Upper Extremity Injuries in CrossFit Athletes. A Review of the Current Literature
Purpose of Review
– CrossFit is a high-intensity fitness regimen that has risen exponentially in popularity over the past two decades.
– The competitive nature and high-repetition, high-load training involved in CrossFit leads to increased injury vulnerability, especially in the upper extremities.
– Due to CrossFit’s popularity, clinicians are likely to see more patients presenting with CrossFit-related injuries.
– This review aims to provide an overview of CrossFit and associated injuries clinicians may encounter.
Overview of CrossFit
– CrossFit is a branded fitness regimen incorporating constantly varied functional movements performed at high intensity.
– Workouts blend weightlifting, gymnastics, and metabolic conditioning into short, high-effort routines.
– The competitive nature encourages athletes to complete workouts as quickly as possible.
– CrossFit’s popularity has grown rapidly since its inception in 2000, with over 15,000 affiliated gyms worldwide.
Injury Rates
– Recent studies indicate CrossFit athletes sustain relatively high rates of injury compared to traditional weight training.
– A meta-analysis by Feito et al. found an overall injury rate of 3.1 per 1000 training hours in CrossFit.
– Injury rates are more comparable to gymnastics and Olympic weightlifting than traditional training.
– The shoulder, elbow, and wrist account for the majority of documented CrossFit injuries.
– A case series by Summitt et al. found upper extremity injuries made up 54% of CrossFit injuries compared to 24% lower extremity.
Risk Factors
– Intrinsic risk factors include strength deficits, flexibility limitations, and poor technique.
– Extrinsic risk factors are high volume, high intensity, insufficient rest, and competitive environment.
– A prospective study by Moran et al. identified overuse, lack of rest, and improper technique as the most common risk factors.
– Males may be at higher risk than females due to greater strength, competiveness, and workout loads.
Prevention and Treatment
– Proper instruction, scaling workouts appropriately, utilizing good technique, and allowing adequate rest can help prevent injury.
– Most documented CrossFit injuries are responsive to conservative treatment like physical therapy and activity modification.
– A case series by Crawford et al. had an 80% return to sport rate after conservative shoulder treatment in CrossFit athletes.
– Surgical intervention may be indicated for some chronic overuse injuries or significant acute trauma.
Conclusion
– CrossFit athletes demonstrate high rates of upper extremity overuse injuries due to the nature of the training.
– Clinicians should have a high index of suspicion for shoulder, elbow, and wrist injuries in CrossFit athletes.
– Further research is needed to better define injury patterns, diagnostic criteria, risk factors, and optimal treatment.
– Utilizing proper technique, scaling workouts appropriately, and allowing adequate rest are key to injury prevention.