Independent risk factors for recurrent or multiple new injuries in CrossFit athletes

CrossFit is a relatively new sport with rapidly growing participation rates in the United States and around the world. We sought to determine risk factors for sustaining multiple CrossFit-related injuries requiring medical evaluation.

CrossFit-related musculoskeletal injuries evaluated at a single hospital system (N.=837) were identified. For musculoskeletal injuries, use of physical therapy, injection, advanced diagnostic imaging including CT or MRI, and surgery were documented. Independent risk factors for sustaining multiple injuries requiring medical evaluation were assessed by multivariate logistic regression analysis.

A total of 94/837 (11.2%) underwent evaluation for 2 or more CrossFit-Related injuries (74% new injury to different body part; 26% subsequent injury, same body part). Independent risk factors for repeat injury (recurrent injury or second new injury) included increased length of follow-up (per year: OR 1.50 CI: 1.29, 1.75; P<0.001), initial injury during spring season (OR 2.03 CI: 1.27, 3.26; P=0.004), advanced imaging not obtained for evaluation of initial injury (OR 2.62 CI: 1.37, 5.02; P=0.002), course of physiotherapy completed for initial injury (2.00 CI: 1.17, 3.41; P=0.008), corticosteroid injection administered for initial injury (OR 2.43 CI: 1.21, 4.88; P=0.01), and increased age (per 5 year increase: OR 1.12 CI: 1.01, 1.24; P=0.03). These risk factors in combination had moderate discriminatory ability for identifying athletes at risk for multiple injuries.

There are multiple risk factors for sustaining a recurrent or second new CrossFit-related injury requiring medical evaluation including older age, length of participation, and spring season participation. Risk factors for repeat injury related to initial evaluation and treatment include not receiving advanced imaging, receiving a corticosteroid injection, or undergoing physical therapy. The anatomic site of initial injury was not related to risk of subsequent injury in this population.