Brett Goldstein, D.C., Todd Rodman, C.C.S.P., D.C., and Christopher Knapp, D.C., at the CrossFit Games
Is CrossFit Safe- Why CrossFit injuries occur & how to reduce your risk of injury
I am writing this blog because I often get asked this question from many different types of people. It usually comes from either a patient, a CrossFit athlete, or an individual interested in knowing about CrossFit. There are many different answers to this, commonly depending on if the person asked has a predisposed bias that is “For” or “Against” CrossFit. My goal here is to present my opinion of the experience that I have had in CrossFit with my background as a board certified sports chiropractic physician.
My background with CrossFit includes:
- Member of the athlete services staff for 4 years at the CrossFit regionals
- Member of the athlete services staff for 3 years at the CrossFit games
- Director of Athlete Services for the CrossFit Southeast region for 2 years
- CrossFit as my main choice of exercise for 7 years
- I have personally treated over 1000 different CrossFit athletes at CrossFit events and in my office located in Boca Raton, FL.
The role of the athlete services director is to assemble a talented team of doctors and manual therapists (Chiropractic Physicians, Osteopathic Physicians, Physical Therapists, etc.) to diagnose and treat CrossFit competitors during their regional event. This experience is valuable because we see and treat many elite athletes with acute musculoskeletal conditions acquired during competition, only minutes after the onset of injury. Our goal is to return the athlete to competition and observe how they respond post-therapy.
Working at the major CrossFit events with the top competitors is only a small percentage of the patients that we treat. More often we are treating the recreational CrossFit athlete who wants to get in shape, lose weight, build muscle or just push themselves to be as fit as they can. Some of our patients compete in local CrossFit competitions, but most often their main training is at the CrossFit gym.
Over the years CrossFit has evolved. It originally started out with WOD’s (workout of the day) being a combination of metabolic conditioning, gymnastic movements and powerlifting. Currently, most CrossFit gyms have a larger emphasis on separate powerlifting training, mobility classes and a WOD. All CrossFit gyms have different equipment, different philosophies/coaching styles and different trainers. The import thing to realize is not all gyms are the same. It has been great to see how CrossFit has evolved in only a short period of time. If you are looking to join a CrossFit gym make sure to do your research and find the one that closely fits your fitness goals.
Now I bring you to a collection of, gathered from my own experience and asking hundreds of people highly involved in CrossFit, some of the more common reasons I believe people get hurt doing CrossFit. Here it is:
- Trainers – Some trainers are better than others. Even the best trainers/coaches cannot watch every rep of every person at the gym. Make sure that your trainer spends time with you individually, getting to know your strengths and limitations, as well as watching your form. They also should give you verbal cues (movement tips and advice) when you are fatigued. Trainers should be well rounded, be able to coach you on perfect form, show you how to improve your mobility and inspire you with words and by their example.
- Clock & Whiteboard – The clock is a double edged sword. Use the clock to push you to your physical limits, but don’t let it compromise your form and put you at a high risk of injury. Also, most CrossFit’s have a whiteboard that records their member’s times and weight during that days WOD. Remember that at the end of each day the whiteboard gets erased. Don’t put yourself at a high risk of injury just to beat a certain time.
- Not knowing your physical abilities – I believe that all CrossFit gyms should do a baseline movement assessment and health history. Movement assessments are used to analyze standard ranges of motion during dynamic movements. An inability to perform a specific movement test shows the coach that your mobility or stability need to be improved before performing any CrossFit exercise that can exceed your range of motion capacity. A health history is a general look into your health that can give a coach the ability to identify red flags in your health that might put you at risk for high intensity exercise.
- Complex movements & heavy weights while fatigued – Most people believe that the real workout starts when you are fatigued. They believe that this is when you can make your most gains and increase your lactate threshold. However, getting to the point of fatigue and doing complex movements and heavy weights increases your chance of injury. Keep in mind that when you get to this point in your workout it is imperative that you concentrate more on perfect form and core activation than ever. When fatigued, your body will use its remaining energy to assist the muscles of respiration (breathing) and less on the muscles that provide stability. This explains that wobbly, jello-like feeling in your arms, legs and entire body when you get tired. For example, when a boxer who has gone late into the rounds of the fight and has a drunken like, staggering appearance. This is the best time to step back, take a deep breath, lower your heart rate and concentrate on each rep being performed perfectly.
- Not spending enough time on mobility & technique (form) – Most CrossFit gyms have powerlifting included in their programming. They base your workout on percentages of your 1 rep max (heaviest weight that you can lift for that specific exercise). If you have not spent enough time perfecting your technique in that specific movement then you should not be performing 100% of your 1 rep max. Instead, take a step back, work on your form and don’t exceed around 70% of your one rep max until your form is consistently great. As we talked about earlier, mobility is very important towards avoiding injuries. If you don’t have full mobility in a specific exercise you should either not perform that exercise or perform it at a decreased intensity until it can be done properly.
- Not factoring in active rest/recovery days – Active rest means to stay active, but to do a different sport or exercise than you normally do. If you are lifting heavy weights and squatting daily then a great active rest day would be to swim, bike, do yoga or pilates. These activities have less loading on your joints, stretch your muscles, improve stability, make you sweat and help you to avoid an overuse or repetitive stress injury. This is a great day to come see your local Sports Chiropractor (had to throw that in) or any talented manual therapist (DC, LMT, PT, DO, Acupuncture, etc.) that you like and gets good results.
- Programming overuse – If the programming at your CrossFit uses the same exercises or the same muscle groups daily, then you are at risk to develop a potential overuse injury. Overuse injuries are very common and account of more than half of the visits to orthopedic offices each year. Make sure that you are not doing the same movements more than 2 days in a row and that can help reduce your injury risk.
- Not including stabilizer muscle training – We have all heard of the big, powerful outer core muscles such as the latissimus dorsi, erector spinae, iliopsoas, hamstrings, adductors, abductors. These muscles are known as the movement system and they are responsible for generating powerful force and moving our body. The problem occurs when our inner core stabilizer muscles do not have as much strength and we do not have the ability to stop that force. If the movement system is too powerful for our stabilizer system than we are out of biomechanical proportion and are more prone to injuries. This would be analogous to building a house without a foundation. The foundation must be developed first to provide a stable platform for the remaining components of the house to be built on. The stabilizer system is also known as our inner core and consists of less known muscles like the transverse abdominus, internal oblique, lumbar multifidus, pelvic floor muscles, diaphragm and the transversospinalis. The stronger the inner core muscles are the better we can stop the powerful movements from pulling out joints out of alignment, straining muscles, spraining ligaments and even tearing them off of our bones. If we want less injuries to occur we need put a higher priority on training the stabilizer system (inner core). We need to make training these muscles as important as the bigger prime mover muscles. The best inner core training programs require the spine to be held in a neutral position while breathing and while moving the arms and legs in motions that mimic the functional ways the core will be stressed in a given sport or activity. The inner core consists of type 1 muscle fibers and are best trained with 6 to 20 second holds on an unsteady surface.
- Improper nutrition – nutrition plays a vital role in your training and can negatively affect your performance and recovery when done improperly. This is not intended to be an in depth article on nutrition, but it is to make you aware of its importance. There are many different types of nutritional programs that are beneficial to CrossFit. Some of the main things that can affect your recovery is not eating enough protein. Performance can be affected by not enough carbohydrates and hydration. If you think that you are not eating properly then research nutrition for CrossFit and find the nutritional program that fits best for you.
While there are definitely more things that can be added to this list, I believe that if you apply this information you can reduce the risk of a CrossFit injury. If you have ideas to add about how to reduce the risk of CrossFit injury please comment below. Please share if you think this blog will help someone that you know.
Stay healthy my friends,
Dr. Todd Rodman, DC, CCSP
Reviewed by: Dr. Christopher Knapp, DC and Dr. Brett Goldstein, DC
