Rates and treatments of CrossFit-related injuries at a single hospital system

Background: CrossFit is a new sport with rapidly growing participation rates that utilizes movements from other sports including gymnastics, Olympic weightlifting, and power lifting. We hypothesized that there would be high rates of nonoperative treatment, that treatment patterns would vary by anatomic site of injury, and that rates of surgical treatment would be higher with increasing age and have no association with patient sex among CrossFit athletes. Methods: Hospital system-wide electronic medical records from 2010 to 02/2017 were queried for reference to CrossFit or a related term within the clinical notes. For musculoskeletal (MSK) injuries, use of physical therapy, injection, advanced diagnostic imaging (CT or MRI), and surgery were documented. Results: Nine hundred and eighty-two CrossFit-related injuries were identified (91.1% MSK injuries, 8.9% non-MSK conditions) (mean age 36.4 yr SD 11.0, 50.3% male) with a >30% yearly increase in cases throughout the study period. Physical therapy was utilized for 76.0% of MSK injuries, 15.8% received an injection, 37.5% underwent advanced imaging, and 15.8% underwent surgery. The most common MSK injury sites were knee, shoulder, and spine. Male sex and later year of injury were independent risk factors for surgery; compared to other MSK injuries, knee injuries had higher surgery risk and spine had a lower risk. Conclusions: CrossFit injury volumes at our center have steadily increased as participation rates have increased. Physical therapy was frequently utilized. Surgery rates for MSK injuries varied considerably by anatomic region. Men were more likely to require surgery. The percentage of injuries requiring surgery increased throughout the study period.