the highest wall, pullup into a tricep press out without using legs.

            Part B:
            - 200m swim, 10 pike hand stand push ups (pHSPU)
            - 150m swim, 20 squats
            - 100m swim, 30 pHSPU
            - 50m swim, 40 squats

            Part C:
            - 5 x 25m sprints on the minute – get out shallow end and walk back to deep end. d
            Diving in is allowed

            Have a go and tell me what you think :)

  7. banman says:

    Excellent one A-Lo and couldn’t be more timely. I’m going on holiday on Thursday and much of the next 10 days will be in a pool I suspect. I’ve typically got appalling exercise discipline on holiday APART from swimming so I shall certainly have a go at that. Loving the sound of pool muscle ups. I’m ok at them with my legs but have never tried without so there’s a challenge..

    • Antony Lo says:

      24.24mins I did it in

      Here is another swimming WOD I did in ~33mins…

      Total for time:
      3 rounds of each couplet
      50m freestyle with 10 pHSPU
      50m breastroke with 25 squats
      50m backstroke with 15 pushups
      50m butterfly with 10 pool muscle ups
      50m progression underwater only with 10 burpees

      Have fun and a great holiday :)

  8. banman says:

    Oh my !! You are creative. I may have to split that one up, it’s been a hell of a long time since I did 50m butterfly uninterrupted. And what’s progression underwater? Just moving forward somehow without using a stroke? How do the pike handstand push ups work? hope it’s not a dim question if I ask if they’re in the water. You know I’m printing these out, will take them with me and do them…. That’s if we get there. Daughter went down with chicken pox over the weekend so we’re desperately coating her with calomine every couple of hrs to try and make sure we’re at ‘scab’ stage by Thurs which is apparently safe to fly stage…

    • Antony Lo says:

      :) thanks banman :)

      Progression underwater just means you can only go forwards underwater – swim under water basically. If you come up for air, you have to stop then go under again. Try not to push off the bottom!

      Pike handstand push ups are out of the water – usual scaling as per crossfit videos.

      You can sub butterfly for freestyle if you like but as with all crossfit style exercises, scale it to what you need and keep going at your own pace!

      Good luck :)

  9. banman says:

    Impressive again A-Lo. I’ll give it a shot as well. Thanks. Been rushing around getting ready for the holiday. I’ll let you know how they go…

  10. Barbara says:

    Hi!! I’m a new crossfitter…about 4 months in. I have a hernia in between L4 and L5. I have been VERY careful and mindful of moves that might be too much for my back. But alas, I finally was able to do box jumps, and they did me in…I strained my back and haven’t been able to go to the box in about a week. My question to you is: what can I do to rehab my back? If I go to my doctor i KNOW he’s going to tell me not to crossfit anymore…but I’m hooked!!! Please help!!!

    • Antony Lo says:

      Hi. Welcome, my fellow addict!

      First of all, my comments do not replace the advice of your PT or doctor. So please check whatever I say with those who care for you :)

      1. you have to respect the injury but not be scared of it…that disc will need at least 6 weeks to heal but you should feel better before then. If I were to guess, you tried box jumps somewhere between 3-6 weeks following your back strain. The scaled option for box jumps is better – step ups/step downs. The impact is too much at this stage for your back it would seem…

      2. If you strained your back doing crossfit, then you are not paying enough attention to your technique, especially under fatigue. Ask the coach to watch you carefully. You will be bending in your back slightly on KB swings, set position for any oly lifting and probably sagging in push ups. Your squats will have a “butt wink” or posterior pelvic tilt causing a bend in your back. Be patient and realize that your body needs more time to adapt. Scale your workload so you can complete your WODs with perfect technique. It is no good going Rx with poor form. It is better to scale the WOD so your weakest movements are taken care of…you will be slower and using less weight but it will mean you will progress further in the long run…

      3. Exercises that might help – again, perfect technique:
      - Deadlift – either standard or stiff legged from a hang clean pos (Romanian)
      - “Good mornings”
      - perfect air squats then add load slowly for OHS, back and front squats
      - GHD hip extensions
      - spikey ball into the hips to release them
      - hand stand push up pos on the wall – get a perfectly straight line for your body – ask the coach for cues and corrections.

      4. What to avoid
      - sit ups (all forms)
      - GHD back extensions
      - box jumps
      - KTE and TTB
      - farmer’s carry

      Hope that helps. Seek advice. Respect the injury. Put the time in. Have fun.

      • Barbara says:

        Thank you SOOOOO much!! I went to the box today and scaled down most of the WOD, and actually felt better!! Now about the cardio aspect…aside from box jumps…is it OK to: run, row, double unders (or single in my case), wall balls, wall climbs? Thanks for all you advice.

        PS: Since I read the whole thread, I now told my coaches about the “Coach’s Eye” App…and they LOVED IT!!!

        • Antony Lo says:

          Hey Barbara. Glad it went well for you.

          Ok, cardio huh?
          1. Running – risky in my opinion…unless you are a trained runner…slow jog or power walk might be better
          2. Rowing – no, risky again…most people, especially under fatigue, flex in their spine too much
          3. Box jumps – no
          4. Wall ball – depends on your full squat and whether you maintain a straight back or not under load and fatigue – reduced range with reduced load might be ok
          5. Skipping – same as running – risky but might be ok if singles only…limit reps and assess slowly
          6. If you want cardio, what about push press at a light wts and high reps? Or thrusters light weight and dec squat range?

          Coaches eye is good fun – I am going to try to talk about some videos I have taken and post them :)

          Keep it up, that is great news. Get your coaches to read my blog!! Don’t forget to subscribe – I will put more on soon…busy…

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  13. Noah Doherty says:

    It appears that crossfit has a fundamental flaw in its philosophy. Its one thing to exercise through fatigue, as long as one’s technique and form is not compromised. After viewing a number of crossfit workouts posted online, I see time and time again that the person participating loses their form and technique due to fatigue and continues to push through. In every sport and competitive activity we see injuries occur when the athlete pushes through the fatigue and lo and behold ends up injured. The trainers I believe must step in right away when form is compromised and encourage the person participating to take a breather and regain form. This I feel will limit to a great degree of the injuries suffered.

    • Antony Lo says:

      Hi Noah. I agree that you see athletes pushing through with bad form. But is that the CrossFit philosophy? I am not sure. I also agree that Coaches stepping in and telling people to back off is a good thing…the good ones I have seen actually do that.

      I advocate that everyone trains with their form as close to perfect as possible…but also realizing that no one is perfect. I have had this discussion a number of times with different coaches…the “acceptable” movement varies wildly from one person to another. I am obviously very conservative as I have seen plenty of bad injuries from seemingly trivial movements (like bending over to pick up the soap!)

      Because no one is perfect, the risk of injury goes up…the further you stray from perfection, the higher the likelihood you have of injury…

      So train hard, train safely and work on your weaknesses.

  14. Dubius says:

    They really need to look at the programs for instance some programs unnecessarily fatigue important muscle groups which are important for stabilizing during complex movements.
    The program Linda has people fatiguing their lower back with deadlifts and then going back for more power cleans. — Unacceptable increase in injury risk that does not outweigh the benefits obtained.

    They prescribe exercises designed for explosive power and therefore best suited to 1 to 3 reps and make their participants to 35+ reps –Unacceptable increase in risk that is not outweighed by the benefits obtained.

    Kipping pullups for time = recipe for “slap tears” … I have seen coaches injured with these

    They prescribe plyometric/jump training exercises that carry with it an increase risk of injury at a point where the athlete is already fatigued and at high reps — Unacceptable increase in risk that is not outweighed by the benefits

    The nutritional advice goes against every professional sporting institute and Dieticians associations and not only that then claims that they have fallen victim to “junk science”. Their athletes are underfed and are in a weakened state

    and finally the workouts them self have been known to induce rhabdomyolosis and they react jokingly with a t-shirt. ……Really isn’t something that should be joked about

    Here Some links to consider

    A New Perspective by Gillian Mounsey former elite crossfit
    http://startingstrength.com/articles/training_perspective_gillian.pdf

    http://crudefitness.com/training/how-crossfit-forges-elite-failure/

    Dr Siff vs Greg Glassman
    http://www.irongarmx.net/phpBB2/viewtopic.php?p=397054

    The crossfit white pages
    http://joshsgarage.typepad.com/Crossfit_White_Papers_–_Timeline.html

    • Antony Lo says:

      Hi Dubius,

      Thank you for your comments. I have taken the time to read each of the references above and my thoughts on them follow…first let me say this…
      1. CrossFit needs to mature as a business…honestly, we are talking about a bunch of guys who used to run small business…as they make mistakes, they will learn from them.
      2. Done correctly, CrossFit is an organized way to do exercise. It is not new (IMHO), it is just organized in a way that has seemed to hit it off really well. If the other “methods” championed by some of the authors quoted were as successful in the combination of results, social inclusion and camraderie, then they would have a worldwide following as well.
      3. Your points above I agree with. I don’t do kipping pullups (even though I can) because I want the strict strength to do them first.
      4. You haven’t really commented on my post but had a go at CrossFit in general…what did you think of the points I made?

      As for the references, I think that Gillian Mounsey was a few years ahead of her time from the sounds of it. The reply by “nick” from North Sydney in the crudefitness blog said it well and I think gillian would actually do well at Crossfit in today’s environment. You need only look at Camille Leblanc Bazinet to see how much more muscle mass she has now compared to 2 years ago. All the competitors lift a lot better than 3 years ago!

      Everyone has their preference. I love CrossFit, I won’t deny it…but I train at a gym (Reebok CrossFit GCS) where the coaches emphasise safe technique. The programming is based on measuring volume overall. Darren Coughlan is a strength and conditioning coach before he was a CrossFit coach and has legit qualifications and experience. He programs based on a Bulgarian Conjugate style of programming. We lift every day. We do met-cons as well but they are all under 17mins. We don’t do 1hr hero WODs. We train for CrossFit so we don’t pretend we oly lift like an oly lifter. He trains specific-sports professionals differently to those in CrossFit and the general public because specific sports need specific training.

      Whatever you do, do it properly, safely and with the best peer-reviewed research available.

      Cheers!

  15. kvcaveman says:

    Hi Anthony, Wonder if you can help. We had some correspondence a while back (see Banman above but lost login details) re crossfit and deadlifts etc. I’m still deadlifting you’ll be glad to know. Cycled up and am shortly due to finish this current cycle at 117.5kg. My bodyweight is 90kg approx. No problems with it and I’m feeling stronger and am happy to look at 18mths-2 yrs as a reasonable timeframe to get to double bodyweight. I never got back to Crossfit. I’m now a confirmed HIIT guy and it’s a mix of running, rowing, swmming, cycling, and the overhead bike machine at the gym for me. Seems to suit me and it’s enough variety and tough enough for my liking. I have however been hit with what I think is a work-related injury from I’g guess excessive laptop keyboard use. Just wondering whether you’ve got any tips for that. It’s in my right arm, varies between my wrist and forearm and saps strength to the extent that I get a shooting pain when I drive and pick up a kettle. It’s been persistent for well over a month now. I did a week on ibuprofen which didn’t help. I’ve started doing 20 mins ice sessions which helps temporarily. I’ve got myself a proper keyboard, got a wrist rest, and brought my mouse closer but still it persists. Any ideas please?

    • Antony Lo says:

      Hey, how are you? Firstly, I don’t care what you are doing so long as it is legal, safe and done correctly ;)

      Your problem sounds a lot like tennis elbow but it can be many things like referred neck pain, joint strain, muscle strain etc etc. Might not be laptop-related if you have made the changes and it is persistent…

  16. kvcaveman says:

    Yeah all good here thanks. Apart from that. I can’t think of anything that would be doing to cause neck, joint, or muscle strain.

  17. top crossfit training shoes says:

    Thanks for finally writing about >Why Do Injuries Seem To Occur With Crossfit?

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