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Sports Physiotherapy

CrossFit Injuries: Prevention and Physiotherapy Treatment Guide

By Gemma Pastor Vila12 min read

39% of CrossFit injuries affect the shoulder. This statistic surprises many, but it hides good news: most of these injuries are preventable with proper preparation.

In our experience treating CrossFit athletes in the Baix Llobregat area near Barcelona, we have observed a clear pattern: those who dedicate time to prevention and listen to their bodies rarely end up in the physiotherapy clinic with serious injuries.

This article offers you a comprehensive guide based on scientific evidence and our clinical experience so you can train CrossFit safely and effectively.

Is CrossFit Dangerous? The Truth About Injuries

There is a persistent myth: CrossFit is a dangerous sport that injures everyone. Scientific data tells a different story.

According to studies published in the Journal of Sports Rehabilitation, the injury rate in CrossFit ranges between 2.4 and 3.1 injuries per 1,000 hours of training. To put this in perspective:

| Sport | Injuries per 1,000 hours | |-------|--------------------------| | Running | 7.7 - 17.8 | | Football (Soccer) | 6.2 - 9.5 | | Basketball | 4.1 - 9.0 | | CrossFit | 2.4 - 3.1 | | Traditional gym | 0.24 - 5.5 |

The conclusion is clear: CrossFit is not more dangerous than other popular sports. However, like any intense physical activity, it requires preparation, correct technique, and respect for your body's limits.

The 5 Most Common CrossFit Injuries

Shoulder Injuries (39% of cases)

The shoulder is the most affected area in CrossFit. Repeated overhead movements, such as the snatch, overhead press, and muscle-ups, subject the rotator cuff to considerable stress.

Common injuries:

  • Rotator cuff tendinopathy
  • Subacromial bursitis
  • Glenohumeral instability
  • Impingement syndrome

High-risk movements:

  • Snatch and power snatch
  • Overhead squat
  • Kipping pull-ups and muscle-ups
  • Handstand push-ups

Warning signs you should not ignore:

  • Pain persisting more than 48 hours after the WOD
  • Night pain that interrupts sleep
  • Weakness when lifting objects overhead
  • Painful clicking during movement

Lower Back Injuries (36% of cases)

The lumbar region bears enormous loads in movements like the deadlift and clean. Poor technique or excessive weight can cause anything from muscle spasms to disc herniations.

Common injuries:

  • Mechanical low back pain
  • Disc protrusion and herniation
  • Quadratus lumborum contractures
  • Ligament sprains

High-risk movements:

  • Conventional and sumo deadlift
  • Clean and power clean
  • Kettlebell swings
  • Good mornings

How to distinguish muscle soreness from injury?

Post-training muscle soreness (DOMS) appears 24-48 hours after exercise, is distributed symmetrically, and improves with gentle movement. A lumbar injury, on the other hand, usually appears suddenly, may radiate down the legs, and worsens with certain specific movements.

If back pain persists for more than a week or radiates below the knee, consult a professional.

Knee Injuries (15% of cases)

Repeated jumping and deep loaded squats can overload the knee joint, especially the patellar tendon.

Common injuries:

  • Patellar tendinopathy ("jumper's knee")
  • Patellofemoral pain syndrome
  • Meniscal injuries
  • Hamstring tendinopathy

High-risk movements:

  • Repeated box jumps
  • Pistol squats
  • Wall balls
  • Heavy thrusters

Wrist and Elbow Injuries

The front rack position and kipping pull-ups generate stress on the upper extremity joints. Although less frequent, these injuries can be very limiting.

Common problems:

  • Pain on the back of the wrist (forced extension)
  • Lateral epicondylitis ("tennis elbow")
  • Flexor carpi ulnaris overload

Prevention:

  • Work on wrist mobility before training front rack
  • Use wrist wraps for WODs with high volume pressing
  • Alternate kipping with strict pull-ups to reduce joint stress

Main Causes of CrossFit Injuries

Understanding why injuries occur is the first step to preventing them. Based on our clinical experience and scientific literature, these are the most common causes:

1. Incorrect Technique (33%)

Poor technique is the main cause of injury. In CrossFit, many movements are technically complex: the snatch, the clean, the muscle-up. Performing them incorrectly, especially under fatigue, multiplies the risk of injury.

2. Poorly Recovered Previous Injury (33%)

Returning to training before an injury has completely healed is a common mistake. The injured tissue is more vulnerable, and the compensation the body makes can cause new injuries in other areas.

3. Progression Too Rapid

The enthusiasm of the first months can lead to increasing weight or volume before the body is ready. Tendons and ligaments adapt more slowly than muscles.

4. Fatigue and Overtraining

Training without adequate rest reduces recovery capacity and increases the risk of overuse injuries. A fatigued nervous system also compromises technique.

5. Insufficient Warm-up

Starting an intense WOD without adequate warm-up is a recipe for injury. Cold tissues are less elastic and more prone to damage.

How to Prevent CrossFit Injuries

Prevention is much more effective than treatment. These are the fundamental pillars for training without getting injured:

Proper Warm-up (10-15 minutes)

A good warm-up prepares your body for effort. Include:

  1. Cardiovascular activation (3-5 min): Rowing, bike, or skipping rope to raise body temperature
  2. Joint mobility (5 min): Shoulder circles, hip rotations, ankle mobility
  3. Specific muscle activation (5 min): Movements that mimic the WOD but without load

For WODs with overhead movements:

  • Band pull-aparts: 2x15
  • External rotation with band: 2x12 per side
  • Prone YTW: 2x8 each

For WODs with deadlifts or squats:

  • Glute activation with band: 2x15
  • Cat-cow: 10 repetitions
  • Light goblet squats: 2x10

Technique Before Weight

This rule should be non-negotiable. The benefits of increasing weight disappear if you end up injured.

Recommendations:

  • Learn each movement with your coach before adding load
  • Record yourself to analyse your technique
  • If technique deteriorates at the end of the WOD, reduce the weight
  • Scale movements when necessary

Prevention Exercises

Dedicating 10-15 minutes, 2-3 times per week, to preventive exercises can make a difference:

For the shoulder:

  • External rotation with elastic band
  • Face pulls
  • Scapular stabilisation exercises

For the core:

  • Dead bugs
  • Pallof press
  • Plank with perturbations

For the hip:

  • 90/90 stretch
  • Pigeon pose
  • Deep squat hold

Physiotherapy Treatment for CrossFit

When prevention has not been enough, specialised physiotherapy treatment can accelerate your recovery and prevent relapses.

Assessment Process

In the first session we carry out:

  1. Detailed clinical history: Type of injury, mechanism, previous history
  2. Physical assessment: Ranges of motion, strength, stability
  3. Functional analysis: We observe the movements that cause pain
  4. Personalised treatment plan: Adapted to your objectives

Techniques Used

We combine different tools according to each case:

  • Manual therapy: Joint mobilisations, soft tissue massage, myofascial techniques
  • Dry needling: Effective for trigger points and persistent contractures
  • Therapeutic exercise: Progressive strengthening and motor control programmes
  • Neuromuscular taping: Support during the return to training phase
  • Education: We teach you to understand your injury and prevent relapses

Approximate Recovery Times

| Injury | Approximate time | |--------|------------------| | Muscle contracture | 1-2 weeks | | Mild tendinopathy | 4-6 weeks | | Moderate tendinopathy | 8-12 weeks | | Lumbar sprain | 2-4 weeks | | Shoulder bursitis | 3-6 weeks |

These times are approximate. Each person responds differently to treatment.

Return to Training Protocol

Returning to training after an injury requires a structured plan. Rushing increases the risk of relapse.

Phases of Reincorporation

Phase 1: Pain Control

  • Objective: Reduce inflammation and pain
  • Exercises: Gentle mobility, pain-free isometrics
  • Avoid: Movements that reproduce the pain

Phase 2: Functional Recovery

  • Objective: Restore range of motion and basic strength
  • Exercises: Progressive strengthening, proprioception
  • Avoid: High load, explosive movements

Phase 3: Sports Readaptation

  • Objective: Prepare the tissue for CrossFit demands
  • Exercises: Specific movements with progressive load
  • Avoid: Competing or seeking PRs

Phase 4: Complete Return

  • Objective: Return to normal activity
  • Criteria: Pain-free, recovered strength, confidence in movement

Physio-Coach Communication

When you work with a sports-specialised physiotherapist, communication with your coach is essential. We provide specific modification guidelines so you can continue training safely while you recover.

Warning Signs During Return

Stop training and consult if you notice:

  • Reappearance of the original pain
  • Swelling that was not there before
  • Sensation of instability
  • Sudden loss of strength

Frequently Asked Questions

How long do I need to recover from a CrossFit injury?

It depends on the type of injury and its severity. A muscle contracture can resolve in 1-2 weeks, while a moderate tendinopathy may require 8-12 weeks of rehabilitation. The key factor is following the complete treatment and not rushing the return to training.

Can I continue training with pain?

Pain is a signal from your body. Post-training muscle soreness (DOMS) is normal and you can train with it. However, acute, localised pain or pain that worsens with movement indicates you should stop and consult. Training with an active injury usually makes it worse.

When should I see a physiotherapist?

We recommend consulting if the pain persists for more than 5-7 days, if it limits your daily movement, if swelling appears, or if the pain wakes you at night. A preventive assessment is also a good idea if you notice recurring discomfort in the same area.

Is it safe to return to CrossFit after an injury?

Yes, as long as the recovery is complete and progressive. Many of our patients return to CrossFit training successfully after an injury. The key is to respect recovery times, work on the weaknesses that caused the injury, and reintegrate gradually.

How do I know if it is DOMS or an injury?

DOMS appears 24-48 hours after exercise, diffusely affects the worked muscles, and improves with gentle movement. An injury usually appears during or just after exercise, is more localised, and worsens with certain specific movements.

Need Help with a CrossFit Injury?

At FisioBaix we specialise in sports physiotherapy and regularly treat CrossFit athletes in the Baix Llobregat area near Barcelona. We offer:

  • Complete initial assessment to identify the origin of your problem
  • Personalised treatment combining different techniques
  • Exercise programme adapted to your case
  • Home physiotherapy in Sant Boi de Llobregat and surrounding areas

Contact us for an assessment. We will be delighted to help you return to training pain-free.


This article is for informational purposes and does not replace consultation with a healthcare professional. If you experience persistent pain or injury symptoms, consult a physiotherapist or doctor for your particular case.

Article reviewed by Gemma Pastor Vila, Licensed Physiotherapist No. 15434 at the Col·legi de Fisioterapeutes de Catalunya.

References

  1. Feito Y, et al. (2018). "A Retrospective Study of Injuries in CrossFit." Journal of Sports Rehabilitation, 27(3), 295-300.
  2. Weisenthal BM, et al. (2014). "Injury Rate and Patterns Among CrossFit Athletes." Orthopaedic Journal of Sports Medicine, 2(4).
  3. Hopkins BS, et al. (2019). "CrossFit-Related Shoulder Injuries." Clinics in Sports Medicine, 38(2), 213-224.

Tags

#crossfit injuries#sports physiotherapy#injury prevention#crossfit warm up

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