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It is January, which means tens of millions of people resolving to work out more this year. High-intensity, interval training (HIIT), Bootcamps, and Crossfit workouts are extremely popular options amongst people looking to get into or stay in shape. They mix endurance and strength training, Olympic and powerlifting, and gymnastics movements under high intensity over short periods of time with little rest. Crossfit, in particular, has been praised for its unique approach to fitness leading to vast improvements in body composition and max aerobic capacity, but also for its camaraderie and competition within the community. One concern with Crossfit and other HIIT/Bootcamp workouts is the potential for injury that could result from overexertion or improper technique.
In a recent study in the Orthopaedic Journal of Sports Medicine, Weisenthal and colleagues (2014) collected survey data from Crossfit participants in Philadelphia, Rochester, and New York City. The results showed that approximately 1 out of 5 Crossfit participants suffered from an injury within the 6 months before the study was conducted. The most common injuries involved the shoulders, lower back, and knees, and the rate of injury was higher for males compared to females. Interestingly, there was no significant difference in the rate of injury between age groups, and neither the length of training sessions nor the amount of time the participants were involved with Crossfit made a difference in injury rate. More importantly, the level of coach supervision had a strong effect on injury rates.
Although no conclusions are definite and more studies on Crossfit are necessary, a recommendation to take away from these results is to choose a Crossfit facility where the coaches are actively involved with the training. This includes trainers modifying the programs based on the injury and exercise history of the participants, and monitoring everyone closely throughout the workouts to ensure proper technique. And, while the study referenced looked solely at Crossfit injuries, the same principles would apply to any such workout class/program.
Since this is the beginning of the year with gym memberships spiking, I thought it would be as good a time as any to review some principles to decrease injury risk.
  • Learn correct technique: Many injuries manifest when one develops bad habits from incorrect technique, which puts stress on body parts and muscle groups not meant to be stressed during an exercise. Therefore, when learning a new movement, be patient with weight progression to solidify muscle memory with the lighter weight so you can progress to heavy weight safely.
  • Supervision of a qualified trainer
    • When learning new technique and exercises for a fitness program, it is safe to work with a fitness trainer that has obtained certification from the National Strength and Conditioning Association and is a Certified Strength and Conditioning Specialist (CSCS).
  • Stop the exercise if fatigue is causing incorrect technique 
    • Although it is necessary to push yourself to improve, you must control your form and safely control the weight. If you use incorrect technique, or perform a lift off balance, you may get hurt
  • If something hurts, stop!
    • While it sounds intuitive, i see too many patients who end up with severe injuries because they pushed through pain during a workout. A good rule is that if something hurts while doing it, stop. If something is sore afterwards, like a good workout, that is ok.
Workout classes such as Crossfit and boot camps have done an outstanding job of creating a sense of community while getting people in better shape. Just be safe so that your attempt to get healthier doesn’t leave you injured!

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