Dr. Jon Hyman

Learn how to Mod your WOD

The rapid adoption of high intensity training regimens and Sports of Fitness: CrossFit, Warrior Dash, American Ninja Warrior, Tough Mudder, P90X, Insanity etc, are putting some people at risk for injury. With increasing frequency, I am seeing significant injuries in patients who do Spartan Race or CrossFit workouts, in particular.

Some of these injuries were previously only seen in rare cases or were unreported in medical literature. As someone who does CrossFit and treats many patients who do it as well, I’m especially interested to provide this public service to help prevent injuries.

The problem isn't CrossFit per se, it's how it's done. The community is supportive, but ultra competitive, and with ego, improper form or coaching, poor body awareness and pre-existing conditions, injuries are more common than they need to be. Olympic type lifting mixed with intense cardio work, under time pressure, isn't for everyone. Modifications are essential for most of us.

Latest from the Blog:

Epidemic of Pec tendon ruptures during CrossFit regionals


Apparently, during the CrossFit regionals in the past couple of weeks, somewhere on the order of 25 men, including some elite athletes, either partially or completely tore their pectoralis major tendons.

American Academy for Orthopaedic Surgeons American Board of Orthopaedic Surgery American Orthopaedic Society of Sports Medicine International Society for Hip Arthroscopy

Women Athletes and Injury Prevention

female athletes

CrossFit appears to be equally popular among men and women. Both genders have excelled in the sport of fitness but both have been affected by injury. Aside from the obvious differences in male and female anatomy, there are functional and mechanical differences as well, and the potential for injury in men and women may be different.

In the sports medicine community, we are now seeing new injuries in women that were previously only seen in men. Two thirds of the hip surgeries I perform are in women. Common injuries include labral tears in the hip and increasingly severe tendon injuries in the elbows and shoulders.

Women pursuing CrossFit need to be aware of the strengths and weakness that relate to their unique physiology and anatomy. They also need to be aware of the potential impact of different physiologic phases they pass through: puberty, pregnancy, childbirth, menopause, etc. Estrogen-containing contraceptive use can even impact the musculoskeletal and vascular systems. Physiologic changes in hormone levels, elasticity and body fat ratios can influence connective tissues in ways that impact everything from regularity of menstrual cycles to ligament tension to urinary incontinence. Through proper training, women can achieve just as much benefit, if not more, from the sports of fitness. If you have concerns about your injury, feel free to contact us at hymanteam@gmail.com.

Typical Injuries from High Intensity Training Like P90X/CrossFit

From my clinical practice, the most common reasons I see for injury include three main types: acute, chronic/overuse and acute on chronic.

Acute injuries are obvious, as something pops, rips or tears. A sudden ‘ouch’ or what was THAT? Chronic or overuse injuries are actually more common and can relate to many factors, as below. Acute-on-chronic injuries occur when there was a problem brewing under the surface to begin with and the exercise exacerbated something and immediate damage occurred.

The most common reasons for injuries include:

  • inadequate rest, ie incomplete recovery
  • overdoing, overtraining
  • excessively heavy weights, not scaling properly
  • poor technique or form, from gripping to squatting
  • inadequate or improper treatment
  • Ego based, with overzealous speed, intensity, volume
CrossFit injuries