High Rate of Return to CrossFit Training After Arthroscopic Management of Rotator Cuff Tear

CrossFit is a conditioning program involving high-intensity exercises performed in rapid, successive repetitions with limited or no recovery time. The shoulder girdle is highly involved in most basic CrossFit training programs.

CrossFit athletes affected by rotator cuff tear may be successfully treated with arthroscopic surgery with a high rate of early return to CrossFit activities.

Case series; Level of evidence, 4.

Included in this study were athletes participating regularly in CrossFit training who had undergone arthroscopic rotator cuff repair. At a minimum follow-up of 24 months, we compared pre- and postoperative clinical outcome scores, including the Constant Score (CS), the American Shoulder and Elbow Surgeons (ASES) score, and a visual analog scale (VAS) for pain, as well as imaging results. Participants completed a return-to-CrossFit questionnaire at the final follow-up, and changes in laboratory blood test results from preoperative to final follow-up were evaluated for association with outcomes and questionnaire responses.

A total of 22 CrossFit athletes (23 shoulders) completed the 24-month follow-up evaluation. Each athlete had undergone single-row rotator cuff tendon repair with additional procedures such as biceps tenodesis. All (100%) athletes returned to intensive CrossFit training at a mean 8.7 ± 3.4 months after surgery (range, 6-15 months). CS and ASES scores improved between preoperative and final follow-up from 73 to 92 (P = .037) and from 71 to 95 (P = .035), respectively; VAS pain score improved from 7.2 preoperatively to 0.8 at final follow-up (P < .001). Imaging evaluation of the repaired rotator cuff tendon showed complete healing in 18 cases (78%) and incomplete healing in 5 (22%). Of the 5 patients with incomplete healing, 2 had lower clinical scores at follow-up. In their questionnaire responses, 13 (59%) participants indicated return to a higher level of fitness, 7 (32%) returned to the same level, and 2 (9%) returned to a lower level. We found a significant association between patients who indicated return to a higher level of CrossFit fitness and higher levels of creatine phosphokinase and testosterone from preoperative to final follow-up (P = .029 and .023).

Arthroscopic repair of rotator cuff tendons led to 100% return to CrossFit participation at approximately 9 months of follow-up. All athletes had returned to sport by the final follow-up. Nevertheless, 2 patients reported a lower level of performance and showed scapular dyskinesis.