One of the most pervasive and harmful myths about CrossFit is one that many of us have readily accepted- CrossFit is relatively safe, but only when its constituent movements are performed with correct technique. On the surface this seems totally reasonable, but it has become the false premise upon which many serious claims about the safety of CrossFit rest.
I believe that this myth is borne from an attempt to reconcile an apparent tension between two major concepts taught by CrossFit. For the sake of this article, I will use the common definition of technique as whatever movement an athletes uses to accomplish a task. Though less well defined, I will consider good technique to be the movement which optimizes the athlete’s mechanical advantage, and bad technique can be considered any deviation from that.
The first of these concepts is that functional movements (defined as those movements uniquely capable of producing power) are inherently safe. The second concept is the importance of striving to move with near perfect technique. This emphasis on good technique is made repeatedly during the CrossFit Level 1 Course. This is for two important reasons: First, good technique is vital for efficiency and efficacy of our program’s results. Second, good technique aids in mitigating risk of injury.
Herein lies the tension. If functional movements are safe, why do we need to do them correctly in order to prevent injury? It should not be a point of contention to claim that all forms of exercise carry some level of risk. This makes terms like “safe,” and “dangerous,” useless without qualification. When we say that functional movements are safe, we mean that they are safe relative to performing non-functional movements, and certainly safer than doing nothing at all. We also point out that these movements are unavoidable in daily life, so while training them is optional, performing them is not.
Our injury myth answers the apparent tension stated above by admitting that functional movements (and CrossFit) are safe, but only as long as technique is good. The myth also retains the important emphasis on technique by holding that when technique goes south, functional movements become dangerous.
While we have acknowledged that there is a relationship between poor technique and injury, we need to be careful about what that relationship is if we want to be accurate. The assumption underlying our myth is that poor technique is a necessary cause of injury.
Yet common sense tells us this must be an oversimplification. We all know someone who does CrossFit in his garage, performing nearly every movement with poor technique, and yet claiming he is fittest and healthiest he has ever been. Most people also know someone who suffers from an injury that occurred when his or her technique appeared correct.
A survey of literature on the subject also seems to reject this oversimplified view of injury. In their paper Understanding Injury Mechanisms: A Key Component of Preventing Injuries in Sport, authors Bahr and Krosshaug describe the complexity of contributing factors that precipitate injury:
“…although the injury may appear to have been caused by a single inciting event, it may result from a complex interaction between internal and external risk factors. Internal factors such as age, sex, and body composition may influence the risk of sustaining injuries, predisposing the athlete to injury, and are therefore by definition risk factors. In addition, external factors such as shoe traction and floor friction may modify injury risk, making the athlete even more susceptible to injury. It is the presence of both internal and external risk factors that renders the athlete susceptible to injury, but the mere presence of these risk factors is not sufficient to produce injury.”
The authors go on to describe the inciting event that causes injury as “the final link in the chain.” In an effort to combine this epidemiological view of injury causation with a more biomechanical view, they offer the following model:
Regardless of the accuracy of Bahr and Krosshaug’s model, the concept proves useful. In light of the inherent complexity of injury precipitation, the view that poor technique alone (biomechanical factors) is a sufficient cause of injury seems indefensible. Rather, they view these biomechanical factors as necessary conditions that occur as part of a larger chain of events leading to injury.
Interestingly, the field of ergonomics and the study of workplace injury proves to be a useful source of data. For example, interdisciplinary research scientist Dr. Shrawan Kumar has published some of the most extensive treatments of the subject of injury. In his book Selected Theories of Musculoskeletal Injury Causation Kumar writes that the precipitation of injury is “..an interactive process between genetic, morphological, psychosocial and biomechanical factors.” Kumar goes on to outline the extent to which these different variables can be combined prior to an injury event, offering a model that is strikingly similar to that described by his peers in sports medicine.
While different models of ergonomic injury place more or less weight on contributing factors such as biomechanics and genetics, all current models stress the complexity and unpredictability of injury. From this we see that while biomechanical factors such as technique may be a necessary part of the causal chain leading to injury, but appear to be insufficient to cause injury alone. These models also neatly explain the coach’s real world observations that:
1. An overall correlation between poor technique and increased likelihood of injury seems to exist, yet;
2. Some athletes train with poor technique for years without experiencing injury;
3. Some athletes are injured during training in which no discernible breakdown in technique occurs.
Yet when someone argues that ‘poor technique causes injury’ he usually does not mean what his words imply. When presented with the complex nature of training injury, he will usually fall back to something like ‘training repeatedly with poor technique, over time, will lead to injury.’
This is a much more reasonable claim, but it begs the question: Just how dramatically does the chance of injury increase when an athlete trains with poor technique?
At this time, we know of three academic studies of CrossFit injury rates. Two have been published in peer-reviewed journals (Girodano and Hak). The third was conducted by Dr. Yuri Feito and we expect to see it published soon. All three studies found CrossFit’s injury rate to be below or equal to that of general fitness training (2.4-3.1 injuries per 1000 hours of training). These studies were all solicited surveys completed by a broad array of CrossFit participants.
How do we interpret these relatively low injury rates in light of the hypothesis that poor technique dramatically increases the risk of injury? The only suitable explanation is that only a very tiny percentage of those surveyed were training with poor technique.
But is this a probable explanation? As someone who has visited hundreds of CrossFit gyms and trained thousands of relatively new CrossFit athletes, I can say with certainty that there are many, many people training CrossFit regularly with poor technique. Even CrossFit’s best athletes occasionally train with less than perfect form.
How do we reconcile this observation with the fact that CrossFit’s injury rates are so low? Only by abandoning the belief that poor technique is inherently dangerous. While poor technique might be a contributing factor to injury, the fact is the available injury data doesn’t support the idea that it is as dangerous as some claim it to be.
Our myth has been dispelled.
“CrossFit is relatively safe but only when its constituent movements are performed with correct technique,” is clearly an oversimplified statement that should be replaced with this one: “CrossFit is relatively safe even when performed with poor technique, but it is safer and more effective when performed with good technique.”
Why is this so important? The myth that poor technique makes CrossFit dangerous is a key assumption underlying the argument that the CrossFit Level 1 Certificate Course is an insufficient credential for opening an affiliate, the argument that CrossFit Trainers need to be licensed by the state, and the argument that only elite athletes should be doing CrossFit. We will look at this flawed argument in greater detail in Part 2.