Intro

Justin Bieber says never say never….BUT, despite that, I never tell a crossfitting patient to stop doing CrossFit. They choose to do CrossFit for a reason and I respect that. If someone pulls a hammy during football practice, I don’t tell them to stop playing football, I get them healthy again so they can get back to doing what they love. It should be no different with CrossFit. Here are my top 5 reasons I never tell a crossfitter to stop crossfitting.

Reason 1: More than just WODs

If you do CrossFit, this is obvious and you know this. CrossFit is more than just the workouts. It is a big part of people’s social life. If, as someone’s health care provider, I tell them to stop doing CrossFit because their knees hurt, I am doing more than just having them stop working out for awhile. I am implicitly telling them to stop seeing their friends, to stop hanging out at the gym, to stop socializing, and I am interfering with their camaraderie.

Telling a crossfitter to stop crossfitting is like telling them to just go in a hole and die. It doesn’t take a doctorate to tell someone to stop doing something that hurts. Anyone can do that; it’s obvious. A health care provider/movement specialist treating a CrossFit patient should have the expertise to help them modify the workouts so they can still do CrossFit, but safely and in a way that will rehab their issues and improve their functionality. This leads us to number 2.

Reason 2: It is infinitely scalable

CrossFit is infinitely scalable. This means that you can change anything and everything in a workout in order to make it safe and therapeutic for a patient. You just have to know enough about CrossFit and how to modify it to make that happen (and have a good working relationship with the gym owners for open communication). If you don’t, I recommend spending some time browsing the crossfit.com videos.

The rehab that I do in my clinic can easily be incorporated into a CrossFit workout. Turkish get ups? Deadlifts? Chops? Lifts? Kettlebell arm bars? Crawling? Bottoms up kettlebell work? Most of those are already CrossFit movements. I have patients cut out the things from workouts that will prevent them from getting better and substitute them with movements that will be beneficial for them. Keeping people active is a great indicator for positive future outcomes in terms of recovery from an injury. This leads us to number 3.

Reason 3: Keeping people active

There is nothing more motivating for people recovering from an injury than being in a class where other people are doing the workout rx’d and they can’t yet because they are rehabbing. The desire to be rx, in my experience with patients, will motivate them to get better. This is extremely powerful, but it is a double edged sword. There is a fine line between a patient being motivated to improve so that they can do a workout rx and the patient being so motivated that they get back to rx before they are ready and re-injure themselves.

As a clinician, it is my job to guide them through that process. That is a great time to use the Functional Movement Screen (FMS) as an audit to decide when to allow them back into full participation.

Now some people will say that during the recovery from an injury, people should be exercising and rehabbing, but shouldn’t be doing it in a CrossFit setting. I really question that. Doing CrossFit is someone’s choice of how they want to be active. I see it as my job to not make them change what they do, just how to improve it. That would be like telling someone who sits at their job and has a low back injury to change jobs to one where they don’t have to sit instead of finding ways to modify their current workstation. It is silly!

Reason 4: Get out of the comfort zone

There is a big thing in physical and pain medicine called fear avoidance behavior. What this model tells us is that people will basically be pushed into a corner where they are afraid to do anything because they think it will hurt. They basically self talk and tell themselves “oh I can’t do this because it will hurt so I better not do it” and then even when they CAN do that task, they won’t because they are afraid of it. Research has even shown that the expectation of pain will lead to pain, even if there is no tissue damage.

CrossFit helps people break through this. Now, before I go on, this needs to be monitored. I don’t just send a patient to a CrossFit gym and say “just do whatever, pain is in your head”. I take them through movements at my clinic and make sure they can do them safely. Then when they go to their CrossFit gym, they can start incorporating those movements into functional workouts and they realize they can do a lot more than they thought and we can prevent chronicity and fear avoidance behaviors and improve long term patient outcomes.

Reason 5: The psychological aspects

How does someone identify themselves when they get injured? Are they now an injured person who is incapable of doing anything? Are they now “that person with a shoulder problem”? Or do they view themselves as the same capable person they were before the injury, but they now just have a small set back?

These psychological aspects of pain and injuries are huge. If, as a clinician, I tell someone they can’t do the things they love (CrossFit) because of their injury, how does that affect them versus finding ways to safely allow them to do what they love? The implications are huge.

I never want someone self-identifying as “that injured person”. The injury should not become their identity. By allowing people to stay at their gym and be part of a class, I think this prevents that “injured person” self-perception.

Conclusion

This is in no ways a complete list of every reason I don’t tell athletes to stop doing CrossFit. These are just the biggest ones that come to mind as I write this. Certainly some clinician’s will disagree with my take on this and that is ok. Everyone can make their own decision and treat patients they way they choose. This is just my take.

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