Injuries

Injuries

You could get injured doing CrossFit.

You could get injured doing Olympic weightlifting, kipping pull-ups, or handstand push-ups. You could get injured while running, biking, swimming, or rowing. You could get injured doing bench press or bicep curls. You could even get injured during a yoga session on your living room floor.

You will NOT get injured if you are sedentary.

Without physical movement, you will be safe from any trauma of muscular exertion and metabolic work. Your body won’t ever experience workout fatigue, oxygen debt, or delayed onset of muscle soreness.

No activity, no injuries, no worries.

At least temporarily.

Instead of injury, of course, you may lose longevity and livelihood. Illness or disease could set in. These aren’t immediate injuries, per se, but are instead quite a bit more devastating.

No activity, no injuries… no benefits.

What issues currently plague human health?
For starters, heart disease is the leading cause of death for both men and women. About 600,000 people die of heart disease in the United States every year— that’s 1 in every 4 deaths. (1)

Each year about 715,000 Americans have a heart attack. Of these, 515,000 are a first heart attack and 200,000 in people who have already had cardiac infarction. Coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and lost productivity. (2; 3)

Secondly, diabetes is so prevalent now that 1 in 3 Americans born after 2000 will develop Type 2 diabetes. This is directly related to poor diet and lack of exercise. 29.1 million people in the U.S. currently have diabetes; this equates to 9.3% of the population. 21 million people are diagnosed; 8.1 million people are undiagnosed. This results in 27.8% of people with diabetes being undiagnosed. (8)

Finally, obesity rates are alarmingly high in America. No state in the U.S. has a prevalence of obesity less than 20%. This means that more than one-third of U.S. adults are obese— 78.6 million Americans, or 34.9% of our population. Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. (9)

safe sets

Are there concerns over the safety of physical activity?
Healthy lifestyle habits, including nutritious eating and physical activity, can lower the risk of becoming obese and developing lifestyle related diseases. We’ve known this for decades.

Obviously the goal is to be as safe as possible while being active. And further, if you believe CrossFit, or any method of fitness, increases the likelihood of being unsafe, then you should find something active that lowers your perceived risk. But if perfect safety is really a concern, then running, weightlifting, and quite a few other modes of exercise should be checked off your list. While we’re at it, be wary of playing pick-up basketball with friends or running around with your kids in the backyard. While these injury rates are often unreported, it’s definitely viable that weekend warriors and Turkey Bowl heroes have an increased risk of injury equivalent or greater than weekly fitness grinders.

The safety first philosophy is always a good one, but major concerns over physical activity, namely CrossFit, are seemingly cloaked in something else entirely. Ego? Ignorance? Misunderstanding?

Fitness professionals and physical therapists ultimately want what’s best for the health and well-being of the general public. This is great and never an issue. The pursuit of safe movement is valid and necessary in any athletic endeavor. Bad form, incompetent trainers, ego over safety? By all means, critique and strive for change. Still, ever see the CrossFit "fail" videos? Much of what gets shown and laughed at isn’t even from a CrossFit gym.

So what are accurate injury rates as we compare methods of training? Let’s check the stats below.

up down

What is the statistical risk of physical training?
If we look at the statistics of workout injuries across any fitness regimen, we see a large discrepancy in what gets reported. We have an issue with what is argued as truth versus hearsay.

Yet while some items remain debatable, all legitimate data gets compiled in reference to number of injuries per 1,000 training hours.

Let’s look at some common exercise and movement trends and their injury rates. References are noted.

  • Running & Triathlons: There is a prevalence of somewhere between 5.5 to 12.1 injuries per 1,000 hours of training in running and triathlons. (Korkia, 1993; Zwingenberger, 2014)
  • Gymnastics: Injury rates range from 3.5 to 22.7 injuries per 1,000 hours of training at the club level to college gymnastics. (Mahler, 2008)
  • Bodybuilding: 45.1% of the test subjects reported some symptoms of physical injury while training, but the overall injury rate reported was 1.0 injuries per 1,000 hours of training. (Siewe, 2014)
  • Power Lifting: 43.3% of tested Powerlifters complained of injury-related problems during workouts, however the injury rate reported was 1.0 injuries per 1,000 hours of training. (Siewe, 2011)
  • Olympic Lifting:In an incorporated investigation of the incidence and prevalence of injuries among both elite Olympic weightlifters and Powerlifters in both 1995 and in 2000, in both sports and across both time periods, the tested subjects incurred 2.6 injuries per 1,000 hours of training. (Raske and Norlin, 2002)
  • Strongman: There is a rate of 5.5 injuries per 1,000 hours in Strongman strength training. In terms of region of injury, the most common locations were lower back (24%), shoulder (21%), biceps (11%), and knee (11%). Researchers observed that strongman athletes were almost two times more likely to sustain an injury when using strongman implements than when using traditional resistance-training methods. (Winwood, 2014)
  • CrossFit: CrossFit has an injury rate of 3.1 injuries per 1,000 hours of training. (Hak, 2013) CrossFit has an injury rate of 2.4 injuries per 1,000 hours of training in regards to true incidence versus prevalence. (Giordano, 2015) In both reports, zero cases of rhabdomyolysis were reported.
Riskin' it...
Riskin' it...

Is CrossFit dangerous?
There are quite a few online articles criticizing CrossFit for being dangerous; criticism exists in everything from small blogs to the Washington Post, CNN, Men's Health, Huffington Post, Breaking Muscle, and ESPN.

The most recent ado in the CrossFit injury debate is the information released from an Ohio State University study performed in 2013. The study, entitled CrossFit-Based High-Intensity Power Training Improves Maximal Aerobic Fitness and Body Composition, included 54 original participants, of which 43 completed the 10-week CrossFit exercise program challenge. The results were subsequently published in the National Strength and Conditioning Association’s Journal of Strength and Conditioning Research.

The conclusion? Participants burned fat and expanded their VO2 max (volume of oxygen uptake).

The kinesiology doctors of the research study inferred from their data, "a CrossFit-based high intensity power training program can yield meaningful improvements of maximal aerobic capacity and body composition in men and women of all levels of fitness." (11)

However, the study also reported that 16% of the 11 participants who didn’t finish the 10 weeks cited “overuse or injury” as their reason for failing to complete the study. The authors also called into question “the risk-benefit ratio for such extreme training programs,” even cautioning that the measured improvements from CrossFit training “may not be worth the risk of injury and lost training time.” (11)

At which point, CrossFit Inc. fired back at what they called “junk science” with a full lawsuit, and in turn incited much of the internet public to label this move as bravado... as well as some other choice words. The issue that CrossFit Inc. stated through Russell Berger, a head trainer and legal advisor, was that "overuse injury" wasn't a defined term by the Ohio State associates, but more so, when questioned, the nine subjects that the NSCA/Ohio State Devor study claimed were injured have all sworn to the court that they were actually not injured throughout the course of the program. (12)

Confusing? Definitely. Yet rightfully questionable on a few angles. Is CrossFit Inc. in fact a bully, or alternatively, did CrossFit simply stand up to the fitness scene with confidence?

The decision lies within.

So as we conclude, indeed, there is an inherent danger in physical activity, and yes, you could get injured doing CrossFit.

Of course, there’s always the contrary to consider.

- Scott, 8.4.2015

References

  1. Murphy SL, Xu JQ, Kochanek KD. Deaths: Final data for 2010. National vital statistics reports. 2013; 61(4).
  2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics — 2014 update: a report from the American Heart Association. Circulation. 2014;128.
  3. Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123: 933–44. Epub 2011 Jan 24.
  4. Heron M. Deaths: Leading causes for 2008. National vital statistics reports. 2012; 60(6).
  5. CDC. Disparities in Adult Awareness of Heart Attack Warning Signs and Symptoms — 14 States, 2005. MMWR. 2008;57(7):175–179.
  6. Centers for Disease Control and Prevention. State Specific Mortality from Sudden Cardiac Death: United States, 1999. MMWR. 2002;51(6):123–126.
  7. CDC. Million Hearts: strategies to reduce the prevalence of leading cardiovascular disease risk factors. United States, 2011. MMWR2011;60(36):1248–51.
  8. CDC. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.
  9. CDC. Obesity prevalence across states and territories. Prevalence of Self –Reported Obesity Among U.S. Adults by Race/Ethnicity and State, BRFSS 2011-2013.
  10. Beardsly C. Which strength sport is most likely to cause an injury in training? Strength and Conditioning Research. 2014.
  11. Smith MM, Sommer AJ, Starkoff BE, Devor ST, et al. Crossfit-based high intensity power training improves maximal aerobic fitness and body composition. Journal of Strength & Conditioning Research: 2013:27(11):3159-72.
  12. Berger R. NSCA “CrossFit Study” Fraud? The CrossFit Journal: 2013.

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