Should active people worry about injuries in CrossFit?

CrossFit competitions have been held in Charleston at the Maritime Center and on the USS Yorktown at Patriots Point in Mount Pleasant. Staff/File

Normally I don’t discuss exercise programs in my sports medicine column, focusing instead on injuries in mainstream sports. Any activity that holds a competition crowning an athlete as the “World’s Fittest Man,” especially one with over 45,000 fans on hand to watch, millions watching on ESPN, and hundreds of thousands competing for a chance of making the finals themselves deserves attention.

The CBS program “60 Minutes” recently aired a profile of CrossFit, and the fitness phenomenon’s creator Greg Glassman. In the story, correspondent Sharyn Alfonsi interviewed Glassman to discover the secrets behind the “largest gym chain in history,” with over 12,000 gyms — or “boxes” — worldwide.

CrossFit workouts mix endurance training and Olympic and power lifting. The sessions are performed at high intensity over short periods of time with little rest between exercises. Participants usually compete against each other and against the clock. Most start CrossFit to lose weight or get in better shape, but they often stick with it because of the competition and camaraderie with others.

Experienced and novice athletes push their bodies to the limits, and they push each other to overcome fatigue and go further. Occasionally that push to keep going can lead to injury.

The risk for injury is one of the aspects for which CrossFit has generated some scrutiny. Media outlets have started to question whether CrossFit has an unacceptably high injury rate.

Partly because CrossFit has only recently exploded in popularity, few research studies exist to provide much insight into injury risks.

In 2014, researchers at the University of Rochester surveyed CrossFit participants to identify patterns of injury. They found an injury rate of 19.4 percent. The shoulder, lower back and knee were the most commonly injured body parts. Most of the injuries were considered mild and did not lead to a long absence from training.

Dr. Joe Powers and Kyle Aune of the American Sports Medicine Institute, who have been studying injuries in CrossFit, found that about 35 percent of the athletes claimed overexertion to cause their injuries. Roughly 20 percent blamed improper technique, while about seven percent claimed fatigue as the underlying factor.

It makes sense that any group fitness program where athletes race to perform a certain number of reps in a set time can lead to poor technique. And certainly having friends there screaming to push each other harder could lead someone to overdo it.

To be fair, these risks exist with any strenuous activity. Much like injuries can occur in all high-impact sports, people can get hurt running, lifting weights or doing more traditional forms of exercise.

I’m in favor of any exercise program that motivates people to perform regular physical activity and adopt healthier lifestyles. If someone told me he wanted to start CrossFit and asked for my advice, I’d say that he should check with his medical doctor, learn proper techniques, start slowly and increase safely, and see a doctor if he develops pain or other symptoms.

If that same person instead asked about starting a running program, I would offer that same advice.

Injuries can occur in any form of intense physical activity, but if CrossFit or other workout programs are done as safely as possible, the benefits usually outweigh the risks.

Dr. David Geier is an orthopaedic surgeon in Charleston. For more information about exercise injuries and other sports medicine topics, go to his blog at