# Patterns, Predictors, and Mechanisms of Injury in Libyan CrossFit Athletes: A Cross-Sectional Analysis

## TL;DR

This study finds that Libyan CrossFit athletes have high injury rates, with experienced athletes being more at risk due to sudden movements and poor coaching.

## Contribution

Provides the first epidemiological data on CrossFit injuries in Libya and North Africa, challenging assumptions about injury risk in experienced athletes.

## Key findings

- Injury prevalence among Libyan CrossFit athletes was 40.6%, with shoulders and lumbar spine most affected.
- Longer training duration was a significant predictor of injury, contradicting the assumption that beginners are at highest risk.
- Sudden movements and tendinopathy were the primary injury mechanisms and types observed.

## Abstract

Public health relevance—How does this work relate to a public health issue?

This study addresses the public health issue of sports-related musculoskeletal injuries, which contribute to pain, disability, and healthcare costs, and can lead to long-term physical inactivity.

It investigates injury patterns in a novel and understudied population (Libyan CrossFit athletes), highlighting how gaps in sports infrastructure (e.g., coaching standards) can become a public health concern.

Public health significance—Why is this work of significance to public health?

It provides the first epidemiological data on CrossFit injuries from North Africa, filling a critical geographical gap in global sports injury surveillance.

Contrary to common assumptions, longer training duration was associated with higher injury risk, suggesting that current injury prevention efforts may be inadequate for experienced athletes. This finding underscores the need for continuous, quality coaching throughout an athlete’s participation, not just during the beginner phase.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?

The finding that longer training duration predicted injury challenges common assumptions and highlights a gap in secondary prevention, emphasizing the need for ongoing quality coaching even among experienced athletes.

(1) For practitioners/coaches: Mandates a shift in practice towards mandatory foundational training and ongoing technique coaching to prevent “sudden movement” injuries, rather than focusing solely on intensity. (2) For policy/sports bodies: Highlights the urgent need to develop and enforce local standards for coach certification and gym affiliation in developing fitness markets to safeguard participants and ensure the sustainable growth of community-based exercise.

Background: CrossFit is a high-intensity training modality experiencing global growth, but its injury risk profile remains debated. Existing epidemiological studies show a significant geographical bias, with a complete lack of data from North Africa, including Libya. To the best of our knowledge, this study provides the first epidemiological data on CrossFit injuries in Libya, addressing this geographical gap. This study aimed to determine the prevalence, characteristics, and associated risk factors of musculoskeletal injuries among CrossFit athletes in Tripoli, Libya. Study Design: This descriptive, cross-sectional study utilized a convenience sample of CrossFit athletes. Data were collected via a self-administered, paper-based questionnaire adapted from validated epidemiological surveys. Methods: A total of 137 male CrossFit athletes from four affiliated gyms in Tripoli were enrolled. Participants completed a self-administered questionnaire collecting sociodemographic data, training characteristics, and injury history based on a time-loss definition (missing ≥1 training day or seeking medical attention) over a 12-month recall period. Data were analyzed using descriptive statistics. Logistic regression was used to identify injury predictors. Results: The injury prevalence was 40.6%. The shoulder (33.3%) and lumbar spine (25.3%) were the most frequently injured anatomical locations. The primary mechanism of injury was sudden movement (38.6%), and the most common type of injury was tendinopathy (34.5%). The cohort was characterized by relatively young athletes with high training frequency, nearly half of whom had less than six months of training experience. Longer training duration was the only significant independent predictor of injury (OR = 0.136, 95% CI [0.034–0.543] for beginners vs. experienced athletes; p = 0.009), indicating that experienced athletes were at higher risk. Conclusions: Libyan CrossFit athletes experience high injury rates, with longer training duration—not novice status—predicting injury. These findings underscore the urgent need for standardized coaching and gym affiliation in developing fitness markets to mitigate technique-related injuries and ensure safe sport participation.