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Three Ways to Prevent Injury in CrossFit

When participating in CrossFit, as with any fitness regimen, there is inherent risk of injury. Currently, the evidence suggests injury risk with CrossFit is comparable to regular gym training and triathlon training, while still having lower risk than contact sports 1.With the high intensity and complex movements characteristic of CrossFit comes equally high prerequisite mobility and stability demands. To mitigate injury risk and facilitate longevity with a training regimen such as CrossFit, it is imperative to take steps to ensure these prerequisites are achieved. The following are strategies to optimize common CrossFit movements and keep you training safely.

1. Latissimus Dorsi Flexibility

The latissumis dorsi is a large shoulder and back muscle that, if tight, limits the arms ability to reach overhead and can contribute to excess strain at the shoulder. The shoulder is the most commonly injured area in CrossFit, and most often during gymnastic movements 2. Full overhead shoulder mobility is utilized in gymnastics as indicated by the findings that gymnasts typically have an average of ~10 degrees greater shoulder flexion range of motion than the general population 3. A large percentage of CrossFit movements include maximal overhead positioning of the upper extremities, whether it is with a barbell, pull-up bar, or gymnastic rings. Having the flexibility to reach these end-range positions is necessary to avoid undue strain at the shoulder. The stretch below is a great option for opening up the shoulder before any overhead movements.

1. *Notes: allow low back to be rounded while upper back arches and chest drops toward the ground; ~1min static stretch, ~1min dynamic movement in and out of stretch

2. Hip Flexion Mobility

The lumbar spine is the second most commonly injured area in CrossFit, most often during barbell lifts 2. With the deep squatting often performed in CrossFit, particularly with Olympic lifts, sufficient hip flexion mobility is required to reduce excessive strain on the low back. If squatting with external load is performed beyond the depth available at the hip, the lumbar spine is forced into a compromised flexed position, which can result in greater than 100% more pressure on the intervertebral discs and other spinal structures 4. Below are exercises to optimize hip mobility in preparation for safe squatting.

2. *notes: do not allow low back to round when pulling knee to chest; ~2min per hip

2. *notes: place feet and hips in same position as you would while squatting; maintain slight arch in back as you rock back; ~2min rocking back and forth

3. Hollow Position Stability

One of the more controversial movements in CrossFit is the “kip”. It is also one of the most common, being utilized for pull-ups, muscle-ups, and even handstand push-ups. If performed incorrectly, the kip can cause excessive lumbar spine extension, resulting in significant compressive forces at the low back as well as problems throughout the body’s kinetic chain. Abdominal exercises that promote global “bracing” of the mid-line have been shown to increase intra-abdominal pressure and improve spinal stability 5. Below is an example of a kipping-specific abdominal exercise known as “hollow holds”. Developing strength in the hollow position is essential to control the kipping motion and distribute force throughout the whole body, thus avoiding excess stress at individual joints.

3. *notes: flatten low back into the ground as you raise up; hold for 3-5 seconds; control descent back to starting position; repeat to fatigue

References:

Weisenthal, B. M., Beck, C. A., Maloney, M. D., DeHaven, K. E., & Giordano, B. D. (2014). Injury rate and patterns among CrossFit athletes. Orthopaedic Journal of Sports Medicine, 2(4), 2325967114531177.
Hak, P. T., Hodzovic, E., & Hickey, B. (2013). The nature and prevalence of injury during CrossFit training. Journal of strength and conditioning research.
Gannon, L. M., & Bird, H. A. (1999). The quantification of joint laxity in dancers and gymnasts. Journal of Sports Sciences, 17(9), 743-750.
Nachemson, A. L. (1981). Disc pressure measurements. Spine, 6(1), 93-97.
Stokes, I. A., Gardner-Morse, M. G., & Henry, S. M. (2011). Abdominal muscle activation increases lumbar spinal stability: analysis of contributions of different muscle groups. Clinical Biomechanics, 26(8), 797-803.

Git Fit for Los Angeles Marathon 2017

Sarah Noble:

I signed up for the Los Angeles Marathon (my first marathon) this past summer to run for Kiss the Sky to raise awareness for Type 1 Diabetes and funds for the Faustman Lab, which is currently conducting phase 2 human clinical trials in hopes to cure the disease. My sister Kate has Type 1 Diabetes and my friend’s brother Murphy Roberts passed away this summer due to complications from T1D.

In September 2016, I hurt my lower back / sacroiliac ligament(s) in a workout class, and the situation continued to get worse and worse - I couldn’t sit down or touch my toes, let alone run, without bad pain / stiffness in my lower back. I started working with Lauren and JJ in December and told them my goal of running the marathon in the end of March. They were both incredibly supportive and fantastic to work with - pushing me to challenge myself and work smarter. I had to amend my marathon training plan a bit, but they worked with me tirelessly on my leg and glute strength, plyometrics and flexibility - equipping me with tools and exercises to support a more balanced training program for this marathon and future races.

My back didn’t hurt me at all during the marathon, and I beat my goal time, finishing the marathon in 3 hours and 43 minutes. Lauren came to the finish line to cheer me on, and I definitely wouldn’t have made it that far without her!

Voyage LA Article – Meet Rick Rafael of SportsFit Physical Therapy in Santa Monica

Today we'd like to introduce you to Rick Rafael.

Thanks for sharing your story with us Rick. So, let's start at the beginning and we can move on from there.

I studied biomedical engineering at the University of Southern California. Upon graduating I started to work at Accenture doing technology and process consultation to fortune 500 companies. However, a few years into my career as a consultant, I realized that my passion was in health and wellness. I therefore, decided to leave the technology field, in order to be able to apply myself in the field of health and wellness. I worked as a trainer and martial arts instructor while completing my doctorate program. After graduating as a physical therapist, I then completed a residency program at Kaiser Permanente and obtained board certification in orthopedics. After a few years of working at various clinics, I established SportsFit in 2010 with the intention of providing the highest quality of service to every patient. It is more than rewarding to hear from patients, colleagues and referring physicians that they consider SportsFit the gold standard for a physical therapy clinic and to have been recognized as a leader in our field.

Has it been a smooth road?

Many of the obstacles that I had considered prior to the inception of SportsFit proved to be less of a challenge than initially imagined. However, we ran into several other challenges and growing pains in the last 6 years. Our business plan had identified and planned for competition, marketing, resources, and equipment needed. However, managing several employees all with different backgrounds and expectations was definitely a learning process for me.

So, as you know, we're impressed with SportsFit Physical Therapy - tell our readers more, for example, what you're most proud of as a company and what sets you apart from others.

My vision for SportsFit has always been to lead a healthy and happy environment optimized for the offering of excellence in the service we offer to our patients and the positions we create for our employees. We are proud to have been able to offer more than 60,000 treatment sessions as a team. At SportsFit, most of our patients are referred by a friend or family. In many cases we have treated entire family members, whom have referred each other to SportsFit for different reasons. I consider this a huge compliment and one of the most important reasons to our success as a clinic. In an economy where insurance providers continue to raise member premiums and reduce provider reimbursements, what keeps us going is the positive feedback we receive from patients on a daily basis. To have been able to assist the recovery and healing of so many patients and leading them back to a healthy and active life is a priceless reward for all of us at SportsFit.

What sets SportsFit apart as a clinic, is the ability to offer a multidisciplinary approach to therapy by providing physical therapy interventions, including orthopedic and sports rehabilitation, Pilates, Acupuncture, therapeutic yoga, therapeutic massage, and sports performance sessions to our patients. At SportsFit, our patients are always treated by a doctor of physical therapy and receive one-on-one treatments for their entire hour long session, receiving true quality care. Our patients benefit from utilizing a 5,000sq-ft therapy and fitness facility at a state of the art clinic with the highest quality of sports & therapy equipment.

Let's touch on your thoughts about our city - what do you like the most and least?

I honestly believe that Santa Monica is one of the best cities in the world. Almost perfect weather, proximity to the beach, access to a variety of different resources, places, and events make our city a fun and exciting place to live. The main issue with a large city like Los Angeles is traffic. I believe the secret to living in LA is to live close to your work in order to limit your commute. Saving time on the daily commute makes everything else much more effortless.

Patient Spot Light – Get Fit for Soccer

"I came to Sportsfit immediately following my first major sports injury in the beginning of 2016. Very quickly, Dr. Rebecca Pitts, her assistant Olivia, and the rest of the team came up with fun yet challenging ways to bolster my strength and my confidence. I left every session feeling energized, more knowledgeable of my prognosis and treatment plan, well-looked out for, and of course noticing a little of that good “burn” from a workout. Soon, exercises evolved from just tensing my quads to jump squats and barbell deadlifts. I was so happy with my experience that I continued training with personal trainer Olivia outside of SportsFit after my insurance ran out. Nine months out of surgery, I am able to go on hikes and kick the ball around with friends, and see my goal of being back on the soccer field not far ahead."

~Evan Choate