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Knee Injury in the CrossFit Athlete

While you’re at the box completing your WOD, injury is probably the last thing on your mind.  However, injury is a major set-back for a workout that contains dynamic, full-body exercises like a CrossFit WOD.  A study was completed this year at four owner-operated CrossFit gyms in Florida.  In this study, researchers found that 51 of 191 athletes suffered from 62 injuries within a six-month period (Montalvo et. al., 2017).  The most common injuries were to the shoulder, knee, and lower back.

The most surprising finding of this study was the impact of the injury.  Due to their injury, 50% of athletes changed exercises to accommodate for their injury, 20% of athletes stopped specific exercises, and 20% of athletes stopped participating in CrossFit altogether.  To learn more about knee injury in CrossFit, keep reading.

What Causes Knee Injury in CrossFit?

The previously discussed study proposed possible risk factors of CrossFit injury, citing length of participation, weekly athletic training hours (CrossFit + other activity), weekly athletic exposure to CrossFit, height, and body mass as possible risk factors.  Researchers found that competitors were more likely to be injured due to increased training hours.  Decreased core and hip strength, improper knee movement, and deep squats can also cause injury.

What are the Effects of Knee Injury?

Knee Injury can present with clicking, locking, grinding, and buckling of the knee.  Also common are instability and stiffness of the knee.  Those with knee injuries may struggle to maintain knee alignment in exercises like squats, lunges, or single-leg exercises.  If injured, your knees may drop in during exercises like wall balls and heavy back squats.

Further, weak muscles and poor hip flexibility can lead to a squat stance that is too wide, feet that are toed out too far, knees tracking in, and heels coming off the floor.  Obviously, pain surrounding the knee is an indicator that shouldn’t be ignored.

How is Knee Injury Treated in Physical Therapy?

If you are experiencing any of these symptoms, a great option is to make a visit to a physical therapist.  With direct access, seeing a physical therapist is easier now more than ever. (See Missy’s blog post here for more about direct access).  A PT will evaluate your strength and/or range of motion deficits.

Based on these findings, an individualized plan of care is created – geared towards getting you back to CrossFit as soon as possible.  This plan may include exercises to activate and strengthen muscles, improve proprioception and balance, increase flexibility, and more.  The PT will also work on fixing form, if necessary.

A common misconception about PT is that you will be forbade from participating in the activities you love until you are completely recovered.

On the contrary, PTs will often allow you to slowly return to CrossFit during your treatment, so that they may monitor your progress.  This enables the PT to modify your treatment accordingly.

How Can You Prevent Knee Injury in CrossFit?

You can work on fixing form before you ever get to the point of needing physical therapy.  One way to fix squat form is to squat to a box and focus on driving weight through your heels as well as proper knee alignment.  Your knees should track over your second or third toe and should not track forward past your toes.

While doing box jumps, focus on soft landings.  You should also focus on the tilt of your pelvis – you want the pelvis to be tilted back, which allows you to maintain the natural curvature of your spine.  Warm-up and stretching have been shown to reduce muscle/tendon-related injuries and overuse injuries of the knee (Woods et. al, 2008).

Should you choose to see a PT, you can stay on the road to recovery by coming as frequently as the PT requests, keeping up with home exercises, and avoiding the activities your PT believes you aren’t quite ready for yet.

For more prevention tips and examples of exercises, check out the Active Physical Therapy Instagram @theactivept.

Written by Taryn Druhot, Spring 2017 Intern from The Ohio State University


Montalvo A.M., Shaefer H., Rodriguez B., Li T., and Epnere K. Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit. Journal of Sports Science and Medicine. 2017; 16(1): 53-59.

Slater L.V. and Hart J.M. The influence of knee alignment on lower extremity kinetics during squats. Journal of Electromyography and Kinesiology. 2016; 31: 96-103.

Woods K., Bishop P., and Jones E. Warm-Up and Stretching in the Prevention of Muscular Injury. Sports Medicine. 2008; 37(12): 1089-1099.


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