CrossFit from a Physical Therapist’s Perspective

By Laura Ragel, PT, DPT at Atlantic Health System

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“A Physical Therapist in the CrossFit Box”

I’ll admit it.  Several years ago, when I treated my first CrossFit athlete, I judgingly shook my head... a lot. He had a rotator cuff tear requiring repair… no surprise.  And, after surgery, he wanted to get back to heavy overhead lifting, right away… obviously. “See you back here in a month”, I scoffed.

You’ve probably heard of CrossFit and most likely know some “extreme” individuals who do it.  Or, maybe you’re actually that extreme individual yourself. If you aren’t sure what it is, here’s the brief rundown: CrossFit is “the Sport of Fitness”.  It offers a mix of strength and conditioning, plyometrics, calisthenics, Olympic weightlifting, and gymnastics. Created in 2000, with thousands of gyms popping up worldwide since then due to the supposed CrossFit benefits, the popular fitness approach has been widely criticized for its alleged high injury risk rate and even something called exertional rhabdomyolysis, the breakdown of muscle from extreme physical exertion.

If you had asked me 8 years ago what I thought of CrossFit and its benefits, I would have told you it’s “a bad idea”.  I cringe to say, I may have even called it “stupid”. I’d formed these opinions with really no knowledge of the activity other than assuming the use of heavy weights for ridiculous repetitions contributing to a high risk of overuse injury when thinking about CrossFit and physical therapy from a professional standpoint. I certainly wasn’t alone in this belief, having met more than enough other Physical Therapists who felt the same way calling it “job security”.

A year ago I joined a local gym for women.  I went and had one of the best workouts of my life.  Having always been an athlete and marathon runner, I loved the intensity and competition of whatever this was and I was instantly hooked. Sometimes, it felt like I was in a foreign land navigating EMOMs and AMRAPS, DUs and TtB, WODs and Murphs, whatever those were.

And then one day, it hit me.  I was doing CrossFit. Even worse, I liked it.  A lot.

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Through each WOD, I would assess the squat or lunge form of other class participants and occasionally think, “they shouldn’t be doing this” or “they’re going to get hurt”. I was, however, impressed at the number of scaled options the coaches gave for each move, making it doable for everyone, along with their attention to form and mechanics. I was humbled to watch those very same individuals I labeled as “high risk” steadily progress through the workouts and enjoy the benefits of CrossFit training in terms of gaining not only strength and endurance but confidence as well.  And, while there’s a definite competitive nature to all of this, the camaraderie and support were unparalleled to any other gym I’ve been to.

Shoot.  Maybe I was wrong.

Clarity around CrossFit benefits and appeal came for me one day when I was working with a coach after class. She was consistently working out on her own, sometimes for hours at a time, pushing herself beyond her own limits. I asked her, “Are you training for something?  Do you have an event coming up?” She shook her head and said, “No, not really, I’m just trying to get better at this sport.”

This SPORT.  

“I’ve been looking at this all wrong”, I realized. I would never roll my eyes at a gymnast in the clinic who hurt her knee on the beam and wanted to get back as soon as she could; a soccer player who tore his ACL and was looking forward to next season already; a marathoner with plantar fasciitis who needed to finish his 20-miler over the weekend.  I would skillfully help these athletes, giving them the tools they needed to get back to their respective sports. And, I would be excited to help them get there.

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What if CrossFit is no different?

I now believe this sport to be like any other and one where the CrossFit and physical therapy relationship should be better understood and cultivated. As a therapist, my goal shouldn’t be to stop the athlete from doing what they love, but teaching him or her how to do it safely and efficiently, whether it’s simply for health or high-level competition. A great number of CrossFit “boxes” have already begun to successfully provide in-home Physical Therapy, but where that isn’t available, individuals should feel comfortable seeing an outpatient orthopedic therapist to get the help they need and maximize the benefits of CrossFit training, without judgment or preconceived notions.

I now also believe CrossFit benefits can be enjoyed by basically anyone, at any fitness level.  I am supportive of every person who steps into one of these gyms, making a commitment toward health and self-betterment.  However, when selecting an affiliate, it’s important to keep some things in mind, most importantly, the competency of the coaches on staff. CrossFit offers four levels of certification for their coaches, starting with entry-level training and progressing to the highest level of practical coaching skills and knowledge available.  Your coach(es) should always emphasize proper form and offer scalable progressions so you can get all the CrossFit benefits in as safe and healthy a way as possible.

Be conscious of classes that are too large for one coach to manage and successfully observe for safety and technique.  If you are just starting and unsure, seek more individualized sessions so you can build a foundation and progress according to your own fitness level.  Always make your coach aware of any pre-existing injuries or areas of concern. When it comes to CrossFit and physical therapy, consultation and evaluation by a PT can also help pinpoint any weaknesses needing to be addressed before starting a new fitness routine or sport.

Do not ignore pain and do not progress before you are ready.  Yes, there’s a good chance you won’t be able to walk after your first CrossFit class because every muscle in your body is sore, but that is much different than experiencing joint pain or muscle injury.  Listen to your body and if you have concerns, ask your coach how to modify your program or seek a Physical Therapist for evaluation and advice.

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Now that I have officially been reformed and recognize the benefits of CrossFit training, I can appreciate these athletes’ dedication, motivation, and desire to fully understand their bodies and get back to work. I firmly believe CrossFit and Physical Therapy should co-exist as both certainly have a lot to learn from one another. While I previously thought them to be “the worst patients”, I now look forward to partnering with more individuals in this population...

Except for Fran.  I will never be ok with Fran*.

(*Fran is not a real person.  She is a CrossFit workout)

If you are interested in finding a physical therapy clinic to help you safely participate in your CrossFit SPORT, you can request an appointment for Atlantic Health System and hundreds of other quality clinics in your area through the BetterPT website and BetterPT mobile app. Don’t let an injury interrupt your CrossFit workout! Book your physical therapy session today.



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