Crossfit: Don't Get Me Started!

Author: Bryan Lang, PT, DPT, MHA, CSCS, Cert.DN: Doctor of Physical Therapy, Business Owner, Associate Professor, and Blog Contributor. Explores common client questions, helps find solutions for every day functional health concerns, and interprets difficult theories in healthcare rehabilitation. Committed to life-long learning and education. Learn more about Bryan on Google+.

In physical therapy there are two main schools of thought regarding the phenomenon that is CrossFit training. There are those who embrace it and those who completely disregard it. As a person who has performed CrossFit in the past and incorporates concepts into my own training, I started noticing a disconnect between the athletes and the physical therapists.

CrossFit requires high intensity interval training and combines it with heavy weightlifting. This creates a type of exercise dubbed high-intensity power training (HIPT). These HIPT exercises are named WODs or “workouts of the day” with athletes attempting to complete the routine for time or trying to perform as many rounds as possible (AMRAP) within a given time frame. WODs for AMRAP can last for only 10-20 minutes. They are designed to push the body to the limit with high repetition and high weight training in short amounts of time. CrossFit touts this style of training as optimal for the body because it focuses on muscle confusion, or constantly activating your muscles in different situations so that they never get used to the exercises. This type of exercise has been adapted both in the military and, more recently, in the general public with CrossFit gyms.

Requiring minimal time commitments using quick HIPT with AMRAP, CrossFit has become increasingly popular in comparison to traditional forms of aerobic and even anaerobic training. A recent study in 2013 found that CrossFit does improve aerobic fitness and body composition regardless of whether the athlete was a beginner or experienced. However, this same article had a dropout rate of 16% due to overuse and injury.

The American College of Sports Medicine has also reported safety concerns with CrossFit, citing the high incidence of injury and the potential for athletes to develop rhabdomyolysis.

Rhabdomyolysis occurs when muscle fiber is broken down and the contents within the fibers move into the bloodstream and into the kidney. The result is damage to the kidney.

Furthermore, a study published in 2014 found that out of 386 CrossFit participants, 19.4% reported an injury during training. Men were more likely to be injured than women, and more women sought additional training from a CrossFit coach than men – notice a trend? Of those injured, 84% reported one area of injury, 13.3% reported two areas, and 2.7% reported 3 injuries. The most commonly injured body parts were the shoulder, low back, and knee.

With the higher likelihood of potential injury, it is easy to see why some physical therapists do not condone CrossFit exercises. They believe this training sets up almost 1 in 5 people for injury because of the way CrossFit overloads the musculoskeletal system so quickly. However, it is important to compare the injury rates to other sports. In runners, the incidence of injury can vary between 19.4-79.3%. When looking at it in that context, one can extrapolate that the injury rate of running is just as high if not higher than performing CrossFit exercises.

The reality is that CrossFit is different from regular weightlifting on a physical and psychological level. It takes something that was once considered a relatively singular activity like weightlifting and turns it into a team sport for the masses. It's different from a typical gym exercise class because you are constantly competing against yourself or fellow CrossFitters to improve the amount of weight you're lifting, the number of repetitions completed, and/or your time. In the end, it brings people together in a collaborative effort to push themselves and their fitness to another level. It keeps people interested in exercise due to its ever-changing nature. Isn't this what we, as physical therapists, have been pushing our patients to do in the long run? We tell them to continue training their bodies and to exercise for life. CrossFit isn't for everyone, but we, as physical therapists, should not completely disregard it.

CrossFit provides another opportunity for physical therapists to provide patient education regarding a sport benefiting overall health and fitness. Physical therapists should provide musculoskeletal exams for new CrossFit athletes and show them proper technique. Most importantly, a physical therapist should be the one to clear someone to perform the complex movements associated with CrossFit when trainers are unsure if the person is ready.

I'm excited that CrossFit is growing in the United States, and I look forward to assisting all CrossFitters in safely reaching their maximum potential.

For more information on proper form or how you should safely begin your own training, contact us at WBHPT and we would be happy to help.