If you’re into CrossFit workouts, you’re part of a fast-growing group of athletes who push themselves to go as hard as they can, as fast as possible. There’s no doubt that CrossFit’s challenging, constantly changing movements push your body to its limits. It’s no wonder, then, that in addition to providing big benefits, these grueling workouts can place CrossFit participants at a greater risk for injury. The key for CrossFit athletes is to be aware of these potential problems and incorporate some common sense tips to help keep them at bay.It’s true that the injuries you can get from a CrossFit workout are no different than those you can get from other sports, but it’s the explosive nature of CrossFit movements that increase your chances of sustaining an injury. These injuries run a wide gamut—from bone fractures and tendon injuries, to a painful heel condition called plantar fasciitis, to ankle sprains.To help you better understand and address some of these potential injuries, let’s take a look at some CrossFit movements in terms of the problems that can commonly occur.We’ll start with box jumps. Doing box jumps puts you at risk for two different problems—Achilles tendon ruptures and Lisfranc injuries. An Achilles tendon rupture occurs in the long tendon that runs down the back of the lower leg, while Lisfranc injuries involve certain bones and ligaments located in the middle part of the foot. Even when box jumps are performed correctly, the Achilles tendon can rupture due to the repetitive loading and explosiveness of the movement. A rupture is a tear that occurs when the tendon is stretched beyond its capacity, as can happen with a rubber band. The rupture can be partially torn, which means the tendon still remains in one piece, or it can be completely torn, in which there’s a complete break in the tendon. An Achilles tendon that is not well conditioned for this movement or has become less flexible with age is especially susceptible a rupture.How do you know if you’ve ruptured your Achilles tendon? The first symptom is usually a sudden pain in the back of the ankle or calf. The pain feels like you’ve been kicked hard. Some people also feel a popping or snapping sensation. Usually the initial sudden pain subsides and becomes a dull ache. Sometimes there will be swelling on the back of the leg between the heel and the calf. At this point you can still walk and get around, but the rupture will make it hard to go upstairs or walk uphill, and it will be very difficult to rise up on your toes.If you have these symptoms, you should make an appointment to see Dr. Menchin or Dr. Hetman at Foot Specialists of Memorial right away! Treatment will depend on the severity of the rupture. For minor tears, sometimes it’s as simple as resting, icing, and taking a nonsteroidal anti-inflammatory, or NSAID, such as ibuprofen. A minor rupture is also sometimes treated through percutaneous debridement of the tendon, a minimally invasive procedure. Other Achilles injuries might benefit from regenerative medicine that entails injections of stem cells, platelet-rich plasma (PRP), or other types of amniotic fluid injections. For more extreme ruptures, surgical repair is often needed. The second type of injuries associated with box jumps are Lisfranc injuries, which can consist of a dislocation, a sprain, or a fracture. The Lisfranc is a complex of joints in the midfoot that helps make up the arch of the foot. It consists of numerous ligaments and nine bones. When rapid loading occurs, or when an athlete falls or lands incorrectly from a jump, these bones can separate, break, and tear the ligaments. Lisfranc injuries can be difficult to detect on x-rays, making it crucial to get the correct diagnosis and treatment from a foot and ankle surgeon right away. Even if you’ve been seen in the ER, be sure to see a Houston, Texas foot and ankle surgeon soon afterward for a complete evaluation and accurate diagnosis.The symptoms of a Lisfranc injury can include swelling, pain, inability to stand, and bruising. If a dislocation has occurred, the bones will look out of place. As mentioned, Lisfranc injuries can be easily missed or misdiagnosed in the ER on x-rays, resulting in improper treatment that often leads to arthritis and chronic pain.If you’re unable to get immediate medical attention, it’s important to elevate and ice your foot. Once Dr. Menchin or Dr. Hetman has carefully evaluated your injury, treatment will be selected. Treatment of Lisfranc injuries varies according to the type and severity of injury. Nonsurgical approaches might include casting, crutches, icing, taking an NSAID such as ibuprofen, and physical therapy. In more serious cases, surgery is needed.Squats are another CrossFit movement that can lead to a foot problem, specifically to a painful condition known as plantar fasciitis. Plantar fasciitis is an inflammation of the plantar fascia, a band of tissue that runs from the heel to the toes. If squats are done improperly, they put strain on the plantar fascia. Repetitive loading on the plantar fascia in an inappropriate way—especially when lifting weights—can lead to inflammation of the fascia. And if this is done repeatedly, tearing of the fascia can occur.The symptoms of plantar fasciitis typically involve a gradual onset of pain at the bottom of the heel that is worse in the morning when taking your first steps, or when standing up after prolonged sitting. After walking around a bit, the pain often goes away, but then it can return later. There may also be pain in the arch. This painful condition often makes it difficult to perform daily activities. Sometimes swelling is present. If you have these symptoms, come to Foot Specialists of Memorial right away for treatment.Treatment of plantar fasciitis can include several options, most of which are conservative and nonsurgical. Some of these include stretching exercises; ice and sometimes heat; NSAIDs; steroid injections; shoe inserts; and physical therapy, including ultrasound. Regenerative medicine, such as PRP, shockwave, and stem cell injections, may also be considered. Immobilization by wearing a cast-boot is sometimes needed. In a minority of cases, surgery may be warranted to release the fascial band.Walking lunges, goblet squats, and alternating split lunges are CrossFit exercises that often put an athlete’s ankles at risk for sprains. An ankle sprain is an injury to one or more ligaments in the ankle. The damage can involve either a stretching out of the ligament or a tear. Not all ankle sprains are alike—some are much worse than others. The severity depends on whether the ligament is stretched, partially torn, or completely torn. Severity also depends of the number of ligaments injured. In some severe cases, a piece of bone may have broken off, or there may be some other type of fracture.The symptoms of a sprained ankle can vary. Typically there is pain and swelling, although some people who have had previous sprains might just feel wobbly instead. Bruising typically occurs, and it may be difficult—or in some cases impossible—to walk. Stiffness in the joint is another symptoms for some people.Ankle sprains require prompt medical attention. If ligaments are torn and treated improperly, you could develop a troubling condition called chronic ankle instability as well as arthritis. The ER will give you an initial diagnosis and temporary treatment, but be sure to follow up with a foot and ankle surgeon who is experienced in treating ankle sprains and other conditions. In the meantime, be sure to ice your ankle, keep it elevated, and stay off your foot as much as possible.Treatment of ankle sprains can include splinting or casting, rest, ice, compression, NSAIDs, and physical therapy. Doing physical therapy as soon as possible, as advised by your Katy foot and ankle surgeon, is important to rehabilitate your ankle. In some cases, surgery may be needed to repair the damage. In fact, among many elite athletes, aggressive management of an ankle sprain through surgical repair of the ligaments is preferred.The final CrossFit movements we’ll discuss today are sprints and related exercises such as running in place, moderate group runs, and agility ladder drills. The high impact as well as repetitive force involved in these exercises can put your foot bones at risk for fractures, most commonly fractures of the sesamoid bones, and stress fractures of the metatarsal and heel bones.You may be wondering what a sesamoid bone is. Actually, there are two of these small, pea-shaped bones in the ball of the foot, just below the big toe. They act as a pulley for tendons to help the big toe move and push off when walking and running. They also absorb the weight placed on the ball of the foot when walking, running, and jumping. When you break a sesamoid, the symptoms include pain in the ball of the foot with weightbearing. Walking, squatting, and lunging are very painful.Sesamoid fractures can be difficult to treat. Nonsurgical options include rest and wearing a cast or removable walking cast for 6 to 10 weeks to allow the break to heal. Another nonsurgical approach is Shockwave therapy, which may be effective in increasing blood flow to the area and stimulating healing. In some cases, surgery may be considered.In addition to sesamoid injuries, sprints and related movements can lead to stress fractures in the foot. These tiny hairline breaks most commonly occur in the metatarsal bones, which are the long bones in the foot, and in the heel. The repetitive pounding in running longer distances for prolonged periods can weaken bones, thus causing a stress fracture to develop over time. And in related CrossFit movements, rapid start-stop loading of the foot can produce a sudden, high-impact stress fracture that could possibly expand into a larger break.The symptoms of a stress fracture are pain at the site of the fracture and sometimes swelling. Treatment typically requires rest and immobilization, and participation in sports should be avoided for 6 to 10 weeks to enable the bone to heal.Now that you have an idea about some of the injuries that can occur in CrossFit, We’ll mention just a few tips for preventing these. Taking a smart, common sense approach to exercise will allow you to continue exercising throughout your lifetime.That common sense starts with choosing the right footgear. To avoid stress fractures, for example, wear traditional cross-training or marathon-style running shoes that absorb shock. By all means, avoid thin-soled, barefoot-types shoes for training because they lack shock absorption.To prevent injuries when doing box jumps, always practice good form, make sure the platform is stable, and have a partner standing by to help steady the surface. To prevent Achilles injuries and other problems, make sure you are warmed up and your muscles and tendons have been properly stretched.And if you already have a chronic foot problem such as plantar fasciitis, the tips that can help you continue with exercise are to make sure your form is always correct, and just as important, cut back a little by decreasing weight and/or decreasing reps.Katy residents should come to our new office on Greenhouse and experience why Foot Specialists of Memorial was the top rated foot and ankle office in the Memorial area the past 4 out of 5 years.
Author Foot Specialists of Memorial