I'd say that 315 will be soon the new 135!

We work a lot with injured folks - shoulders, knees, backs, hips.

Proper technique is paramount. Start them slow, teach the basics and don't rush.

Same as number 1...we have a lot of people with injuries. Sacle is the name of the game!!! My only problem is with what that dude in the picture's cast is gonna smell like by the time he gets it taken off...PEACE, B

Not a lot of injured people but one of my oldest members (oldest as in the 2nd member to join, he's only 23) fell off a ladder at work and buggered his shoulder up. we managed to get him back up to 100% over several months of CrossFit and a little physio. Scaled, took it easy on the injured shoulder, lots of squats, running, box jumps and 1 armed KB work. We was very glad to be able to go overhead and do pullups again. Even if it was scaled WAY back for him. heh

My background before CF was physical therapy and sports medicine and it is important when working with post surgical folks to understand the protocols for surgical procedures like ACL, Rotator Cuff tear, Labral Tears, Post Surgical backs, knees(meniscus), and ankles.
Most Orthopedic surgeons give the protocol to the patient, so as CF affiliate owners, it would be our job to ask for the protocol and familiarize ourselves with the lingo and restrictions so that we understand what we can and cannot do for our athletes.
Adapting the WOD to their limitations then becomes simple because we understand the guidelines.

Crossfit is great Rehab. Before opening the affiliate, I was using CF principles in the Rehab setting. My patients got better faster, were stronger, and had better carryover after discharge than the other patients in the office who were not being treated with CF principles.

As far as adapting the WODs to injured athletes, it is imperative to understand the biomechanics of human movement so that we can safely and effectively design a WOD that gives improvement without negatively affecting recovery.

On a side. Great to see you in the AF Blog Mike.....keep up the good work down there on the Emerald Coast. I hope to get down there soon and spend some time at the gym!!

As gently as I can, I'm going to caution trainers and affiliates against advertising or offering acute post surgical rehabilitation as a service that affiliation or CF certification qualifies them to deliver. While I agree that a legion of anecdotal examples of overcautious medical care (including rehabilitation/physical therapy) can be provided, it does not logically follow that extraordinary results with a comparatively healthy population transfers to individuals with tissue recently traumatized by surgery.

FWIW, I carry over 20 years as a physical therapist, doctorally trained, and have been studying and using CF for almost 3 years. I love a great many things about this system, the leaders in this group and the results I've experienced first hand as someone over 50 years old. It is a powerful approach to training that I share with a small collective in my community. Having said that, exposure and experience with pathomechanics and surgical repair is a pretty useful tool for determining modifications and scaling for the client trusting you to move them to greater health, not reinjury.

My advice? Win over a skeptical physical therapist or orthopedic surgeon (I currently train 2 ortho docs who swear by this stuff) and use them as both a source of information and referrals. Take advantage of the work these folks put into careful study of rehabilitation principles and codevelop more effective approaches to working with this population.

One last word - this is offered because I value and appreciate the hard won gains this group has accomplished, and would hate to have those gains hurt by unnecessary risk into an area where some degree is caution is warranted. In the end, you will do as you see best and proper since it is your business, but I'd be less than honest to not offer up that perspective for consideration.

Lisbeth - thanks for posting Wendy's video! Its true, we couldn't be more proud of her accomplishments!

Beleive it or not, as a grandmother, Wendy is one of our most competitive athletes! She frequently rocks out the WOD (scaled to her level, but always pushing her own limits) as fast or faster than many of our 'firebreathers', yet barely breaking a sweat! While most of our athletes writhe on the floor post-WOD, Wendy (frequently) calmly walks to her car and drives off before we can even say 'great job today!'

Wendy and her husband Bob are two of our most dedicated athletes and CFEC would not be the same without them! Thank you for letting us share with you on the Affiliate Blog!

John,

Absolutely I don't advertise any type of rehab going on here, and I always told my guy that I am not a Dr or Physio, so go with what they tell you first. All I was trying to do was get him back to doing the movements he wants to do, at full ROM, without re-injury. If something I wanted to do went counter to what his physio said I would back down. But ultimately he would do what he wanted... even if it went against what both myself and his physio would tell him... heh

Great job Wendy! What a great performance!

My only advice (just my humble opinion) is to the creator of the video - try and keep internet videos under 3:00. As a rule of thumb, people have a hard time paying attention to anything much longer than that.

Otherwise, great job on the editing! The music was cool....great song choice!

And Wendy's snatch form looked good! Take the suck and make it your b@tch Wendy!

I would like to hear Kelly talk about training clients with pacemakers and are still capable of very high intensity. Dealing with flexibility and not banging on the device has been a challenge, especially when the athlete wants to push it and the doc is saying he'll pull his wires out.

Working with injured tissue requires a significant understanding of how all connective and non-connective types heal and what loads, forces, stresses, etc.. can be placed on these structures and when. I have been rehabilitating at all levels injured patients for 20 years, and I can say that I am still learning everyday how I can better serve my patient population needs. Crossfit training healthy tissue is definitely not the same as rehabilitating physiologically impaired tissue where there may be an actual change in the organic structural matrix. Some of the movements required for the essential elements are not quite so "elementary" for a joint, contractile or non-contractile structure when it is impaired. If not careful, loads or even ROM can be applied that can actually slow or even damage healing. I apply Crossfit training methodology throughout my practice, but only when the pathological healing phase allows it. This may offend some, but crossfit coaches/trainers are not adequately trained for rehabilitation through the certification process. On the other hand, medical professionals may also not be adequately educated to train/coach crossfit methods without continuing education. I have always believed that we must be careful to observe what we do best! Just because we can, does not mean we should.

Sorry but I forgot to say that I am a Licensed PT, APTA orthopedic certified specialists with 20 years of experience and teach at the doctrinal level while finishing my doctrate. Crossfit Level 1 cert.. I agree with John T. We should proceed with caution!

I appreciate those who gave a word of caution. I think CF is great pre-hab, keeping people from most disuse problems/injuries.
I'd love to learn more about how it can be used for rehab. Is PT the best field to learn more in?

What do you recommend for someone that wants to learn more about injury rehab and injury prevention? I know Starrett's program would be great but what about other classes or certifications outside of the CrossFit world?

Buretto: I think you are absolutely right - the CF approach in the right hands can help folks avoid so many unnecessary injuries and degenerative issues that plague our Western existence. In a sense, it is rehab if weakness, obesity, etc are perceived as disabilities. That is not often how the term "rehab" is used, so I like the distinction you make with the term "prehab."

PC Klein: I've not seen any classes or seminars out there that look strong in terms of helping trainers understand injury rehab or prevention or training folks with some level of injury history. K-Star's class seems to me to be something that is needed, and Kelly (in the few times we've talked) has impressed me as someone careful, thoughtful and smart. His initiative with this class and his knowledge of both CF and rehab are assets to this growing community.

Thanks John T

I would suppose there is a large amount of liability with giving a cert or seminar regarding injury rehab / prevention and then having a bunch of people running around claiming to be PTs.

I really like what K-Star has been doing. The more crossfitters can learn about how the human body is put together and how it works the better we will be as trainers and athletes.

I would like to echo what has been presented by the very thoughtful Physiotherapist professionals on this topic.

I also couldn't agree more with DL about proceeding with caution. This is expressly why I think this seminar is a vital piece of information for the working Crossfit trainer/coach. There is a significant gap between clinically healed and returning to activity. For example, Coaches Hollis and Danielle (in the photos above) are both working with athletes that have been Ok'd to train by their physician of record. Having a basic understanding of "generic" orthopedic problems like ACL recon, meniscus repair, or OCD's, only helps them to make better programming decisions. This is not to mention working with athletes that have manageable, chronic conditions like osteo-arthritis, DDD, extension sensitivity, or osteoporosis.

Would I send every athlete with any orthopedic/patho problem to a CF coach that also happens to be a licensed physio? Of course. Let's compile a list of Crossfit friendly musculoskeletal experts for these situations.

But, in lieu of the fact that the bulk of physio-therapists fail to even teach injured athletes to squat, or deadlift, or press, and have systematically failed to bridge the gap between low level, sub-acute rehab and return to moderate activity that goes beyond the bike and bosu balancing, and the fact that everyone crossfit trainer on the planet will run into an injured athlete (sub-acute ankle sprain) at some point, we must begin to prepare our trainers to do no harm, and to facilitate return to full Crossfit function.

This seminar in SantaCruz will not include soft tissue techniques, or diagnosis of any kind. It will help the trainer have basic understandings of the things they are seeing EVERY day in their athletic populations. No one is getting certified, and everyone will leave understanding their scope of abilities, and the capacity to ask for help if they are unsure about what it is they are seeing.

We should be able to move beyond "just don't use it until an extreme amount of time has passed".

We must empower our coaches to more effectively deliver the care and training that they are going to give anyway. Teaching coaches how to scale squatting movement for clinically "stable/cleared for activity" athletes is not asking them to perform any more or less than is legal or ethical.

And maybe, I can cut down on the 50 emails a week I get asking for help from CF trainers that have athletes that have been "discharged" from PT. Are are ready to reclaim their lives.

Hope to see you all there.
Kstar

Kelly - well said on all points.

I'd like to go on record as the first one in this thread who pointed out that the guy is smart.

Can't think of one good reason why folks in this collective would pass on the seminar he has pulled together. This kind of information can only make the CF brand stronger.

Kelly, I am afraid that I am one of the fifty people to send you an email. Sorry to trouble you. Hopefully one day you can run a seminar here on the east coast. It is hard for me to get the time off for a trip to the other side of the country.

FWIW: My arm is not broken. I had a distel rupture of my bicep tendon, doing inverted ringwork. Fun.

A little late to posting but based on my personal experience (although a bit different from degenerative issues) I am absolutely a proponent of working out while injured. I broke my elbow within 2 weeks of starting xfit. I did not have my pull up before breaking my elbow. Despite many people's cautions of doing one-armed workouts, I kept it up...including one armed pull ups on the gravitron (since your one arm is not used to handling your body weight it needs more rest between 1-arm push ups and pull ups than if you did it 2-armed). I worked out "one-armed" for about 12 weeks...2 DAYS after being released I got my first pull up. If that doesn't speak for itself I don't know what does. See CFJ article in issue 33 "Working Wounded".

As for therapy for the elbow itself: the key was to push the range of motion "as much as I could tolerate". It is rare for people to get their full range of motion back after breaking their elbow but my Dr. and physical therapist were quite amazed at my progress. Attribute that to what you wish.