From Sweat to Strain: An Epidemiological Analysis of Training-Related Injuries in CrossFit®

Purpose: This study aims to conduct an epidemiological investigation into the types and causes of injuries during CrossFit^® training in Germany.
Patients and Methods: Voluntary athletes from various German CrossFit^® gyms participated, providing personal information, training habits, and details on injuries through a standardized questionnaire.
Results: The study involved 308 participants, with an equal sex split, a peak age of 20– 40, and a BMI of 24.3 ± 3.3 kg/m². Most participants trained for over two years (49.4%), primarily in supervised groups. Motivations for engaging in CrossFit^® included health prevention (33.1%), athletic training (32.8%), and work-life balance support (17%). Injuries were reported by 28.6% of participants, with 61.4% experiencing single injuries. The majority of injuries (55.3%) occurred during the middle of workouts. Injury types included wounds (23.3%), contusions, sprains, or strains (cumulative 30.8%), and fractures (2.9%). Almost all injured individuals (96.5%) had a time-loss injury, with a return to sport ranging from a day to over three months. Treatments varied, with 50.6% not requiring medical intervention, 34.1% undergoing physiotherapy, 21.2% receiving medication and 8.2% needing surgery. Barbell exercises, notably Snatch and Clean, were main exercises with association to injuries, accounting for 36.3%. The Box Jump stood out as the exercise with the highest isolated injury prevalence (14.3%). Notable injury causes included falls during Pull-Ups and lumbar disc herniation linked to Deadlifts. Following injuries, 45.8% of participants made training adjustments.
Conclusion: This study provides an epidemiological investigation into the types and causes of injuries during CrossFit^® training in Germany. The shoulder and knee joint exhibited the highest injury prevalence. Barbell exercises, box jumps, and bar pull-ups were identified as major exercises with association to injuries. Prevention through technical training and the incorporation of soft boxes could reduce the risk of injuries in CrossFit^®.

Plain Language Summary: This study looks at the types and causes of injuries during CrossFit^® training in Germany. A total of 308 CrossFit^® athletes took part, with an equal number of men and women, mostly aged 20-40, and an average BMI of 24.3 ± 3.3 kg/m². Most had trained for over two years, often in supervised groups, and were motivated by health, fitness, and balancing work and life.
About 28.6% of participants reported injuries, mostly single injuries happening in the middle of workouts. The types of injuries included cuts, bruises, sprains, strains, and fractures, with the shoulder and knee being the most commonly affected areas. Notably, exercises involving barbells like the Snatch and Clean caused a significant number (36.3%) of injuries, followed by Box Jumps (14.3%) and bar pull-ups. Causes of injuries included falls during pull-ups and back injuries from Deadlifts.
After getting injured, nearly half of the participants changed their training routines. Treatments varied, with some not needing medical help and others undergoing physiotherapy, taking medication, or having surgery.
The findings suggest that focusing on proper technique and using softer equipment, like softer landing surfaces for Box Jumps, could help reduce the risk of injuries in CrossFit^® training.

Keywords: fitness, weightlifting, bodyweight, barbell, sport injury, gymnastics