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.


– 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.

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