The image of CrossFit as a sport with a high risk of injuries, does not reflect what CrossFit really is. CrossFit is about improving your physical, mental and emotional health. Injuries happen. That is inevitable in sports, but also with a sedentary lifestyle. In this article we provide straightforward information about CrossFit and injuries, to self-manage your health and minimize the risk of injury. Because 100% prevention simply does not exist.
Functional movements limit injuries
CrossFit is a core strength and conditioning program, with the aim of improving physical, mental and emotional health in a very effective way. Workouts are built around functional movements: Natural movement patterns found every where in human behavior. Such as picking up the groceries, pushing a wheel chair, or putting a bag on a top shelf.
Exactly these functional movements are, what is tested in Functional Movement Screens (FMS) by doctors and therapists. FMS are tests to identify limitations in movement patterns, mobility and stability, that may increase the risk of injury. FMS help to ensure a person has a solid movement foundation and can take on more complex exercises and other demanding activities. And that is what is trained in CrossFit. Additionally, the beauty of CrossFit is that every workout is scalable to an individual level: a tailor-made workout. This makes CrossFit a sport for everyone, regardless of age, fitness or impairment.
Nevertheless, CrossFit does have some elements that, under certain circumstances, in certain individuals can trigger injuries. Read more in the next section.
Multilevel perspective on injuries
Injuries should be considered from a multilevel perspective in which health and illness are determined by a dynamic interaction between biological, psychological, and social factors. It is the interplay between people’s genetic make- up (biology), mental health and behavior (psychology), and social and cultural context that determine the course of health-related outcomes.[i]
Biological influences on health include an individual’s genetic make- up and history of physical trauma or infection. Non-biological factors such as the environment can trigger the expression of an illness or an injury in case of genetic predisposition.[ii]
Psychological factors can put a person with a certain genetic predisposition at risk for risk- behavior. For example, thrill- seeking may not cause injuries on its own, but thrill seeking may drive a person to ignore red flags of the body (risk behavior), leading to injuries.[iii]
Social factors such as life events or social media can put a person at risk for stress and illness. It can predispose someone to developing an injury. A competitive culture, common in CrossFit, can create certain circumstances, expectations, and belief systems that contribute to the risk of injuries.[iv]
This multi-level biopsychosocial perspective on health and illness clearly demonstrates that it takes much more than just one factor to cause an injury. In CrossFit there are certain factors, red flags, on different levels, to be aware of.
Red flags in CrossFit
- A competitive mindset
Getting out of your comfort zone is where the magic happens. But when a competitive mindset leads to ignoring red flags of the body, especially for a longer period, the athlete is at higher risk of overtraining and of chronic injuries.
- Men versus women
Men, especially younger men, are more prone to injuries than women. There are several possible explanations, such as the adolescent brain, the need to proof oneself, or social display rules.
- Former athletes
People with a history of playing sports at high level, often have a competitive mindset and tend to overestimate themselves. They can have a hard time accepting their decline in fitness. A combination that leads to a higher risk of injuries.
- Playing other sports on the side
In CrossFit we encourage athletes to be active outside the box as well. Yet, we need to keep in mind that CrossFit is high intensity. The body needs to recover from the stress of CrossFit. Low intensity activities such as walking, biking or swimming at a recreational level can enhance recovery and performance. But playing several other sports at an intense level on the side, increases the risk of injuries.
- Training too irregular, too much, too often, too hard or too little
Athletes who train irregular, sometimes weeks in a row followed by weeks of abstinence, are at higher risk of injuries. Especially if they think they can pick up where they left off. Athletes who train too much, too heavy and too long; and who never take recovery days or do mobility are at higher risk. On the other hand, athletes who do not train enough, for example only once or twice per week are also at higher risk. Frequent and consistent training sessions and rest days are key.
- Training without focus
Athletes who train without focus are at higher risk of injuries. Without focus can mean they are not concentrated during a WOD. For example, they joke around and then pick up a heavy barbell without first concentrating on a proper setup.
Without focus also means ‘just randomly doing something’. Athletes who do not track their scores and have no clue what the appropriate load or scaling options are. Not because they are a beginner but because they are not committed to their training and health journey. Without focus is also not willing to be coached and be open to tips and tricks to enhance performance and prevent injuries.
- Training with single focus
The cherry pickers who only do what they like and who avoid the hard stuff, often their weak spots, are at higher risk. The same goes for athletes who are not willing to work on the foundations and accessory work, and who are not willing to be patient and stick with the program, but mainly focus on wanting to do the fancy stuff, asap. The ring muscle up before the strict pullup. Athletes who are not willing to scale and modify, when this is exactly what they need to get fitter, stronger an healthier, are at higher risk of injuries.
- Lifestyle factors and health related behavior
Lack of sleep, inadequate nutrition, too much stress, not seeking medical attention on time, a sedentary lifestyle (desk-job), a lack of social support. Lifestyle factors can increase the risk of injuries. Also not sufficiently taking into account these lifestyle factors, ignoring pains and aches and not adjusting the workout to it, can increase the risk of injuries. Such as deciding to do heavy deadlifts after a short night of sleep on the couch. Or planning a heavy workout on Monday at 11 PM and on Tuesday at 5 AM.
- Disturbing thoughts and negative self- talk
Cognitive representations affect our movement patterns. In other words: how we interpret certain situations, tasks, signals of our body, affects how we feel and how we act. If we think we cannot do it (disturbing thoughts), we often cannot do it. Thinking something is going to hurt can evoke a physical stress response. When you are afraid of getting an injury your body cramps up, increasing the risk of an injury. Cognitive representations are a product of past experiences, knowledge, personality, culture and many other factors.
Disturbing thoughts and negative self- talk affect performance and health (Experiment to improve positive self- talk). This undermines performance and increase the risk of injuries and health issues.
- Insufficiënt professional coaching
The risk of injuries increases with insufficient coaching. Such as in situations where coaches do not coach, lack knowledge and experience, are not committed to their athletes, are not willing to put in the time and energy, are not relentless on an athlete’s technique and performance, push athletes over the edge all the time, and do not guide athletes on an individual level in CrossFit and lifestyle.
- Not taking injuries into account
Not taking into account current and previous injuries increases the risk of more, or more severe injuries. This does not only apply to the athlete, but also to the coach. Prevention and treatment of injuries requires a cooperation between both, and both have to be committed. CrossFit Eudokia in Rotterdam is the first CrossFit box accredited as NL Actief Prevention center, specialised in coaching athletes with an injury or (risk of) a chronic disease.
Awareness of current and previous injuries is crucial because injuries are often accompanied by depression, tension, anger, anxiety, fear of reinjury, and low self-esteem. Mental and emotional disturbances can affect an athlete’s perceived progress in recovery and therefor slow down the healing process and affect the outcome. A coachs job is not to treat injuries (unless this coach is also involved as a professional therapist). Yet a coach does have role in an athlete’s psychological responses to injuries and in guiding the athlete to stay active despite injuries. All in close cooperation with the athlete’s therapist/doctor. Psychosocial coaching skills can help decrease the negative consequences of an injury. By encouraging positive self-talk, helping the athlete with journaling and goal setting (techniques that supports an athlete’s progress), advising on relaxation techniques, and applying imagery* a coach can enhance an athlete’s recovery.[v]
*Imagery is a mental technique, such as visualizing the specific execution of a performance skill; imagining the exuberant feeling of returning to a workout or a competition; and understanding that other athletes have successfully endured similar rehabilitation. [vi]
Concluding
Sports and injuries are inseparable. So are a sedentary inactive lifestyle and life-threatening chronic diseases. Injuries are often short- term and treatable. In contrast to often untreatable chronic diseases such as cardiovascular diseases, type 2 diabetes, obesity, muscle and bone degeneration and Alzheimer. The health benefits of exercising are far greater than the health risks of an injury.
Injuries can happen for numerous reasons. It is often in a window of unfortunate opportunity in which one thing, such as a CrossFit workout can be the trigger. But it can also been something else, such as picking the groceries out of the car or bending over to put your socks on.
Hundred percent prevention is unrealistic. Being aware of red flags can minimize damage, while still improving health.
Create your own health!©
References
This article is inspired by the CrossFit Health Seminar 2022.
[i] Retrieved from: Lumen Learning. An introduction to health psychology. Chapter biopsychosocialmodel.
[ii] Idem
[iii] Idem
[iv] Idem
[v] Covassin T, Beidler E, Ostrowski J, Wallace J. Psychosocia laspects of rehabilitation in sports. Clin Sports Med. 2015 Apr;34(2):199-212.doi: 10.1016/j.csm.2014.12.004. Epub 2015 Jan 24. PMID: 25818709.;Smith AM. Psychological impact of injuries in athletes.Sports Med. 1996 Dec;22(6):391-405. doi: 10.2165/00007256-199622060-00006.PMID: 8969016. Scherzer, C. & Williams, J. (2010). Injury risk and rehabilitation: Psychological considerations. Applied Sport Psychology:Personal Growth to Peak Performance, 6th Edition 2010, McGraw-Hill.
[vi] Idem
