What do studies say about injuries in CrossFit?

Sam Briggs, Queen of the UK CrossFit, is now the winner of two sanctioned events, The Dubai CrossFit Championship and The Australian CrossFit Championship. 

Her incredible capacity and performance in the individuals division, despite the age difference compared to the other elite athletes she's competing with and also her injury history, made us want to have a closer look into the subject of injuries in CrossFit, a very debated subject in the functional fitness community.

According to the studies conducted so far, when considering the same number of hours of training, CrossFit injuries are less likely to appear compared to other sports, especially endurance sports, such as running. It appears that injuries in CrossFit are directly related to the volume and intensity of training.

Injuries are more likely to happen in people with high competitiveness and low skills, also more likely to appear in the very first months after athletes pick up CrossFit training (the period when people are still unaware of their own limits and their body’s signals). 

So why the commotion around the dangers of doing CrossFit? Is it because of media’s constant search to find any sort of potentially scandalous thread regarding still fresh training regimens (still fresh when you compare it to running) and questioning techniques in order to gain news traction? Or is it because of the high risk of injuries in elite level athletes, this 0.001% of the entire CrossFit community? 

We’ll try to answer some of most ardent CrossFit injuries related questions in the article below, and we will also share what studies have found to be the body parts with the highest injury risk, finally diving into the injury history of a top athlete, Sam Briggs: types of injuries, recovery time & come-backs. 

Here’s what you’ll find out when reading this article:

When did the the subject of CrossFit injuries blow up?

What are the reasons for CrossFit injuries?

Injury rate in other popular sports: running and triathlon

Injury rate in CrossFit versus other strength sports

Which are the most common types of injuries?

Who is more prone to injuries in CrossFit?

How to avoid CrossFit injuries?

What if it’s too late and I’m already suffering from a CorssFit injury?

3 supplements that reduce the recovery time after a sports injury

A look into Sam Briggs’ injury history

Conclusions & take-aways

When did the the subject of CrossFit injuries blow up?

In 2013 the Journal of Strength and Conditioning Research made public a study conducted on 132 CrossFit athletes. The results were easy to grab the attention of the media, to say the least: 74% of them (97 athletes) experienced an injury during their CrossFit workouts. Out of those, 9 athletes (7%) needed surgery.

However, the research also pointed out that the injury rate is 3.1 per 1000 hours of training. The conclusion of this study was that the injury rate in CrossFit is similar to the one in Olympic weightlifting, powerlifting and gymnastics. However, the media’s conclusion, though slightly incomplete, spread much faster: doing anything that involves barbells and heavy weights for time is unsafe, as compromised form can be easily overlooked when you’re trying to beat the timer. 

While 74% is an alarming number when you’re talking about the risk of injuries in any sport, and clearly makes for a good news headline, we feel it’s fair to look at the bigger picture and dig deeper into the facts.

What are the reasons for CrossFit injuries?

CrossFit coaches and other types of strength and conditioning trainers have identified 5 reasons why people are prone to injuries while working out with these fitness regimens:

  1. Training volume and intensity
  2. Faulty technique
  3. Poor muscle strength and endurance
  4. Muscle imbalances
  5. Mobility limitations

Out of this list, the one reason that stands out the most is the training volume and intensity. When you work out frequently and at a very high intensity, chances for problems to appear are much higher than in any other cases iterated above.

Injury rate in other popular sports: running and triathlon

Over time, many research studies have been conducted regarding the injury rate in more mass sports, such as running. Several studies have shown that the injury rate in long-distance running ranged from 2.5 to 12.1 injuries per 1000 hours of training, with more recent studies concluding that the injury frequency is actually in the top end of this range. 

When studying triathlon athletes, the injuries rate dramatically changed, with a range of only 1.4 to 5.5 injuries per 1000 hours of training. Several hypothesis can be formed and still need to be tested, such as focusing on several sporting activities reduces the risk of injuries versus overusing your body in one single type of activity.

Injury rate in CrossFit versus other strength sports

Strength and Conditioning Research has compiled several studies into the chart below, to give a proper big picture of the injury incidence in strength sports. 

What the chart shows us is that the risk of injury is lower when doing strength sports versus endurance sports such as running, given the injury rate between 0.24 to 5.5 per 1000 hours of training in strength sports versus the 2.5 to 12.1 injuries per 1000 hours in long-distance running. 

However media hasn’t been feeding the public with titles regarding the dangers of long-distance running. Maybe it’s simply not a news-worthy title. Moreover, a study from 2012 in US reported that among triathloners there is one death every 76000 participants. Out of the approximate 4 million CrossFitters today, we haven’t heard any deaths being reported yet. 

Which are the most common types of injuries?

The injuries that strength athletes most commonly suffer from are located in the lower back, shoulder, knee, achilles and elbow. 

No matter where you are in your CrossFit progression, no matter your goal and how often you work out, you must know that preventing is always easier than treating. For this reason, we strongly encourage you to take a little time to educate yourself on the most common CrossFit injuries. In this article we cover reasons for, the prevention methods and the treatment for lower back pain, anterior shoulder impingement and anterior knee pain. As the feedback was overwhelming at the time we published this article on the top 3 injuries in CrossFit, we decided to cover the full list, so in this second article you will be able to educate yourself on the reasons, prevention and treatment of achilles issues and elbow pains. 

Common CrossFit Injuries and how to prevent and treat

Common CrossFit injuries - part II

Who is more prone to injuries in CrossFit?

It’s been reported that most likely to suffer from an injury while doing CrossFit are:

  1. People with higher body mass
  2. Competition level athletes
  3. People training long hours

While all the profiles listed above make perfect sense, competitors and people training longer hours have one thing in common: training volume. In these instances there is a risk of over-training, due to the fact that the body can have a healthy recovery only up to a certain volume of training. Experts coined the concept of Maximal Recoverable Volume which is “the highest volume of training an athlete can do in a particular situation and still recover.” Although it’s hard to determine precisely what this volume in each particular case, every person training CrossFit, or any sport for that matter, should be aware of this concept and try to figure out more or less which is their own maximal recoverable volume.

CrossFit HQ recommends each workout to be composed of a single strength/skill element or a metabolic conditioning workout. The schedule should be 2 days on, 1 day off or every week 5 days on, 2 days off. However, a lot of CrossFit boxes program a strength AND a conditioning workout each day, 6 days per week. The weekly volume that most gyms program is significantly higher than what CrossFit HQ suggests and that means exceeding the maximal recoverable volume in most cases. This means that again, it’s up to each individual to find their optimum flow, without exhausting themselves beyond their recovery abilities.

How to avoid CrossFit injuries?

First and foremost you need to be aware and accept your limits and your recovery abilities. Being aware of the fact that your body needs time and help to recover is a good start. Remember that health comes first. Even if you want to see progression and you’re chasing those immediate gains, risking an injury is not worth it. Be aware it can sideline you from training and that the overall damage can be much higher than the gains. 

What if it’s too late and I’m already suffering from a CorssFit injury?

There are several ways to cope with injury. Depending on its gravity, you can still consider some types of training that use those muscle groups unaffected by the injury. But do it only under your coach’s supervision.

This being said, there are a few ways in which you can speed your recovery. One of these, is supplementing your diet with protein, omega 3 fatty acids and creatine, all of them having been proven to boost the body’s recovery after injuries. 

3 supplements that reduce recovery time after a sports injury

1. Protein

Protein is an important building block for many tissues in your body, including muscle.

After a sports injury, the injured body part is often immobilized. This generally leads to a decline in strength and muscle mass.

However, getting enough protein can help minimize this loss. Furthermore, a protein-rich diet may help prevent inflammation getting out of control and slowing down your recovery.

Slightly increasing your protein intake once you start training the injured body part again helps you rebuild your lost muscle.

Have one More Muscle protein shake first thing in the morning and one later in the afternoon, to allow your body to access a source of protein that will be absorbed fast by your muscles to help speed recovery and slow down the loss of muscle.

2. Omega-3 Fatty Acids

After an injury, the first phase of wound healing always involves some inflammation. This inflammatory response is beneficial and needed for proper healing. However, if this inflammation remains too high for too long, it may slow down your recovery.

One way to prevent excess inflammation from delaying your recovery is to have enough omega-3 fats in your diet.

Some studies report that omega-3 supplements may help increase the creation of muscle protein, reduce the loss of muscle during immobilization and promote recovery from concussions.

Progenex Omega+ is an excellent source of Omega 3 fatty acids, proven to reduce joint pain and accelerate recovery. 

3. Creatine

Creatine is a substance naturally found in meat, poultry and fish. It helps your body produce energy during heavy lifting or high-intensity exercise. Creatine has become a popular supplement commonly used to increase muscle mass and improve performance in various sports and also helping you recover from an injury. 

One study reported that creatine supplements enhanced the gain of muscle mass and strength lost during a two-week immobilization period more than a placebo. Another study found that individuals supplementing with creatine lost less muscle in their upper body during a week-long period of immobilization than those given a placebo.

Progenex Amplitude is a top quality source of creatine for your body. Mix one scoop of Amplitude with your More Muscle shake every day and you can boost your recovery and reduce muscle loss immediately after your injury. It will also help you regain muscle more quickly once you go back to training.

A look into Sam Briggs’ injury history

An interesting case study to look at is Sam Briggs, the 36 year old CrossFit athlete that's still one of the strongest Individual athletes out there. Her behaviour in regards to injuries is in no way to be copied as her innate level of competitiveness is pushing her to compete at times with serious injuries, but let’s rather look at the types of injuries Sam sustained over her CrossFit career and what were the outcomes of being sidelined for a period of time, due to recovery. 

Sam Briggs started her CrossFit career in 2009. In 2010 she had already qualified for the CrossFit Games and finished 19th that year. In 2011 she finished 4th in the CrossFit Games, but soon after the season ended, she started experiencing knee pain during the preparation for the 2012 season. 

2012 knee injury: kneecap and fractured patella

In 2012, Briggs stepped down from competition because of her knee injury. She officially withdrew from competition in March, midway through the CrossFit Open, with severe problems in her right kneecap, that she had overseen for a couple of years. After medical investigations, she found out she had a fractured patella.

Sam Briggs recalls from this injury time “not being able to drive for more than 30 minutes without screaming”. Therefore half way through the Open her coach and her physiotherapist sat her down and convinced her to withdraw from the competition.

The recovery was tough, but it was a time of reflection and rethinking her training regimen, resulting in a more disciplined and also more determined Briggs, who amazed everyone the following year by winning the Open, the Regional and the Games. 

2015 pelvic injury and broken foot during the CrossFit Open 

Briggs had another rough year in 2015 when she injured her Sacroiliac joint midway through the CrossFit Open qualifying stage, and then breaking her foot prior to the Regionals. Briggs still managed take part in 2015 Atlantic Regional (having moved to Florida during that year). In her uniquely pain resilient way, she did the Atlantic Regional with a broken foot, thereby qualifying for the 2015 CrossFit Games.

That year placed 2nd overall in the Atlantic Regional, ensuring this way her qualification for the 2015 CrossFit Games. A weekend of rough workouts on a broken foot. 

After a proper assessment of her broken foot, the outcome was that the fracture became bigger during the Regional, but luckily no surgery was needed. This gave Sam the chance to rehabilitate by August, when the Games happened, and climb up to an incredible 4th place on the 2015 Games leaderboard.

2018 Broken elbow with a fractured joint and ruptured ligament

In the spring of 2018, Sam Briggs suffered from a broken elbow, fracturing the joint and rupturing the medial ligament, after the Open, just before the Regional.

Since it was already the second year Briggs had the right to take part in the Masters competition, “not wanting my season to be over I managed to strap the elbow up and complete the age group qualifiers”. We’re talking rope climbs, heavy thrusters, heavy cleans, handstand walking, and handstand push-ups. All with a broken elbow and ruptured ligament. 

After surgery, Briggs was constantly training her lower body, doing also cardio, doing a lot of recovery work, enough that by August she was able to take part in the competition and finish 2nd Fittest 35-39 year old Master on Earth. 

Conclusions & take-aways

The take-aways are simple: high training volume and intensity puts you in danger for CrossFit injuries. Knowing your body’s limits is as important as the work itself. If injuries occur, allow your body to recover and provide it the proper nutrients so that it can heal well. And lastly, in case of injury, take the time off to reflect on the type of training you have, your goals and how you want to get to them - do you really need to get there at the fastest pace possible, while putting your body at risk, or actually slower and more consistent, enjoying a healthy, sustainable process, preventing the injuries that might occur. 

Sam Briggs is only one, and she has a mental capacity, endurance and pain threshold that seem to be higher than anybody else on Earth. The take-away from her injury history is in no way pushing yourself when you’re already at risk, but rather that come-backs can be much more rewarding if you take the time to recover, get proper assistance and focus your energy and time on what you can and want to do better.

Liked this article?

For tips & special offers, updates on Sam Briggs and CrossFit news, follow us on Facebook and Instagram.

Check out more about Progenex athlete Samantha Briggs, her career as a firefighter and her full competitive history with CrossFit, in this article that includes a video featuring Sam talking about her struggles beore becoming the 2013 Fittest Woman on Earth. 






Sources:

  • Borresen J, Lambert MI. The quantification of training load, effect on performance. Sports Med. 2009;39:779–795. doi: 10.2165/11317780-000000000-00000.
  • Hak PT, Hodzovic E, Hickey B. The nature and prevalence of injury during CrossFit training. J Strength Cond Res. 2013; 10.1519/JSC.0000000000000318.Smith MM, Sommer AJ, Starkoff BE, Devor ST. Crossfit-based high-intensity power training improves maximal aerobic fitness and body composition. J Strength Cond Res. 2013;27:3159–3172. doi: 10.1519/JSC.0b013e318289e59f.Thompson WR. World wide survey of fitness trends for 2017. ACSMs. Health Fit J 2016;20:8–17.
  • Fisker FY, Kildegaard S, Thygesen M, Grosen K, Pfeiffer-Jensen M. Acute tendon changes in intense CrossFit workout: an observational cohort study. Scand J Med Sci Sports. 2016; 10.1111/sms.12781.
  • Fernández JF, Solana RS, Moya D, Marin JMS, Ramón MM. Acute physiological responses during Crossfit® workouts. Eur J Hum Mov. 2015;35:114–124.
  • Drum SN, Bellovary BN, Jensen RL, Moore MMT, Donath L. Perceived demands and post-exercise physical dysfunction in CrossFit® compared to an ACSM based training session. J Sports Med Phys Fitness. 2017;57:604–609.
  • Hak PT, Hodzovic E, Hickey B. The nature and prevalence of injury during CrossFit training. J Strength Cond Res. 2013; 10.1519/JSC.0000000000000318. [PubMed]

Tagged with: crossfit injuries crossfit injuries study crossfit injuries 2018 crossfit injuries compared to other sports crossfit injuries statistics crossfit injury risk crossfit back injuries crossfit athlete injuries common crossfit injuries crossfit shoulder injuries sam briggs crossfit sam briggs injursy sam briggs athlete sam briggs age

Sign up for newsletters

Most popular