It’s often called the “world series of fitness racing” because it challenges both strength and cardiovascular endurance in a competitive but accessible way.

Hyrox is a demanding event because it combines repetitive running with intense strength-based movements. Throughout the race, your body will experience many different types of forces and stresses that affect both  muscles and joints.

Here’s a breakdown of what happens during some of the main exercises:

• Running: Each kilometre of running puts repeated impact through your hips, knees, and ankles. Good footwear, running technique, and muscle strength are key to handling this load.
• Sled Push and Pull: this exercise will challenge your whole body,especially your legs, core, and upper body. During these exercises you will need to push or pull heavy weight across the floor. This requires strong leg muscles and good posture to protect your back.
• Rowing (Erg and Ski-Erg) : Rowing uses a powerful pulling motion from your arms and legs while your lower back works to stabilise your body. Repetitive bending and straightening can strain your lower back if your technique or core strength isn’t well developed.
• Burpee Broad Jumps: During this exercise the individual will repetitively do burpees that end with a jump forward. This will  be done over a set distance. These are explosive, high-impact movements that challenge your tendons and joints, particularly in the legs and ankles. They require good control and spring through your muscles to absorb impact safely.
• Lunges: Lunges strengthen your quads and glutes but place repeated stress on the knees and hips. Proper alignment and muscle balance are important to prevent strain or discomfort.
• Farmer Walks:  This movement involves walking while holding heavy weights in each hand. It challenges your grip strength, shoulders, and core to keep your body upright and balanced. Your legs also work hard with each step to stay stable, and if posture or core strength isn’t maintained, it can put extra strain on the lower back and shoulders.
• Wall Balls: This exercise combines a squat with an overhead throw, you have to squat and come back up and throw a medicine ball at a specific target that is set at a specific height. Wall balls are working your legs, shoulders, and back. It places high demands on your coordination and joint control, especially when fatigue sets in.

This mix of impact, load, and endurance fatigue increases the risk of injury if training load, recovery, or technique are not carefully managed. Let’s take a look at 5 common injuries that can occur during Hyrox or training for Hyrox.

1. Patellofemoral Pain Syndrome (Runner’s Knee)

• Pain around or behind the kneecap due to irritation of the cartilage and joint surfaces.
• Signs & symptoms: Pain at the front of the knee, worse with running, squatting, or stairs. Clicking or stiffness may also be present.
• Mechanism: Repetitive running, lunges, and squatting with poor biomechanics or fatigue.
• Why Hyrox athletes are at risk: High running mileage combined with deep knee flexion in wall balls and lunges overloads the patellofemoral joint.
• Prevention: Strengthening quadriceps, glutes, and hip stabilisers; proper footwear; gradual training progressions.

2. Achilles Tendinopathy

• Irritation or degeneration of the Achilles tendon.
• Signs & symptoms: Pain and stiffness in the Achilles (especially in the morning or after activity), tenderness to touch, swelling or thickening of the tendon.
• Mechanism: Repetitive impact and explosive loading, especially with running and burpees.
• Why Hyrox athletes are at risk: Repeated high-volume running and plyometric demands (burpee broad jumps) can overload the tendon, particularly if training load spikes.
• Prevention: Calf strengthening (eccentric and isometric), mobility work, progressive plyometric (explosive) training, and structured load management.

3. Lower Back Strain

• Overload or irritation of the lumbar muscles, ligaments, or discs.
• Signs & symptoms: Localised or diffuse low back pain, stiffness, and discomfort with bending, lifting, or prolonged sitting.
• Mechanism: Heavy sled pushes/pulls, rowing, and wall balls can create high compressive and shear forces through the spine.
• Why Hyrox athletes are at risk: Fatigue may lead to poor lifting and bracing technique, placing the lumbar spine at risk.
• Prevention: Core stability training, proper lifting mechanics, and gradual load increases in sled and row training.

4. Shoulder Impingement / Rotator Cuff Overload

• Irritation of the rotator cuff tendons and shoulder structures when they are compressed or overloaded.
• Signs & symptoms: Shoulder pain with lifting the arm overhead, pain at night, weakness in throwing or pressing movements.
• Mechanism: Repetitive overhead movements and poor scapular control
• Why Hyrox athletes are at risk: Wall balls, sled pulls, and rowing place the shoulder under repeated load in overhead or pulling positions.
• Prevention: Rotator cuff and scapular stabilisation work, improving thoracic mobility, and ensuring correct overhead throwing technique.

5. Hamstring Strain

• Tearing or overstretching of hamstring muscle fibres.
• Signs & symptoms: Sudden pain in the back of the thigh, difficulty running or bending the knee, possible bruising or swelling.
• Mechanism: Sudden explosive activity or fatigue-related overload.
• Why Hyrox athletes are at risk: Running sprints within fatigue, lunges, and sled work place high eccentric loads on the hamstrings.
• Prevention: Eccentric hamstring strengthening (Nordic curls, RDLs), warm-up drills, and progressive sprint/plyometric exposure.

Physiotherapists play an important role in both injury prevention and injury management for Hyrox athletes, this done through the following :

• Injury prevention screening: Identifying muscle imbalances, mobility restrictions, or technique faults before they cause injury.
• Tailored strengthening & mobility programs: Building resilience in key areas (knees, back, shoulders, tendons).
• Load management guidance: Structuring training plans to balance running, strength,stretching and recovery.
• Rehabilitation after injury: Hands-on treatment , rehabilitation and return-to-performance programs.

Hyrox is an exciting challenge that pushes athletes to their limits, but the mix of running, lifting, and functional exercises places the body under unique stresses. With the right injury prevention, training strategies, and physiotherapy support, you can stay strong, avoid setbacks, and perform at your best on race day.