Does Crossfit Cause More Injuries? - The Current Status Quo

Increased risk of injury is commonly associated with Crossfit and is one of the key concerns it’s critics cite most frequently, especially across the various forms of social media. Crossfit is an exercise program that utilizes high-intensity functional movements with limited amounts of rest to build strength and endurance using a combination of cardiovascular, weightlifting (Olympic and power), and gymnastic-type exercises. Some of the movements involved in Crossfit workouts are considered to be of higher difficulty and complexity (namely the Olympic lifts and the various forms of gymnastic movements utilized) and the critics of Crossfit cite that these movements should not be performed in a rapid and successive fashion, instead they should be performed in a non-fatigued state, focusing on performing the technique correctly over quickly.
Additionally, the frequency at which individuals train may also be seen as a cause for concern and could lead to increased injury risk (due to reduced recovery between sessions). However, this is highly dependant on the given individual, and the frequency of work and the ability to handle a certain capacity of work is extremely difficult to quantify given the differences between what would be “professional” Cross fit athletes to recreational athletes and all those on that spectrum. Making a sweeping statement for the entire sport of Crossfit with regards to “over work/over training” would be irresponsible and most likely inaccurate.
There are of course many other critiques of Crossfit but this article isn’t going to address these or those presented, being that many are heavily based on the opinion of opposing groups and is subjective based on your personal views/experience, but instead will look at the results of a recently published review paper (2018) which accumulated the available data regarding injury frequency with Crossfit performers. Of note, the research surrounding injury frequency and Crossfit is still in it’s infancy and much more work needs to be done to better understand the subject, especially with regards to the frequency of injury between professional and recreational Crossfit athletes, long term studies to evaluate injury frequency and severity between the two groups and the actual accurate reporting of injuries which have occurred during Crossfit and again where these injuries rank in terms of severity.
So, are injuries more common in Crossfit than other sports?
"...reported incidences of injuries associated with CrossFit training programs were comparable or lower than rates of injury in Olympic weightlifting, distance running, track and field, rugby, or gymnastics"
In short, apparently not. The review found that the reported incidences of injuries associated with CrossFit training programs were comparable or lower than rates of injury in Olympic weightlifting, distance running, track and field, rugby, or gymnastics. They also found that injuries to the shoulder(s) appear to be somewhat common with Crossfit and injury risk increases (particularly in males) when exercise is not supervised by a qualified instructor.
The review paper is limited however. Following the use of inclusion and exclusion search term criteria and the scaling of the following databases; PubMed, CINAHL Plus, SPORTDiscus, MEDLINE, EBSCOhost, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Academic Search Complete, Academic Search Premier and any additional resources obtained via manual search of reference lists and suggested articles via searched databases. The review paper looking at studies performed between 2006 and 2015 comparing injury rates in Crossfit to other forms of exercise/sport. One thing to note is that they did limit this to only English language studies so may have excluded some useful data to this end.
Of their search, only three studies met the eligibility requirements and were selected for review. The distinction for what was and what wasn’t an injury was not cohesive between the three studies however were somewhat similar (all indicating an injury would be anything which impeded or stopped the individual from training, working and or competing). Of these three, the groups that were studied were not overly cohesive either and ranged in exercise and Crossfit experience. One group being a military brigade, another being self proclaimed athlete-level participants (those who train in affiliated “boxes” and are monitored/supervised) and the final being a group who had been involved in Crossfit training for any length of time. This group had the highest rate of injury among the studies and may suggest that training experience plays a key part in mitigating injury risk. Additionally, it is important to note that the data collection for this study was conducted by distributing an online questionnaire amongst international Crossfit forums. The accuracy of the reporting, whether the exercise was monitored/supervised, the level of the experience of the reporter etc. all come into question here.
We believe it is also important to note that no incidents of rhabdomyolysis or  were reported amongst the studies. Rhabdomyolsis or “rhabdo” as it is sometimes referred to, is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream. This can lead to serious complications such as renal (kidney) failure. Rhabdo was more popularly associated with Crossfit several years ago when a number of cases were brought to mainstream attention.
What should be noted, and this is from a purely neutral perspective as we, like many others, are still awaiting long term clarification on the subject of rhabdo frequency among the Crossfit community, is that many cases of rhabdo, caused by Crossfit style and or any other form of training, are caused by individuals not understanding their body’s recovery capacity and inadequate supervision. It is not the sport per se which is at fault but the carelessness and or lack of awareness of those within the locality, be they performing and or supervising, who are at fault. You have to be aware of your limits and those supervising/instructing should program adequately for who they are overseeing. Rhabdo is not unique to Crossfit and is seen in other sports and activities. The literature notes that rhabdo is one the rise (having risen 20 fold or something of that ilk) but this could be for a number of reasons. The change in exercise habits (especially increases in repetitive exercise amongst men and women to achieve the “perfect physique” pressurized on them by various forms of media) and rise in awareness (both the patients and the medical practitioner) of the condition thanks to the various forms of media.
In summary
Crossfit is on the verge of becoming an extreme sport (if not already). With the demand for moving heavy loads, moving these loads in rapid succession, a high level of exercise related work capacity, performing highly complex movements, endurance related activities etc. all to be performed in a bid to achieve the fastest time and or highest score, athlete’s are pushing themselves right to the edge of their body’s physical (and arguably psychological) limits. The literature, as it stand, does not support the claim that injury frequency is higher in Crossfit than in other sports. However, the data we currently have is limited and must be improved upon. For those engaging in Crossfit, seek a qualified trusted instructor. Seek external help to aid in improved recovery (be that through dietary means or through use of rehabilitation specialists etc.). Speak up if something about a certain workout or exercise makes you uncomfortable. Crossfit, and all other forms of sport, are, at their core, supposed to be fun and sustainable with the end goal of making you a fitter, healthier, stronger version of yourself. Use common sense when it comes to your body people.
Added reading
Klimek, Chelsey & Ashbeck, Christopher & J. Brook, Alexander & Durall, Chris. (2018). Are Injuries More Common With CrossFit Training Than Other Forms of Exercise?. Journal of Sport Rehabilitation. 27. 1-17. 10.1123/jsr.2016-0040.

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