An osteopath’s advice to prevent the most common injuries during CrossFit training

Created by Greg Glassman and Lauren Jenai in 2001, CrossFit has steadily gained popularity worldwide, with new boxes opening every month.

In Spain, around 190,000 practitioners enthusiastically follow their national representatives’ performances in international competitions. Some of the best-known athletes include Elena Carratala Sanahuja and Sara Alicia Fernández for the women, and Fabian Beneito and Martín Cuervo for the men.

CrossFit is defined by the repetition and chaining of high-intensity movements from different disciplines: weightlifting, gymnastics, running, rowing, swimming, and more. Each training session, known as a WOD (Workout of the Day), is unique and combines different types of physical and technical demands.

While this type of training offers proven benefits for health and performance, it also raises valid questions about safety, especially when complex movements are performed at high intensity with a high number of repetitions.

With an injury rate of 3.1 per 1,000 training hours, CrossFit has a risk level similar to weightlifting (3.3/1,000 h), gymnastics (3.1/1,000 h) or running. By comparison, some sports are far more injury-prone: rugby (20–150/1,000 h), ice hockey (78.4/1,000 h) and football (up to 35/1,000 h).

Contrary to popular belief, it’s not beginners who get injured the most, but rather experienced practitioners. Once athletes master the basics, they often push their limits: increasing intensity, lifting heavier weights or trying more complex movements. The competitive spirit can amplify this tendency, pushing some to exceed their actual capacity, which increases the risk of injury.

Injuries most often affect:

• Shoulders (25%): rotator cuff tendinopathy, instability, impingement syndrome.
• Back (14.3%): lumbago, dorsal pain.
• Knees (13.1%): patellofemoral pain syndrome, meniscal injuries.
• Elbows: medial or lateral epicondylitis (golfer’s or tennis elbow), ulnar nerve compression.

Most of these injuries are related to overuse or traumatic movements, often aggravated by poor technique.

For example, pull-ups or overhead movements put a lot of strain on the shoulders if performed incorrectly. In fact, the expression “CrossFitter’s shoulder” has become commonplace in many gyms.

Additionally, the risk of injury increases with:

• the number of training hours,
• participation in competitions,
• dietary changes,
• longer training history,
• and previous injuries.

In this context, the coach’s role is essential: adapting sessions to each athlete’s level, correcting movement patterns, and ensuring proper supervision throughout training.

Warming up plays a crucial role in injury prevention. It prepares the body for the intensity of the WOD by gradually increasing muscle temperature and mobilizing the joints. A few minutes of light cardio, joint mobility work, and targeted muscle activation can significantly reduce the risk of trauma.

Similarly, active recovery — gentle stretching, mobility work, foam rolling — supports muscle waste clearance and tissue regeneration, helping prevent long-term pain and overuse injuries.

Beyond technique, lifestyle habits have a direct impact on injury occurrence. Poor sleep disrupts muscle recovery and increases neural fatigue, which reduces attention and control during technical movements.

Likewise, an unbalanced diet can slow tissue repair and promote chronic inflammation. Adequate intake of protein, omega-3, and essential micronutrients (such as magnesium and vitamin D) helps support performance and lower injury risk.

In some cases, consulting a sports nutritionist can be beneficial. A tailored nutrition plan can help athletes match their dietary needs to their training intensity and performance goals, further reducing the risk of injury.

In osteopathic practice, we often see patients after they’ve been injured, forcing them to stop training for several days or weeks. Yet, prevention should play a central role.

Why does a movement you’ve mastered and repeated hundreds of times without pain suddenly become painful? Several factors may contribute: overconfidence, accumulated fatigue, lack of recovery, postural imbalances, or lifestyle habits.

An osteopath can help to:

• relieve muscle and joint tension,
• improve mobility,
• correct inefficient movement patterns,
• and enhance recovery between sessions.

While prevention is a widely accepted concept in osteopathy, robust scientific evidence is still limited. However, it helps reassure athletes and optimizes their training conditions, reducing the likelihood of injury.

When an injury occurs, the osteopath works to restore residual mobility and rebalance mechanical loads that affect movement.

They may also collaborate with other healthcare professionals (physiotherapists, strength and conditioning coaches, sports physicians) to ensure a safe and progressive return to training.

A good example is Anthony López Brun-Buisson, osteopath, who supported Jeff Adler and his coach Caroline Lambray for eight years in Canada, accompanying them to their victory at the 2023 CrossFit Games.

You don’t need to wait for an acute injury to see an osteopath. At the first signs of discomfort — persistent stiffness, reduced mobility, unusual muscle fatigue, or recurring post-training pain — a session can help identify and correct imbalances before they become more serious.

For regular CrossFitters, a preventive osteopathic check-up a few times a year can help keep the body performing optimally and minimize the risks associated with high-intensity training.

CrossFit is a demanding discipline that combines intensity, variety, and personal challenge. Like any sport, it involves an injury risk — but that risk can be significantly reduced through proper technique, tailored coaching, healthy lifestyle habits, and regular osteopathic support.

Prevention over cure remains the best strategy for long-term, safe, and sustainable practice.

“CrossFit puts a lot of stress on the human body. I put my body in vulnerable positions every day.

Osteopathy treatments take pressure off where I need it. In my case, in the lumbar area and in the hip. My difficulty bending practically disappeared 100% in just a few treatments.”

Jeff ADLER

2023 CrossFit Games Champion

This blog article is not intended to generate new knowledge; its content is based on a review of scientific publications, blog posts, and other written sources.