Progenex: Common CrossFit injuries

This article by Lucy Fry picks the brain’s of Clinic Director Kelly Robinson

A physiotherapist’s view on common CrossFit injuries and how best to help yourself stay strong.

Lucy Fry talks to Physiotherapist, Kelly Robinson (www.sixphysio.com) about the common injuries suffered by the CrossFitters amongst her patients. A physiotherapist for many, Robinsons here sheds some light on what these injuries are, why they occur, as well as how best to prevent or – worst case scenario – treat them.
i) Lower back pain.
What, why and when:
“This usually occurs due to an overload of the lumbar spine when doing things such as
squats and deadlifts. If the CrossFitter goes into hyperextension of that region, it can put huge pressure on it. So, if there’s any excessive lordosis or kyphosis then this could cause problems.”

How to prevent, strengthen and treat:
For those of you who don’t speak ‘physiotherapist’, that refers, in this instance, to your pelvic alignment and upper back / shoulder positioning. We need to try and ensure the pelvic alignment doesn’t stray too far from neutral (unless there’s a darned good reason, which there sometimes is, when different exercises require a tilt).
Imagine you were cut in half (yes, it’s not nice, but just go with it for a moment please) and you have a cup of water, filled to the brim, sitting on top of your lower half. That water needs not to spill forwards, were you to tilt the pelvis back, and not to spill backwards, were you to tilt the pelvic forwards. It should stay exactly as it is, in
the cup – that’s neutral. You’ll need to bring the weights right down, or even lay off certain exercises (anything that aggravates it) altogether for a little while, whilst you build up your core and glute strength so that your lower back can be supported.

ii) Anterior Shoulder Impingement
What, why and when:
“Impingement of the rotator cuff tendon within the sub acromial space is usually caused by poor ability to maintain the shoulder joint in its correct position,” explains Robinson: “The humeral head shears forward too much so people try and use their pectoral (chest) muscles a lot and their thoracic (upper) spine might be too flexed as well when they try and lift weights overhead or laterally, or do pull ups for example, so you get a pinching of the rotator cuff.

How to prevent, strengthen and treat:
Inbetween sets, don’t just stand around talking to your buddy, use the time to do some pectoral stretching (the doorframe stretch is particularly useful) and flexibility drills, placing a ball into the pec against a pillar as you stand, move the arm around and generally release some of that tension (you’ll know when you get it right…). Thoracic mobility and extension exercises will also help prevent the rounding of the shoulders that can, over time, cause an excessively tight chest.

iii) Anterior Knee pain
What, why and when:
You know those 150 wall balls and those heavy back squats that left you rubbing your kneecap the next day? Do you remember if your knees dropped in at all, especially when things got heavy / you got tired? “If you get pain around the front of the knee, on the knee cap, this could be patella femoral joint dysfunction,” says Robinson. “It’s usually caused by an overload of the joint because of the muscle imbalance around the thigh.” One major warning sign, says Robinson is when: “people struggle to maintain their knee alignment in a squat or lunge, or in single leg work, so the knee rolls in.”

How to prevent, strengthen and treat:
“It’s usually a fault at the pelvis and / or a weakness in the glutes,” Robinson explains, adding: “The people to whom this happens tend to get tight ITBs – the ‘iliotibial’ band that runs down your thigh from the hip, on the outside of your leg.”

So use a foam roller on that ITB in the first instance, to release it a bit, and then get to work on strengthening your glutes so that they’re strong enough to help the pelvis to stay in place and support the thighs and knees. The best exercise for this is a single leg “sit-back” squat. Start by holding onto something in front of you, like TRX or a band wrapped around a pole, and sit back onto a chair or bench then stand up, immediately, ensuring your knee doesn’t travel in front of the toes and stays in line with the second and third toe throughout.

By Progenex Administration, Progenex Team

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