CrossFit Injury Research
Updated: Apr 19, 2020
"A 4-Year Analysis of the Incidence of Injuries Among CrossFit-Trained Participants"
Purpose:
"To examine the incidence of injuries related to CrossFit participation and to estimate the rate of injuries in a large cross-sectional convenience sample of CrossFit participants around the world."
Methods:
3049 participants engaged in a CrossFit questionnaire between 2013-2017
Questionnaire inquired about age, sex, frequency of participation in CrossFit, and injury history while performing CrossFit
Participants needed to be > 18 years old and performed CrossFit for > 3 months
Definitions:
Injury: "any muscle, tendon, bone, joint, or ligament injury sustained while doing CrossFit that resulted in your consultation with a physician, or health care provider, AND caused you to stop or reduce your usual physical activity, your typical participation in CrossFit, or caused you to have surgery".
Injury Incidence: number of injuries experienced during the previous 12 months as a result of participating in CrossFit
Injury Rate: the total amount of time that a person was exposed to CrossFit before reporting an injury
Results:
Injury Incidence:
931 out of 3049 (30.5%) reported injury related to their participation in CrossFit
62.4% reported injury to a single body part & 37.6% injured multiple body parts
Location: shoulder (39%), back (36%), knees (15%), elbows (12%), wrists (11%)
Experience: >3 years of experience reported more injuries
Volume: 3 to 5 days per week reported greater number of injuries than < 3 days or > 5 days
Injury Rate:
Significantly higher injury rate for people who participated < 3 days per week
Participants with < 6 months of experience reported the highest injury rate
Less engaged/experienced CrossFitters = 0.74 injuries per 1000 hours
More engaged/expecienced CrossFitters = 0.27 injuries per 1000 hours
Conclusion:
"Overall, CrossFit training seems to be a safe training modality for most participants; however, our findings suggest that there are 3 main groups that might be at a greater risk for injuries, including those who (1) are within their first year of participation, (2) engage in this training modality less than 3 days per week, (3) participate in less than 3 workouts per week."
References:
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"Injury Incidence and Patterns Among Dutch CrossFit Athletes"
Purpose:
"To investigate the incidence of injuries for persons participating in CrossFit. Risk factors for injury and injury mechanisms were also explored through athlete demographics and characteristics."
Methods:
449 participants, they must have been > 18 years old and were currently training at a CrossFit gym
A questionnaire was distributed to all 130 CrossFit gyms in the Netherlands between July 2015 and January 2016
Definitions:
Musculoskeletal Injury = any new pain, feeling, or discomfort as a result of a CrossFit workout that met 1 of the following criteria:
Total removal of CrossFit training and other outside physical activities for > 1 week
Modification of normal training activities in duration, intensity, or mode > 2 weeks
Any physical complaint severe enough to warrant a visit to a health professional
Results:
Injury Characteristics
252 athletes (56.1%) sustained an injury in the preceding 12 months
68 athletes (15.2%) sustained > 2 injuries
Location:
Shoulder (28.7%)
Lower back (15.8%)
Knee (8.3%)
Types of training:
WODs (39.7%)
Strength Training (21.4%)
Skill Training (9.1%)
Condition Training (4.0%)
Athletes' analysis for cause of injury:
Bad/Incorrect Form (20.5%)
Fatigue (20.2%)
Too heavy of weight (16.1%)
Relapse of an old injury (9.3%)
Too little or bad coaching (1.6%)
Injury Rate Analysis:
"Duration of participation in CrossFit for 0 to 6 months was the only independent risk factor for injury"
Conclusion:
"The injury incidence rate for athletes participating in CrossFit among the studied cohort was 56.1%. The most commonly injured body parts were the shoulder, lower back, and knee. A short duration of CrossFit participation was significantly associated with an increased risk of injury."
References:
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"Injury Rate and Patterns Among CrossFit Athletes"
Purpose:
"To establish an injury rate among CrossFit participants and to identify trends and associations between injury rates and demographic categories, gym characteristics, and athletic abilities among CrossFit participants."
Methods:
386 participants that were > 18 years old and actively were participating in CrossFit
Questionnaire was collected from October 2012 to February 2013. It was sent out to CrossFit gyms in Rochester, NY; New York City, NY; Philadelphia, PA; and it was also made available on the CrossFit website.
Athletes were asked in the questionnaire to recall over the last 6 months if they experienced an injury
Definitions:
Injury = new musculoskeletal pain, feeling, or injury that results from a CrossFit workout and leads to 1 or more of the following options:
Total removal from CrossFit training and other outside routine physical activities for > 1 week
Modification of normal training activities in duration, intensity, or mode for > 2 weeks
Any physical complaint severe enough to warrant a visit to a health professional
Results:
Injury Rate by Demographics
75 participants (19.4%) experienced at least 1 injury from CrossFit within the last 6 months
No significant differences were found in injury rate for athletes of various ages
No significant differences in injury rate based on length of training session
Participants that went to a gym with an on boarding process for beginners had a lower injury rate
Males were more likely to be injured than females
Significant correlation between injury rate and level of coach supervision, females were more likely to seek coach supervision. This may contribute to why males are more likely to be injured
Injury Characteristics
Most common body parts injured were shoulder (21/84), low back (12/84), and knee (11/84)
Gymnastic movements - the shoulder was injured the most often
Power lifting - the lower back was injured the most often
Conclusion:
"Injury rates in CrossFit are comparable with established injury rates for other recreational or competitive athletes, with an injury profile resembling that of gymnasts, Olympic weight lifters, and power lifters. The increasing involvement of CrossFit trainers in coaching participants corresponds to a decreasing injury rate. The shoulder and lower back areas were the most commonly injured body regions and mostly frequently were injured during gymnastics and power lifting movements."
Reference:
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"Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit"
Purpose:
"Examine injury epidemiology and risk factors for injury in CrossFit"
Methods:
191 participants from 4 CrossFit affiliates in South Florida, they were eligible to participate if they were members of the affiliate and were present on the day of data collection
The survey was composed of 3 parts: (1) Athlete's participation which included length of participation in CrossFit, frequency of participation in CrossFit, and whether or not the athlete warmed-up or cooled-down. (2) Injury history within the last 6 months. (3) Fitness level prior to CrossFit, motivation to participate in CrossFit, activity participation outside of CrossFit, and participation in CrossFit competitions.
Definitions:
Injury - any physical damage to a body part that caused them to miss or modify one or more training sessions or hindered activities of daily living
Injury Rate - calculated by estimating the number of athlete training hours in the preceding six months with the number of injuries
Results:
Risk Factors for Injury
50 out of 191 athletes sustained a total of 62 injuries
Incidence rate of injury = 2.3 injuries per 1000 hours of participation
The following differed between injured and uninjured athletes - years of participation, weekly athlete training hours, weekly athlete-exposures, height, and body mass
An athlete that participated in CrossFit for a greater length of time had an increased injury risk
40% of competitors were injured compared to 19.05% of non-competitors over the previous 6 months
Injury Epidemiology
12 athletes experienced > 1 injury
Most frequent injury locations: shoulder (14/62), knee (10/62), lower back (8/62)
24% did not impact training
50% altered their performance with training
20% reported injury caused CrossFit cessation
20% reported injury caused cessation of specific exercises
Conclusion:
"CrossFit offers a solution to achieving vigorous physical activity and weight training recommendations with the added benefit of cohesion, which may improve exercise adherence. While the rate of injury in CrossFit is similar to other forms of exercise, some injured respondents reported the need to cease physical activity or seek medical attention. Individuals interested in pursuing CrossFit for fitness, competition, or both should weigh the risks and benefits of participation."
Reference:
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"Rates and Risk Factors of Injury in CrossFit: A Prospective Cohort Study"
Purpose:
"Evaluate the level of injury risk associated with CrossFit training, and examine the influence of a number of potential risk factors (including movement competency)."
Methods:
117 CrossFit athletes from 2 CrossFit affiliates in the United Kingdom were followed for 12 weeks. They must have been > 18 years old and an active member of either affiliate
A baseline subjective questionnaire was given to each athlete asking about: gender, age, height, previous injury history within the last 6 months, coaching exposure, previous experience with Olympic lifting/gymnastics, and the number of CrossFit sessions attended per week
Movement competency was assessed using the Functional Movement Screen (FMS)
Definition:
Injury - Any physical complaint that was sustained during CrossFit training that resulted in a participant being unable to take part in future CrossFit training
Severity - determined by the number of day's absent from full training
Results:
15 athletes out of 117 experienced time-loss injuries over the 12 weeks
Overall injury incidence rate = 2.1 injuries per 1000 training hours
Median severity = 7 days absent from full training due to the injury
Most common injured body region was lower back (5/15), knee (3/15), wrist (2/15), thigh (2/15)
Most injuries were considered acute (11/15)
Most common cause of injury was weightlifting exercises (squat, deadlift, overhead press, snatch) followed by metabolic conditioning activities
Higher rate of injury was seen in male participants, participants with a previous injury within the past 6 months, and participants that had more asymmetries on the FMS
Conclusion:
"Injury Risk associated with CrossFit training is likely to be acceptable, relative to its apparent health and performance benefits. Male participants and those who have incurred previous injury in the preceding six months appear to have a higher underlying risk of injury, and so CrossFit coaches should manage these groups prudently."
Reference: