Int J Sports Med 2021; 42(14): 1281-1286
DOI: 10.1055/a-1386-5188
Training & Testing

Effects of an Injury Prevention Program in CrossFit Athletes: A Pilot Randomized Controlled Trial

1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
2   Systems Biology Department, University of Alcalá, Alcalá de Henares, Spain
3   Department of Sport and Health, Agencia Espanola de la Proteccion de la Salud en el Deporte, Madrid, Spain
,
Susana Moral-González
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
,
Alejandro Lucia
4   Physiology, Universidad Europea De Madrid, Madrid, Spain
5   Physical Activity and Health Laboratory, Instituto de Investigación Sanitaria Hospital ‘12 de Octubre’ (‘imas12’, PaHerg), Madrid, Spain.
,
David Barranco-Gil
1   Faculty of Sport Sciences, Universidad Europea de Madrid, Spain
› Author Affiliations
Funding: Research by P.L.V. is funded by University of Alcalá (FPI2016). Research by A.L. in the field of physical activity and health is supported by Carlos III Health Institute (Spanish ministry of Science and Innovation) and Fondos Feder (grant # PI18/00139).

Abstract

The present study aimed to assess the effects of an injury prevention program in CrossFit athletes. Thirty-two CrossFit athletes were randomized to either an intervention group (n=16), that performed mobility and stability exercises during the warm-up of all CrossFit sessions for a 10-week period or to a control group (n=16) that kept performing their usual warm-up. Incidence of injuries (primary outcome) as well as average training loads, fatigue and pain perception were registered during the study. The overall injury incidence rate was 0.04 per 1000 training hours, with no differences between groups (p>0.05). Similarly, no between-group differences were found for injury severity, nor for average training volume, intensity, training load, pain, or fatigue perception during the study (all p>0.05 with trivial-to-small effect sizes). In summary, a 10-week injury prevention program consisting of stability and mobility exercises provided no benefits on injury rates, fatigue and pain perception in recreational CrossFit athletes. Further research might corroborate the preliminary evidence reported here.

Supplementary Material



Publication History

Received: 09 November 2020

Accepted: 29 January 2021

Article published online:
12 July 2021

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Giordano B, Weisenthal B. Prevalence and incidence rates are not the same: Response. Orthop J Sports Med 2014; 2: 232596711454326
  • 2 Feito Y, Burrows EK, Tabb LP. A 4-year analysis of the incidence of injuries among crossfit-trained participants. Orthop J Sports Med 2018; 6: 2325967118803100
  • 3 Weisenthal BM, Beck CA, Maloney MD. et al. Injury rate and patterns among crossfit athletes. Orthop J Sports Med 2014; 2: 2325967114531177
  • 4 Hak PT, Hodzovic E, Hickey B. The nature and prevalence of injury during crossfit training. J Strength Cond Res 2013; Online ahead of print. doi:10.1519/JSC.0000000000000318
  • 5 da Costa TS, Louzada CTN, Miyashita GK. et al. Crossfit®: Injury prevalence and main risk factors. Clinics 2019; 74: e1402
  • 6 Moran S, Booker H, Staines J. et al. Rates and risk factors of injury in CrossFitTM: A prospective cohort study. J Sports Med Phys Fitness 2017; 57: 1147-1153
  • 7 Larsen RT, Hessner AL, Ishøi L. et al. Injuries in novice participants during an eight-week start up crossfit program – A prospective cohort study. Sports (Basel) 2020; 8: 21
  • 8 Szeles PR, de Q, Costa TS. et al. CrossFit and the epidemiology of musculoskeletal injuries: A prospective 12-week cohort study. Orthop J Sports Med 2020; 8: 889-894
  • 9 Lerch C, Cordes M, Baumeister J. Effectiveness of injury prevention programs in female youth soccer: A systematic review. Br J Sport Med 2011; 45: 359 doi:bjsm.2011.084038.140
  • 10 Brunner R, Friesenbichler B, Casartelli NC. et al. Effectiveness of multicomponent lower extremity injury prevention programmes in team-sport athletes: An umbrella review. Br J Sports Med 2019; 53: 282-288
  • 11 Andersson SH, Bahr R, Clarsen B. et al. Preventing overuse shoulder injuries among throwing athletes: A cluster-randomised controlled trial in 660 elite handball players. Br J Sports Med 2017; 51: 1073-1080
  • 12 Taddei UT, Matias AB, Ribeiro FIA. et al. Effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: Feasibility study for a randomized controlled trial. Phy Ther Sport 2018; 34: 216-226
  • 13 Rodríguez C, Echegoyen S, Aoyama T. The effects of “prevent injury and enhance performance program” in a female soccer team. J Sports Med Phys Fitness 2018; 58: 659-663
  • 14 DiStefano LJ, Marshall SW, Padua DA. et al. The effects of an injury prevention program on landing biomechanics over time. Am J Sports Med 2016; 44: 767-776
  • 15 Everhart JS, Kirven JC, France TJ. et al. Independent risk factors for recurrent or multiple new injuries in crossfit athletes. J Sports Med Phys Fitness 2020; 60: 1470-1476
  • 16 Harriss DJ, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020. Int J Sports Med 2019; 40: 813-817
  • 17 Horschig A, Sonthana K, Neff T. The Squat Bible: The Ultimate Guide to Mastering the Squat and Finding your True Strength. 1st. Great Britain: Squat University LLC; 2017
  • 18 Colado JC, Garcia-Masso X, Triplett NT. Construct and concurrent validation of a new resistance intensity scale for exercise with thera-band® elastic bands. J Sports Sci Med 2014; 13: 758-766
  • 19 Andersen LL, Andersen CH, Mortensen OS. et al. Muscle activation and perceived loading during rehabilitation exercises: Comparison of dumbbells and elastic resistance. Phys Ther 2010; 90: 538-549
  • 20 Johnson KD, Grindstaff TL. Thoracic region self mobilization: A clinical suggestion. Int J Sports Phys Ther 2012; 7: 252-256
  • 21 Wilk KE, Yenchak AJ, Arrigo CA. et al. The advanced throwers ten exercise program: A new exercise series for enhanced dynamic shoulder control in the overhead throwing athlete. Phys Sportsmed 2011; 39: 90-97
  • 22 Van Oosterwijck J, De Ridder E, Vleeming A. et al. Applying an active lumbopelvic control strategy during lumbar extension exercises: Effect on muscle recruitment patterns of the lumbopelvic region. Hum Mov Sci 2017; 54: 24-33
  • 23 Distefano LJ, Blackburn JT, Marshall SW. et al. Gluteal muscle activation during common therapeutic exercises. J Orthop Sports Phy Ther 2009; 39: 532-540
  • 24 Henriksen M, Aaboe J, Bliddal H. et al. Biomechanical characteristics of the eccentric Achilles tendon exercise. J Biomech 2009; 42: 2702-2707
  • 25 Fuller CW, Ekstrand J, Junge A. et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med 2006; 40: 193-201
  • 26 Foster C. Monitoring training in athletes with reference to overtraining syndrome. Med Sci Sports Exerc 1998; 30: 1164-1168
  • 27 Gabbett TJ. The training-injury prevention paradox : should athletes be training smarter and harder ?. Br J Sports Med 2016; 50: 273-280
  • 28 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377-381
  • 29 Rio E, Kidgell D, Purdam C. et al. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med 2015; 49: 1277-1283
  • 30 Elloumi M, Makni E, Moalla W. et al. Monitoring training load and fatigue in rugby sevens players. Asian J Sports Med 2012; 3: 175-184
  • 31 Chatard JC, Atlaoui D, Pichot V. et al. Suivi de l’entraînement de nageurs de haut niveau par questionnaire de fatigue, dosages hormonaux et variabilité de la fréquence cardiaque. Sci Sports 2003; 18: 302-304
  • 32 Hopkins W, Marshall SW, Batterham AM. et al. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc 2009; 41: 3-12
  • 33 Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd edition. Hillsdale, New Jersey: Lawrence Erlbaum Associates; 1988
  • 34 Fanchini M, Steendahl IB, Impellizzeri FM. et al. Exercise-based strategies to prevent muscle injury in elite footballers: A systematic review and best evidence synthesis. Sports Med 2020; 50: 1653-1666
  • 35 Porter T, Rushton A. The efficacy of exercise in preventing injury in adult male football: A systematic review of randomised controlled trials. Sports Med Open 2015; 1: 4
  • 36 Summitt RJ, Cotton RA, Kays AC. et al. Shoulder injuries in individuals who participate in crossfit training. Sports Health 2016; 8: 541-546
  • 37 Mehrab M, de Vos RJ, Kraan GA. et al. Injury incidence and patterns among dutch crossfit athletes. Orthop J Sports Med 2017; 5: 2325967117745263
  • 38 Sugimoto D, Zwicker RL, Quinn BJ. et al. Part II: Comparison of crossfit-related injury presenting to sports medicine clinic by sex and age. Clin J Sport Med 2020; 30: 251-256
  • 39 Minghelli B, Vicente P. Musculoskeletal injuries in Portuguese CrossFit practitioners. J Sports Med Phys Fitness 2019; 59: 1213-1220
  • 40 Tafuri S, Salatino G, Napoletano PL. et al. The risk of injuries among CrossFit athletes: An Italian observational retrospective survey. J Sports Med Phys Fitness 2019; 59: 1544-1550
  • 41 Keogh JWL, Winwood PW. The epidemiology of injuries across the weight-training sports. Sports Med 2017; 47: 479-501
  • 42 Friedman MV, Stensby JD, Hillen TJ. et al. Traumatic tear of the latissimus dorsi myotendinous junction: Case report of a crossfit-related injury. Sports Health 2015; 7: 548-552
  • 43 Montalvo AM, Shaefer H, Rodriguez B. et al. Retrospective injury epidemiology and risk factors for injury in crossfit. J Sports Sci Med 2017; 16: 53-59
  • 44 Tibana R, de Sousa N, Cunha G. et al. Validity of session rating perceived exertion method for quantifying internal training load during high-intensity functional training. Sports (Basel) 2018; 6: 68
  • 45 Williams S, Booton T, Watson M. et al. Rate variability is a moderating factor in the workload-injury relationship of competitive crossfit tm athletes. J Sports Sci Med 2017; 16: 443-449
  • 46 Tibana RA, de Sousa NMF, Prestes J. et al. Monitoring training load, well-being, heart rate variability, and competitive performance of a functional-fitness female athlete: A case study. Sports (Basel) 2019; 7: 35