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5 Common CrossFit Injuries

How to prevent and treat the most frequent CrossFit injuries

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crossfit.JPG ©Aaron Hewitt

CrossFit is a strength and conditioning program that has grown in popularity in recent years. The full-body workout helps participants lose weight, gain strength and improve cardiovascular endurance, speed, flexibility, coordination and balance.

D. Levi Harrison, MD, orthopedic surgeon and author of The Art of Fitness: A Journey to Self-Enhancement, has participated in CrossFit, and treats patients who partake in the exercise program as well.

Like any sport, injuries occur in both well-trained athletes, and mid- to lower-level fitness enthusiasts, he said, acknowledging that he treats many CrossFit-related injuries each month.

Dr. Harrison revealed to About.com a list of the five most common injuries he sees in his orthopedic surgery practice involving CrossFit athletes:

1. Tennis Elbow or Lateral Epicondylitis:

This is often due to over-use or repetitive exercises. Many of the athletes feel their lateral elbow pain is worsened by “muscle-ups” or heavy weight-lifting exercises. "If you have elbow pain like this, stop the exercise," warned Dr. Harrison. "I recommend listening to your body. Ice the area and consider an anti-inflammatory medication, such as ibuprofen or naprosyn." Nirschl exercises are also a good way to stretch the extensor muscles, especially the ECRB and ECRL tendons/muscle bellies. A compression elbow brace can be effective in minimizing further micro-tears of the extensors during treatment. Acupuncture and physical therapy are also valuable techniques to treat tennis elbow pain. Steroid injections can be used if the non-invasive techniques are not effective, and surgery is the last option to consider.

2. Achilles Tendonitis:

There appears to be a correlation with excessive amounts of high box jumps and the development of Achilles tendonitis in some CrossFit participants who present for care in Dr. Harrison's practice. "Some athletes often tell me that they just “over do it” while in class. I remind them to go at their own pace, and to have a “healthy competition” only with themselves while in the intense, competitive CrossFit environment," he said. Stretching and strengthening the calf muscles along with physical therapy modalities are essential treatments for Achilles tendonitis. Dr. Harrison recommends rest, ice and anti-inflammatory medication along with therapy. Heel or wedge inserts for tennis shoes can also help decrease the stress on the Achilles. For long standing Achilles tendonitis, the wedge inserts can also help decrease the pain. The Achilles can also be immobilized with a cast or removable type walking boot when minimal improvement is noted with other treatments. Surgery should never be considered until all other modalities have been part of the treatment plan. Cortisone injections should never be used in treating Achilles tendonitis because this may incite an Achilles tendon rupture.

3. Rotator Cuff Tendonitis:

This type of shoulder tendonitis is common in many of Dr. Harrison's injured CrossFit patients. Many of them commonly feel that it is exacerbated by the repetitive over head weight lifting exercises, like overhead presses and the “clean and jerk” exercise. "I recommend that they really understand and master the proper techniques of the exercises before using heavy weights," he said. This type of tendonitis can be treated with shoulder rest, ice packs, anti-inflammatory medication and acupuncture. Strengthening exercises that are specific for internal and external rotation of the shoulder can be quite beneficial. (These exercises are properly demonstrated on Dr. Harrison's website, www.drlevifitness.com.) Physical therapy that includes massage, ultrasound, iontophoresis, stretching and strengthening exercises, is also a great treatment strategy. Steroid injections can also be used when other non-invasive strategies have been utilized without any amelioration of the shoulder symptoms.

4. De Quervain’s Tenosynovitis:

There are tendons of the thumb that cross the wrist which may get inflamed. Some of the CrossFit participants that Dr. Harrison treats, commonly find that the repetitive wrist, hand or thumb movements needed for some exercises commonly cause this problem. Repetitive barbell and kettlebell type exercises which necessitate repetitive wrist flexion, extension and ulnar deviation aggravate this condition, he noted. This form of wrist tendonitis is commonly treated with some of the same modalities used to treat other types of tendonitis. This treatment plan consists of rest, ice, anti- inflammatory medication, thumb spica splinting, physical therapy or occupational therapy, as well as acupuncture. "If these treatments are not effective, a steroid injection can be administered," he advised. "Surgery is, of course , the last option to treat this type of wrist tendonitis."

5. Low Back Pain:

CrossFit athletes who present with low back pain, often say this injury occurred while doing overhead press movements (like the “clean and jerk”) or even basic squats. This problem is treated with rest and appropriate modifications in their exercise program. "Often, my patients can continue to do light exercises which do not exacerbate the lower back pain, as well as take anti-inflammatory medications," said Dr. Harrison. Physical therapy is an essential part of rehab for lower back pain in his practice. Proper stretching and strengthening exercises along with acupuncture have been effective techniques to treat this form of back pain in patients who do CrossFit.

In conclusion, Dr. Harrison noted that injuries which occur during CrossFit classes may be minimized with stretching, proper form and execution of exercises, and by listening to your body and the trained CrossFit instructor.       

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