CrossFit participants are intense in their pursuit of this training regimen and sometimes this can lead to back injuries. Judging by the number of participants, CrossFit is possibly the largest fitness trend in the world, with more than 13,000 affiliated gyms, over half of which are in the United States. Because of its rigorous exercises, CrossFit can also be dangerous to the spine health of participants. However, it doesn’t have to be.
One of the newer members of the Texas Back Institute team of spine surgeons is Dr. Peter Derman and in his undergraduate days at Stanford University he was on another team. He was the captain of the Stanford gymnastics team and a world-class athlete. With his athletic background and medical training in spine surgery, he is an excellent source of information on how CrossFit athletes can build strength and stamina without incurring injuries to their spine.
“Despite its popularity, there has been increasing recognition of the potential risks of CrossFit participation,” Dr. Derman said. “Adrenaline, competitiveness, and exhaustion sometimes combine to produce injuries – most commonly of the lumbar spine.”
By adhering to these 10 tips, CrossFitters can maximize their fun and fitness while reducing the chance of spinal injury.
Ten Tips to Avoid Spine Injuries from CrossFit Workouts
1. Find the right “box”
“Finding the right CrossFit gym or ‘box’ which is challenging without being potentially dangerous is a critical first step,” Dr. Derman said. “I suggest that participants spend some time researching – with personal visits and interviews – a box with a philosophy of fitness and wellness. Coaches and fellow gym goers should be focused on progressive skill and strength acquisition rather than simply a no pain, no gain mentality, which can result in burnout and injury.
2. Check your ego at the door
“One of the great aspects of CrossFit training is its communal environment that motivates athletes to push their limits,” Dr. Derman said. “This can produce remarkable results when harnessed appropriately. However, don’t get so carried away that you put your health at risk. Remember the reason you started CrossFit in the first place – to get fit and have fun doing it. Work gradually toward your goals because taking shortcuts and sustaining injuries will only set you back.”
3. The core is key.
“A strong core is essential for stabilizing the spine and pelvis,” he said. “Strengthening these muscles can offload the spine itself and reduce the risk of strains, sprains, and disc herniations. However, a ‘6-pack’ is only part of the equation. The paraspinal and other trunk muscles are just as important and should not be neglected.”
4. Having the proper form is critical
“In a CrossFit workout program, more injuries are caused by improper form than any other factor,” Dr. Derman said. “This cannot be overstated. Poor form places the spine in a compromised position and radically increases the forces imparted across it. Having a well-trained instructor, who is observant and involved with every participant, can dramatically help here.
“Deadlifts and other Olympic lifts can be particularly hard on the spine. Never compromise form, even as you fatigue and reach the point of exhaustion. This requires focus and is why CrossFit is as much a mental as a physical sport.”
5. The effect of cold and hot weather on CrossFit injuries
“It is important to adequately warm up before workouts to prevent muscle, tendon and ligament injuries,” he said. “This is especially relevant in the winter months when cold temperatures cause peripheral blood vessels to constrict. Doing some light aerobic activity before jumping into the intense workout helps increase circulation and helps reduce the chance of injury to your back and elsewhere.
“On the flip side, warm weather can take a toll as well. Heat stroke, a dangerous elevation in body temperature, is most common in the summer months. Symptoms include confusion, nausea, vomiting, flushed skin, headache, and rapid breathing. If someone at the gym exhibits these warning signs, immediately get them to a cool, shaded environment and call 911. Even if it doesn’t produce heat stroke, overheating in the setting of dehydration and physical exertion can lead to severe muscle breakdown and possible damage to kidneys. Adequate hydration, appropriate attire and attention to your body’s cues can help prevent these scenarios.”
6. The importance of pre-workout and post-workout stretching
“The scientific literature on stretching is somewhat limited,” he said. “There is some evidence to suggest that stretching before a workout can reduce the risk of muscle strains but has no impact on the development of overuse injuries. Aggressively stretching muscles while still ‘cold’ may actually cause muscle strains. It is therefore advisable to structure your workout session as follows:
(1) warm up
(3) WOD (workout of the day)
“The post-workout stretch is a great way to boost overall flexibility while your muscles are warm and pliable. Prone extensions, cat-camels, bridges, and seated twists can help keep your spine mobile and nimble. Attention to hamstring flexibility is also key to maintaining a healthy back as tightness in these muscles may transfer more stress to the lumbar spine during bending and lifting activities.”
7. Take time for recovery
“Most CrossFit athletes are highly competitive,” Dr. Derman said. “And this overtraining can sometimes lead to decreased performance and elevated risk of injury. Your muscles sustain minor damage during routine workouts and respond by rebuilding in stronger configurations and increased size. However, this process takes time.
“The exact amount of rest needed between workouts depends on many factors, including baseline fitness level, age, workout duration, and exercise intensity. Ice, heat, massage, and appropriate nutrition may help speed recovery. Again, this is where a trained instructor can help. If an injury is sustained, don’t make matters worse by ‘training through it.’ Rest and seek a medical opinion if your symptoms are severe or persistent.”
8. The difference between injury and muscle fatigue
“Muscle fatigue during a tough workout builds with increasing reps and can resemble a burning sensation,” Dr. Derman said. “Once you stop exerting that muscle group, the burn should resolve within minutes. However, sudden and sharp pain while exercising is cause for concern, and you should rest until symptoms resolve. Ice, heat and non-steroidal anti-inflammatory medications can be helpful for persistent aches and pains. However, consult with a doctor before taking medications if you have any underlying health issues. If symptoms are severe or if they don’t steadily improve with time, it is best to seek the opinion of a medical professional.
“Debilitating back pain with sciatica may represent a disc herniation and is something that should prompt more rapid medical attention, especially if you are experiencing weakness in your legs. If you develop numbness about your genitals, inability to urinate, or loss of bladder control in the setting of back and/or leg symptoms, this could represent critical nerve compression and necessitates an immediate trip to the emergency room to reduce the chance of permanent nerve damage.”
9. CrossFit and kids
“Some parents worry about the weight-training aspect of CrossFit,” Dr. Derman said. “Research suggests that it is safe for children to participate in light weightlifting after age eight. Rather than stack on the plates and aim for full muscle fatigue, kids should use relatively light weights with high reps – they should be able to perform 8-15 at a given weight without significant struggle. Parents and trainers should reinforce the importance of form above all else.”
10. Don’t forget about foods and beverages for quicker recovery
“Post-exercise nutrition is key to speeding recovery and maximizing the benefits of your workout,” Dr. Derman said. Because powering through ‘Fran’ or ‘Murph’ can result in depletion of your body’s glycogen stores and even break down muscle proteins, eating the right nutrients afterward can help your body recover more rapidly.
“I recommend that the CrossFit athlete consume 0.14-0.23 grams of protein and 0.5-0.7 grams of carbohydrates per pound of body weight (1:3 ratio) within 45 minutes of completing your workout. This allows you to take advantage of your body’s enhanced ability to rebuild glycogen and protein immediately after exertion. Plus, don’t forget to hydrate. Water is sufficient after a typical workout, but a sodium-containing beverage is advisable to maintain proper electrolyte balance when exercising indoors for more than two hours or in the heat for over an hour.”