Written by the Phoenix Rehab physiotherapy and hand therapy teams. Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H; hand, wrist and elbow sections by Nigel Chua, Hand Therapist, AHPC A1300362Z. Last reviewed 4 October 2026.
The shoulder, the lower back, and the hand and wrist are the areas most often injured in CrossFit, in a 2022 review of the published studies.1 Overall injury rates are similar to Olympic weightlifting, distance running and rugby.2 What is specific to it is the format. Skilled lifts sit inside workouts scored on time, so the rep that hurts is often one of the last ones, done tired, after the position has already gone.
This page goes movement by movement: what each one loads, the injury it usually produces, what is normal, and what needs a doctor first.
The movements, and what they load
| Movement | What it loads | What it most often irritates |
|---|---|---|
| Kipping pull-ups, toes-to-bar, muscle-ups | Shoulder, elbow, grip, skin of the palm | Rotator cuff and the labrum, inside of the elbow, torn calluses |
| Snatch, overhead squat, push jerk | Shoulder overhead, wrist, upper back | Rotator cuff, back of the wrist |
| Cleans and the front rack | Wrist, elbow, upper back | Wrist pain when the elbows cannot get up, so the wrist bends back to hold the bar |
| Handstand push-ups | Shoulder, neck, wrist | Neck, back of the wrist |
| Deadlifts, kettlebell swings, cleans off the floor | Lower back, hamstrings | Lower back strain late in a high-rep workout |
| Box jumps | Achilles, calf, knee | Achilles tendon on rebounding jumps, front of the knee, shins scraped on the box |
| Double-unders | Calf, Achilles, foot, pelvic floor | Calf strain, Achilles, heel, leaking on jumps |
| Thrusters, wall balls, squats | Knees, hips, shoulders | Front of the knee, shoulder overhead |
The injuries, by body part
Shoulders
Kipping moves the shoulder fast through the end of its range, many times, with the body swinging below it. Overhead lifts then ask the same shoulder to hold a barbell still at the top. Pain at the front or side of the shoulder that is worse overhead and worse at night is usually the rotator cuff. A deep clunk or catch can be the labrum, covered in SLAP tears. A shoulder that feels like it might slip on the kip is an instability problem, covered in shoulder dislocation and subluxation. Strict strength comes before kipping volume, and that is measured, not guessed.
Lower back
Most CrossFit back pain comes from the hinge: deadlifts, swings and cleans off the floor, done for reps against a clock. When the trunk tires, the back rounds and takes the load the hips were carrying. Most of it settles in days to a few weeks. See lower back pain from deadlifts and lower back pain from squats. Leg symptoms change the picture, and are covered in slipped disc.
Wrists and hands
The front rack is the usual culprit. If the shoulders and upper back cannot get the elbows high, the wrist bends back to hold the bar and takes the load instead. Handstand push-ups and burpees load the same position with body weight. Pain on the little-finger side of the wrist is often the TFCC; on the thumb side, De Quervain’s; across the back of the wrist, usually a load problem covered in wrist pain and sprains. These are seen by our hand therapy team, who measure grip and wrist range on both sides.
Torn calluses. A rip on the palm from pull-ups is a skin wound. Keep it clean and covered, and file calluses down before they get thick enough to catch. Redness that spreads, pus, or a fever means a doctor the same day.
Elbows
Pull-ups, toes-to-bar and rowing all grip hard with the elbow bent. Pain on the inside of the elbow is usually golfer’s elbow; on the outside, usually tennis elbow. Both are tendons asked for more than they can currently take, and both are loaded back progressively rather than rested to zero. Deep pain at the front of the elbow after a heavy pull-up block is often the brachialis: see brachialis pain and strain.
Knees
Thrusters, wall balls, box jumps and squats are a lot of deep knee bending. Pain at the front of the knee is usually the joint behind the kneecap (patellofemoral pain) or the tendon below it (patellar tendinopathy). A twist on landing with swelling the same day is a different problem, and covered in ACL injury and meniscus tears.
Achilles and calf
Rebounding box jumps and long sets of double-unders load the Achilles fast and often. A tendon that is stiff on the first steps in the morning and warms up during training is the usual Achilles tendinopathy. A sudden pull in the calf mid-set is more often a calf strain. Stepping down from the box instead of rebounding cuts the Achilles load while the tendon is sore.
Leaking during double-unders
Leaking urine during double-unders, box jumps or heavy lifts is common among women who do CrossFit, including women who have never had a baby. It is not something you have to accept. The pelvic floor is trained like any other muscle group. See pelvic floor physiotherapy and women’s health physiotherapy.
Is this normal?
Usually expected: muscle soreness 24 to 72 hours after a hard workout, on both sides, that eases once you are moving. A new movement or a heavy day leaves you sore in a new place.
Worth getting checked: pain on one side, at one spot, that is there at the start of the next workout, that makes you change a movement to avoid it, or that is still there after a week of lighter training.
When to see a doctor first
- Call 995 for chest pain, collapse or fainting, breathlessness out of proportion to the effort, or confusion or slurred speech after training in the heat.
- Go to the emergency department now if your urine turns dark brown or cola-colored with severe muscle pain or swelling after a hard workout, which can be exertional rhabdomyolysis. It is linked to high-volume workouts, especially in the first weeks of training or after a long break. Also if back pain comes with numbness between the legs or new problems passing urine or stool, or a shoulder or elbow looks out of place.
- See a doctor the same day for a pop at the front of the elbow with bruising or a change in the shape of the biceps, which can be a distal biceps tendon rupture. The same for a pop at the chest with bruising, covered in torn pec, and a kick or snap at the back of the ankle that stops you pushing off, which can be an Achilles rupture.
- See a doctor soon for a knee that swells within hours of a twist, locks or gives way, pins and needles or weakness down an arm or a leg, night pain that does not change with position, or pain at one spot on a shin or foot that is worse with every jump.
CrossFit: what we focus on
Fine at the warm-up. Not by round four.
The shoulder you now scale to ring rows. The front rack you hold on your fingertips because the wrist will not take it. The box jumps you step down from without saying why. Every week off settles it, and every workout with that movement in it finds it again.
- Shoulder. Strict pulling and pressing strength, and rotation strength against the other side, before kipping volume comes back.
- Wrist and front rack. Wrist range and grip in kilograms on both hands by our hand therapy team, and the upper back and shoulder range that let the elbows come up.
- Back. The hinge and trunk endurance tested tired as well as fresh, because that is when the workout asks for it.
- Knee and Achilles. Single-leg strength and calf raises counted against the other side, then landing and jumping in steps.
Tested, not dated. Each movement comes back when the measures say so, not when the leaderboard does. Pain is the first thing to leave. Strength is the last to train and recover.
WhatsApp us · Get Assessed & Treated · One 45-minute appointment, $230, nett, no GST.
Where are you with this right now?
1. It is settling on its own
If it eases week by week while you scale the movement that aggravates it, you are on the right road. Bring the movement back in small steps, lighter and slower first, then for reps. You do not need us for this, and we would rather say so.
2. It has stopped improving
It settles when you scale and comes back the day you go back to the prescribed version. You have quietly stopped doing a movement, changed your grip, or started every workout already planning around it. That pattern is usually a strength and load problem, and rest alone rarely changes it. It is worth measuring. If it has been months, the Stalled Recovery Review is three appointments over three weeks with the same therapist, $690.
3. You have had surgery, or you have a date
A shoulder stabilization, a rotator cuff repair, an ACL reconstruction or a biceps repair each has a shape, with protected weeks before the barbell comes back. See physiotherapy after surgery and the recovery programs. All of it runs on the four stages of the Phoenix Recovery Protocol.
Related reading
Sources
- Brandsema CJ, Mehrab M, Mathijssen NMC. Most common injuries in CrossFit training: a systematic review. Int J Sports Exerc Med. 2022;8:228. doi:10.23937/2469-5718/1510228.
- Klimek C, Ashbeck C, Brook AJ, Durall C. Are injuries more common with CrossFit training than other forms of exercise? J Sport Rehabil. 2018;27(3):295-299. PubMed 28253059.
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