A Physical Therapist’s Guide to Avoiding Injuries at CrossFit

By: Chelsea Savage, PT, DPT, OCS

I probably shouldn’t do CrossFit, right?”

I’m getting this question more often from my patients, as CrossFit and other high-intensity workouts become increasingly more popular. Patients assume that as a physical therapist who specializes in orthopedics, my recommendation will be to avoid this high-intensity form of exercise. They’re usually surprised to find out I do CrossFit myself.

Some would argue that all CrossFit workouts are extreme and inherently dangerous – lifting heavy weights against a running clock, throwing medicine balls overhead, and swinging from a bar all sound like they would most likely end in an injury eventually. Interestingly, a review was published in 2017 in the Journal of Sports Rehabilitation comparing injury rates in people who participate in CrossFit workouts to those who enjoy other forms of exercise. They found that injury rates from regularly doing CrossFit workouts are actually comparable to those other sports like distance running, soccer, ice hockey, football or gymnastics.1

There is a well-established body of evidence supporting that weight training is great for you. Youth and adults can improve bone density, metabolism and overall fitness, while older adults can fight age-related bone loss and maintain independent living.2,3 Because the benefits of strength training are so numerous, I will always encourage my patients to lift weights if they are able – and your bodyweight counts! So what’s the secret to doing high-intensity workouts like CrossFit, having fun and avoiding injuries? In the 3 years I’ve been doing CrossFit, I’ve seen people excel and I’ve seen people get seriously injured. Here are my surprisingly simple tips to a healthy CrossFit experience:

Do go shopping.

Choose carefully knowing that not all CrossFit gyms – or “boxes” as they’re called – and coaches are the same. Before attending a class, check their website and make sure all coaches are at least “Level” certified. Then try a few classes and see what the style of the instruction is like. Your coach needs to be invested in your safety – you are looking for an instructor who will walk around and interact with each person while they’re working out and provide feedback on technique. You want a coach who can quickly give you ways to scale or modify a workout if you need it. If you see coaches checking their phones while you’re sweating it…keep shopping.

Don’t skip your warm-up.

We all know that warming up before a workout is typically a good idea, but a warm up is very important for preventing injuries, specifically during high-intensity workouts.4 It is also one of the most tempting parts of the workout to skip. We understand, traffic was terrible and now you’re late to class. Whatever you do, do NOT jump straight into your heavy back squats or burpees without warming up properly. Your coach should lead the class through 15-30 mins of light cardiovascular exercise, stretching and bodyweight exercises prior to you picking up a barbell or starting the clock. This allows your muscles and tendons to become more compliant and less likely to become injured during your workout.4,5

Never sacrifice technique.

If your coach gives you feedback – take it. If you don’t get feedback – ask for it. Don’t let your ego get in the way of asking for suggestions for improving your technique. Sacrificing form might be the biggest trap of a fast-paced high-intensity workout, even for experienced athletes. How valuable will be setting a personal record or beating a buddy’s time if you get injured in the process and need 6 to 8 weeks to recover? It’s not. Working out should never cause an injury. Rather the goal to improving your strength is to prevent injuries. Proper form when squatting, snatching, and deadlifting matters. Make technique a priority and your body will thank you.CS_CF

Know when to modify.

If you’re a human, you might have days when you have pain somewhere. That’s your body’s alarm system telling you something isn’t quite right. It is not your body telling you to add another 25 pounds to your barbell. Pain is not gain – don’t push through it. Listen to your body and learn the difference between cardiorespiratory fatigue and muscle soreness versus acute pain in a specific area. Your mindfulness before and during your workout will help you know when you need less reps, lighter weight or a different exercise altogether. In addition, if you know that box jumps are a bad idea for your body, ask to modify to step ups, mini squats or something else. The beauty of CrossFit is that is “scalable” for athletes of all ages and abilities. Just ask your coach for ideas.

If you find yourself constantly modifying because of pain, call an understanding ortho PT (ahem, me) and I’ll help get you back on track. No judgement. Three years ago, I thought CrossFit was just for the crazy people. Now I’m hooked. I guarantee, if you use these tips you will find something you like about it too, sans injury!



  1. https://www.ncbi.nlm.nih.gov/pubmed/28253059
  2. http://www.acsm.org/public-information/articles/2016/10/07/the-basics-of-starting-and-progressing-a-strength-training-program
  3. http://www.acsm.org/public-information/articles/2016/10/07/strength-training-for-women
  4. https://www.ncbi.nlm.nih.gov/pubmed/15233597
  5. https://www.ncbi.nlm.nih.gov/pubmed/18027995