Injury Prevention for the Female Crossfitter

Women are getting stronger, faster and more powerful every single day. With this new-founded power also comes new problems: pain.

Crossfit has changed the world of fitness as we know for it good. For many years people would just head to the gym to “workout.” This would typically translate into a person going from one exercise to the next and “pushing’ themselves to a point that fringed on the edge of comfortableness. Thus bodies would not change and frustration would emanate. Now because of daily “measureable” workouts the intensity level of the average Crossfitter forces the body to make metabolic and physiological changes.

What is interesting and unforeseen is the influence that Crossfit has had on females in fitness. Just five years before the first CrossFit affiliate had opened in Santa Cruz, California, it would have been pretty uncommon to see a female training with heavy weights let alone Olympic weight-lifting, powerlifting or Strongman training.

Unfortunately, there was negative stigma attached to women with regards to lifting weights that made females either reluctant, opposed to or prevented from participation. This may stem all the way back to inaugural Olympic games in Greece which limited women to mere observant or the ever-present fear of “getting bulky.”

Regardless of the reasoning, CrossFit is thriving worldwide largely due to it’s more than fifty-percent female membership base. Seven million female athletes participate in CrossFit across the globe.

Exercise in general is the practice of doing more. Crossfit in this regard is no different than any other form of fitness in that we learn a movement and we express it repetitively, regardless of the load we have to carry or the time constraints we are forced to face.

While there is an unfounded negative prejudice by those outside of the Crossfit community with regards to injury rates (the number of injuries sustained by runners each year is nearly double that of Crossfitters, for example!), moving more does highlight a person’s postural deviation’s, muscular imbalances, and increases the chances of chronic pain’s.

Instead of ignoring this fact or joining up with naysayer’s let’s see what special considerations our female athletes should make to allow them to continue to thrive in CrossFit to push the sport even further.

Anatomical Landmarks

male to female skeletal differences

Men and women are born with the same bones which make up the same joints. Subtle differences arise between genders when we investigate the lengths, width’s and shapes, as well as the effects of gravity on these bones. Generally, there are three areas in which we can turn our attention towards in efforts to link back to the source of injury for our CrossFit female.

1. Thoracic Spine Curvature (upper back rounding)

Both males and females have a spinal column that continuously develops from birth to early adulthood as deal with the effects of gravity. Developing breast tissue during the puberty has an influence on the development of this curvature in females. The added weight increases the kyphotic (rounded) shape of the thoracic spine. What we have to understand is that the thoracic spine extends into the cervical spine which holds the head. The thoracic spine is also attached to the rib cage, which is the “house,” for the shoulder.

2. Pelvic Shape and Width (wider hips)

The biggest difference between males and females in the genetic structure we are given is width of our hips. The female pelvis is adapted to allow for the delivery of a baby. This means that it is not as high, is angled with a downward tilt (anterior tilt) and is proportionately wider than that of the male. We have to understand that the pelvic bones are attached to the sacrum (tailbone). The tailbone is the base for the vertebrae that make up our lower back. Therefore, we can draw to the conclusion that if our pelvis tilts forward, it drags the tailbone along with it and forces women to have an increased arch in their back when compared to their male counterpart.

3. Increased Knee Angle (knock knee’s)

Remembering that a females pelvis is wider than that of a male, allows us to understand better why her knee’s would have a “caved-in,” appearance.  The extended width of the pelvis pushes the distance between where femur (upper leg) connects to the pelvis (acetabula) to form the hip joint. The hip joint is called a ball-and-socket joint because the top of the upper leg has a ball shape and it sits inside the acetabula which has a cup shaped appearance. With wider hips, the upper leg needs to roll around in the socket and angle itself inward to connect with the lower leg at the knee-cap (patella). What we need to understand is that the forward tilt of the pelvis twists the upper leg inward. To maintain balance, the lower leg needs to adapt by twisting itself outward from the knee down into the sole of the foot.

These landmarks are important to remember when we consider the most common pains that our female athletes unfortunately complain of. Let’s take a quick look at the area’s that are a problem and see if we can understand why.

Three Most Common Sources of Pain for Female Crossfit Athlete

1. Knee

The knee is the number most common area of pain for a female Crossfitter. When we look at the job of the knee it is easy to understand why with all of the bending, twisting and shifting of weight that Crossfit WOD’s require there is a high incidence of injury. When we factor in the structural alignment differences between a man and a woman it is increasingly obvious why females would need to take extra concern with the health of their knees. Here is a special consideration for female Crossfit athletes:

if the knee hurts, blame the hip – Remember our lesson on the female pelvis. Remember that the width of the hip’s create the knee knocking posture by changing the angle at which the femur (upper leg) intersects with the lower leg at the knee. This creates a lot of stress for the all the structure’s responsible for keeping the knee together in the correct spot. Also, remember that females have a pelvis that tilts forward (even more after pregnancy) this normally makes the knee’s bend more to prevent the body from falling too far forward. The end result is that the quadriceps have to work over-time to slow the body down with every step she takes.

How do you know – Try a standing quadriceps stretch. If your quads scream, it is because they are overworked.

Solution – Try relaxing the tissue with a foam roller prior to any WOD that requires repetitious knee bending.

WOD MODification – For any exercise that requires bending of the knee (squat, wall ball, running, etc.) concentrate on two things: 1. Widen your stance a little 2. Push your knee’s outward. This modification will allow you to better recruit the muscles in your backside to help out the quadriceps as you lower your body.

2. Ankle

We really can’t talk about the health of the knee without mentioning the foot and ankle. Our definition of the knee was the position in which the upper leg connects with the lower leg. Once we realize that the lower leg is connected to the foot via the ankle than we can easily understand the knee is really the foot and the foot is really the knee. With that in mind we need to go back to the differences in male versus female structure. The “knock knee,” deviation that is common in female athletes is very commonly associated with a flattening in the arch of the female foot. Remembering that one of the responsibilities of the foot is to pass weight from one leg to the other, it is important that our arch doesn’t overpronate. Overpronation occurs when her foot can’t successfully collapse slowly into the ground when walking, running, and jumping.

How do you know – Take a look at your footprint to get an idea of the arch you have. You can easily do this by wetting the bottom of your foot and stepping on to a paper-bag. A low-arch or flat foot can explain why your foot isn’t so happy.

arch

Solution – Change your shoes and get a custom orthotic made. The orthotic will act kind of like a doorstop and prevent your foot from slamming into the ground and dragging your lower leg with it. By getting a shoe that is flatter and without a raised heel (i.e running shoe) the muscles in back of your lower leg will relax a bit more and allow you better control of your knee.

WOD MODification – While running, ask your glutes to do more. You can do this by making sure that you rotate well at your shoulders.  We have to understand that the muscles that are largely responsible for controlling pronation in your foot are attached to a long steam of connective tissue that runs through your upper-body to the opposite shoulder. Because of this, we can create tension in other places and use our body better as a whole. We can encourage our backside to help the peroneal muscles in your foot to act like a stirrup and form our arch if we rotate our shoulders better while running.

3. Shoulder

The shoulder is probably the easiest to look at and see just why there would be problems when we remember the structural anatomy lesson we had earlier. Remember that the most common deviation we see between men and women is a rounded upper back. Understand first that the shoulder is the junction in which the upper arm (humerus) unites with the scapula. The scapula provides a home for the shoulder to sit and this house has a roof above, which needs to move out of the way when we lift our arm overhead. The problem occurs for females is that since the scapula is fixed to the rib cage, and rib cage gets pulled forward when the upper back is rounded, the “roof” collapses downward on the upper arm. Basically, the bones provide a physical roadblock for the humerus and when the arm is raised a collision occurs.

How do you know – Take a push-up “side-selfie.” Have someone snap a picture of you from the side to see how well your ear stay’s in alignment with the center of your shoulder while you execute a push-up. The farther forward your head is, the more your upper back has to “round,” which compromises the shoulders health.

rounded push

Solution – Relax your upper back with two tennis balls between your shoulder blades. This will mobilize the shoulder blades and allow them to move into the correct position.

WOD MODification – If your upper-back rounds, then try replacing push-up’s with “plank-pushups.” Basically set yourself up into a plank position, keeping your ears, shoulders, hips, knees and ankles in alignment. Maintain this alignment as pinch your shoulder blades together, followed by retracting them. This allows for you to regain the proper mobility and strength for the muscles required to maintain scapular position while at the same time strengthen the rest of the body in the position that push-ups would.

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About The Author

My name is Jeremy McCann, I am a pain relief exercise expert and owner of Range of Motion Fitness in Riverside, California. In addition to my world class certifications from The BioMechanics Method, I also hold numerous corrective exercise specialty certifications from some of the industry’€™s most prestigious institutions including the Gray Institute, National Academy of Sports Medicine, PTA Global and FMS.

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