To Crossfit, or Not to Crossfit

By: Dale J. Buchberger, PT, DC, CSCS, DACBSP

As a physical medicine healthcare provider, I see 5-10 patients a month with Crossfit injuries. I entertain 5 times that number in questions about Crossfit between internet requests, office based requests and parents of young athletes that I coach. The general consensus is that you are all for Crossfit or you are against it. My opinion is matching crossfit to the person. I hope that this article will suit the Crossfit “disciples” and the Crossfit “bashers”.

What is Crossfit? According to the Crossfit, Inc. Website: “CrossFit is the principal strength and conditioning program for many police academies and tactical operations teams, military special operations units, champion martial artists, and hundreds of other elite and professional athletes worldwide.” And therein lies the problem. The majority of people that participate in Crossfit classes or at “boxes” are not high-level police, tactical, military or elite personnel. Your average “crossfit participant” is not preconditioned to participate in Crossfit. While elite personnel are preconditioned, they are not impervious to injury. Injuries sustained during Crossfit by elite personnel are considered a work-related hazard. Injuries sustained by the average person are a great inconvenience and expense.

So what’s right with Crossfit? It provides an avenue for the general population to become active, lose weight, and regain their health. Crossfit can be motivating and provide a strong support network for all involved. In this sense, the general idea of increasing physical activity to improve quality of life is a good thing.

What is wrong with crossfit? As previously stated, the methods used in Crossfit workouts (for the most part) are not made for the general public that enters the program deconditioned. If anything, there should be a preconditioning phase to Crossfit that prepares the individual for the more advanced rigors of the program. Some of the exercises and how they are used are counter to safe and appropriate practices. As an example: performing Olympic style lifts for time, speed, and volume is an injury waiting to happen. Instead of performing a set of 10-20 Olympic lifts as fast as you can, you should think in terms of 10 sets of 1, performing each lift perfectly. If you have participated in or witnessed a Crossfit class you honestly know that there is a variety of techniques and very few are good. Premature fatigue is a primary reason for failing technique. How can this be improved and still incorporated into Crossfit with less risk of injury? First, teach the technique over weeks not minutes. Then perform the drill within the context of its intent: speed and power, one time.

There are a large number of jerking type motions involved in Crossfit, such as close grip kettle bell swings and kipping pull-ups. If these are performed as described, they are all but guaranteed to cause shoulder issues to the point of requiring surgical repair. The most common injuries we see are labrum tears of the shoulder cartilage and rotator cuff tears. Close grip movements are tough enough on the shoulder, but performing them with ballistic movements will only compound the problem. Performing them with one arm at a time with a lighter kettle bell will compromise the shoulder less and still allow some high intensity work. Kipping pull-ups serve no real purpose. If you need to “kipp” on a pull-up then you should be using some sort of elastic assistance and concentrate on improving your technique.

These are only a few examples of potential and common Crossfit errors. There are ways to modify them to improve safety and reduce risk of injury. The idea of Crossfit is to get in shape and improve your quality of life. Why, then, follow a plan that increases the chance of injury? If you are doing the “work out of the day” (WOD) the same as everyone else in the class then there isn’t much individualization to the program. If your instructor recognizes your needs are different from another classmate, then you have found a good instructor. If you are told to push through regardless of your symptoms, pain, or their relationship to the mechanism of the exercise, then you probably need a different, more knowledgeable instructor.

Exercise should be matched to the person based on starting level of conditioning, age, and body type. Crossfitters in their 40’s and 50’s will have some preexisting level of degenerative changes not just in their joints but in their tendons. Exercising too aggressively too fast will surely bring out an injury. Younger individuals in their late 20’s and early 30’s commonly have poor stability systems usually exacerbated by the fast jerking motions of the common Crossfit program. The key to a safe effective Crossfit program for the general population is knowledge and the willingness of the instructor to individualize the program based on morphologic and demographic indicators. If you choose to Crossfit, do so with caution.