Dr. Jon Hyman

Jon Hyman, MD

Injury Prevention Tips

1. Factor in Rest

If you are feeling fatigued, try working out every other day..or take a few days off consecutively BEFORE you feel things tearing. Get proper sleep. Learning body awareness and listening to your body’s subtle messages can keep you out of my office.

2. Body Awareness

Sit still on the floor. Lay on your back. Go through a movement check like making an angel in the snow (or sand) and quietly feel for areas of stiffness, asymmetry, pain or imbalance. Yoga, meditation, and mindfulness can be very helpful and learning where you body is ailing or about to fail. Turn down the music and listen to your body. This cannot be overemphasized.

Pushing through the pain?

Maybe. Maybe not. What's the difference between the healthy burn, fatigue and lactic acid buildup we know as enduring workout pain...and the 'oh snap, I just felt something pain.' Well, you know what the difference is: if it crosses your mind that something just happened in your body, something went awry, it's the 'oh snap' issue.

What caused the Pain? aka WTF just happened?

Sometimes you'll feel pain after a workout and it will be b/c of what you just did. But other times, the pain will be because of inflammation or an injury that occurred days earlier, but isn't coming out until it's been provoked now. If the body were so simple, every one would be their own doctor (and let's face it, doctors don't know everything about the body either). So, don't assume that just b/c you are feeling pain on Friday, that it's b/c of what you did on Thursday. It doesn't always work like that.

3. Flexibility and Mobility

Stretching before and after exercise. It doesn’t have to be every part of your body, but it should be sustained for a few minutes. Stretching muscle, tendon, etc for less than a couple of minutes doesn’t really give a lasting increase in length. Some people are hypermobile and don’t need to stretch, but they have the opposite issue, laxity. Hypermobile individuals need to also pay close attention to active mobility so things don’t slip out of joint.

Warm Up, Warm Up, Warm Up

Seems cliche. It is. Proper warm up isn't just your coaches responsibility. It's yours. You know your body better than they do, but listen to their insight. Warm up what the coach says is proper for the day's movements but also warm up your weak links. You should make a habit of identifying your 'weak spots' and pay particular attention to warming those up before the WOD. Habitually working on mobilization of your vulnerable areas can help them stay injury free, as the regular group warm up may not cover all of YOUR bases.

4. Leave your EGO at the door.

Ego, or sense of self importance, is a killer. It masquerades as competitiveness, drive, motivation, ambition, goal orientation, etc, but it can get you hurt. You can be intense and competitive while being compassionate to your body and to others as they pursue fun and fitness. If you are watching others and watching times and weights on the board, likely you have brought your EGO inside the gym with you.

Go Lighter

When in doubt, choose a lighter weight. Seems obvious right? Nope. Reasons why we choose heavier weights:

  • the guy/gal we usually compete with chose a heavier weight
  • coach says, 'c'mon, you can go Rx with that'
  • the 10 lb plates are gone, so grab the 15's
  • there's a bunch of people from the next class who arrived early and are watching
  • you can do one movement in a couplet with the heavier weight, but not this one
  • your PR is calling your mind, but not your body
  • you want to impress someone later who's gonna look at the whiteboard later in the day
  • you want to say "who’s your daddy now?!” to the people who will try to beat you in subsequent WODs

If I left any out, leave your ideas in the comments below.

5. Modalities

Consider using heat, ice, aquatics, massage as part of your body fitness program. Physical therapists, Chiropractors and Acupuncturists, etc can be helpful in identifying imbalances and helping address them via safe manipulation and modalities.

Insurance

Have health insurance if at all possible. I'm not talking Obamacare/Affordable Care Act insurance, (this isn't a political statement or site), but it makes sense to have a back up payor lined up if you are going to be putting your body through the rigors of the sport of fitness - to have a way to pay if you need medical attention. Face it, medical costs are high and if you need more than Tylenol or Robitussin, you could be in a jam. Xrays, ultrasound and certainly MRI scans are not cheap. Don't get caught 'out there' when something goes 'pop.'

At a minimum, know a friendly sports medicine doctor like me, or a chiropractor, physical therapist or primary care who might be able to hook you up. If you don't know one now, make sure you get friendly with one before too long...

Most boxes have one or more such practitioners as members. You want someone who has a 'CrossFit friendly sports medicine practice.' or is sensitive to and knowledgeable about P90X or whatever you're in to.

6. Modify your WOD

Scaling, adjusting, or not finishing if it’s too intense. Know your limits before you body tells you what they are. Injury, recovery and re-injury … this cycle of damage and repair causes scar tissue and more injury potential down the road. Listen to your body and obey. If you need to keep track of benchmark workouts to see your progress, make note of your modifications so you can track those as well.

DNF

If you feel pain during the workout it's okay to stop. We've all had that experience where we feel something tweak during a movement and we hope it will go away, but it doesn't. Yet, caught up in the moment, we keep going and going and going, only to push our body too far. Even if the pain stops during the workout, it may just be because the endorphins and adrenaline have allowed your perception of the pain to diminish. Be careful 'pushing through the pain' when it's really pain. The pain is a message from your body, and if you don't stop, it may bite you back. The body has it's own mind of what it takes to heal, and grinding out 5 more reps after the tweak can make a problem that would have healed in 3 days take 3 months to recover from.

It's okay to put a Did Not Finish (DNF) on the whiteboard. At least you can come back tomorrow or later in the week, and be okay, as opposed to being out for weeks.

7. Form, Form, Form

Frequently check in with yourself and with your coaches, on your form. Proper technique is so important, and you may get off track as a workout progresses or as your experience progresses. Sometimes movements are not repeated for many months and you don’t want to assume you got it just because you got it the last time. Learning will occur, but without frequent repetition of certain movements, always being mindful of form is a key point.

Travel for Quality

The box in your hood may not be the best, but it may be the most convenient. Good equipment and good coaches can be more important than good community. Try a couple of different boxes out before you land on your final choice. Maybe it's the gym closest to your house, or your job, or it's on the way to work, but maybe you have to travel to get the experience that will best match your needs.

Notice the absence of vitamins, supplements and dietary recommendations here. Though a healthy balanced diet is important (you may be into paleo, low carb, gluten free, vegan, McDowells or whatever), I’m not aware of specific edible regimen which is a proven injury prevention program. Find what works for you.

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Our thanks to FlexBuilding: A New Way to Move. A New Way to Live. for providing the anatomical images for this website.

Tips & Techniques

Box Jump Overs

Whether jumping over a box, a tire, or a barbell, the jump requires explosive recruitment of specific muscles. Pre-loading muscles and increasing starting spring coil length has an impact.

Lunge

To get the maximum benefit from the movement, and to protect your knees from injury (especially the patella or knee cap cartilage), it is important not to smash your trailing knee into the floor.

Muscle Ups

This complex gymnastics movement has become a trademark move of sorts in CrossFit. It requires power, coordination, timing and technique. Some people take years to get muscle ups.

Plank

The appearance of the plank carries a degree of simplicity that masquerades it's power. Proper form in this position creates a great deal of core stability and base power.

The Kettle Bell

Tough on the low back. Keep chest up and don’t let it pull your face down toward the floor as the kettle bell passes back between your legs.

The Rope Climb

Multiple Injury opportunities here. When executed well, you can blast up and down the rope like a seasoned inchworm on steroids.

Wall Ball Shots

Moving a fixed weight a fixed distance. Up. A great exercise when done in good form. A good benchmark to use to measure your progress in strength and endurance.

Your Body & Injury

Elbow

The biceps tendon can tear up by the shoulder (rupture of the long head of the biceps) or tear by the elbow.

Foot and Ankle

Achilles Injuries. Most commonly, CrossFitters will sustain overuse tendinits.

Hips

CrossFit and Plyometrics involves a fair amount of squatting and crouching. Wallballs, slam balls, olympic power lifts, eg squat cleans etc, all involve ‘dropping down low’ and getting your hip crease below knee crease.

Knees

Knees are more than just the platform that supports our stance, run and squat.

Muscle

Muscle physiology is a complex science. There are fast twitch, slow twitch muscle fibers and elaborate mechanisms of enhancing strength, power, endurance speed and fatigue resistance of muscle.

Shoulder

There are two labra or labrums in the body. They are both at somewhat high risk in the Sports of Fitness activities which involve a lot of deep squatting and overhead lifting.

Spine

The spine is a complex anatomic masterpiece of axial structural support for our body.

Wrist

Sprains and tendonitis are the most common ailments.

American Academy for Orthopaedic Surgeons American Board of Orthopaedic Surgery American Orthopaedic Society of Sports Medicine International Society for Hip Arthroscopy
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