Now before you read the title and think, “I don’t do crossfit so this won’t apply to me”, I’d urge caution, because although this post specialises in Crossfit injuries, much of the advice is applicable to powerlifters, bodybuilders and general gym-goers who may have experienced similar injuries before.
This is likely because all of these different exercise styles incorporate similar if not the same lifts, such as the main compound movements benchpress, barbell squat and deadlift.
Why Are Shoulder Injuries Rife In Crossfit?
Now, shoulder injuries are one of the primary injuries sustained in the sport of Crossfit due to the volume of gymnastics and heavy lifts involved, especially kipping pullups, benchpress, push-ups and muscle-ups.
Now, there will be no discussion of whether kipping pull-ups are ‘cheating’ or not.
Kipping pull-ups are an aspect of Crossfit whether people like them or not, and to compare them with a strict pull-up is obsolete, because both movements are designed for different outcomes.
In simple terms, strict pull-ups are used for strength, whereas kipping pull-ups are designed to be a test of stamina.
The kipping pull-up tends to engage more muscle groups than the strict pull-up as it uses more hip drive to perform the movement.
Anyway, aside from that, shoulder injuries are the most prevalent Crossfit injury sustained in the sport, with many professional Crossfitters (such as Camille LeBlanc Bazinet) needing to take time out of competition for such issues, and some even having to go as far as getting surgery.
A study performed in 2017 indicated that roughly a third of Crossfit injuries sustained by participants were located in the shoulder region (Mehrab et al., 2017).
Now, when you’re training as rigorously as a professional athlete, it’s highly likely that you will get at least one injury during your career.
But taking precautions to avoid them and limit their impact should mean that you only ever get one or two, as opposed to getting injured every few months.
However, if your programming is not designed to limit injury, or you’re not focusing on mobility and functionality in your own time, then it’s very likely that you’ll stumble upon a shoulder issue at some point.
And because shoulders are quite complex structures, there’s never just one specific problem that can arise as a result of improper form or lack of strength.
Most Common Shoulder Injuries (and what to do about them)
Rather than going into the anatomy of the shoulder, I’ll mention the most common shoulder injuries in Crossfit and why they occur. We’ll also chat a little bit about how we can avoid them and how to rehabilitate them so that the issue doesn’t keep cropping up again and again.
First up, we have the shoulder impingement. This is a problem where a tendon within your rotate cuff becomes inflamed and irritated, often as a result of poor posture, causing the tendon to rub against nearby soft tissue and bone.
When you have poor posture and your shoulders start to roll forwards (think slouching at work, driving for long distances), all of the soft tissue in your shoulder becomes compressed.
If this occurs for too long, you can experience side effects like pins and needles down the arm, or sharp pain in the front of the shoulder, particularly in movements like lifting your arm overhead.
Obviously, this doesn’t transfer well to Crossfit, because many movements in the sport require good mobility and strength in the shoulder, especially the snatch, overhead squat and muscle-up.
So the best way we can combat the shoulder impingement is to either,
Stop working at a desk or driving for long periods;
Improve shoulder mobility and strength, as well as strengthening particular muscles around the rotator cuff, such as the rhomboids and lats.
The unfortunate reality that most of us are faced with is that we can’t just up and quit our jobs in favour of something more ‘active’, and the likelihood is that even if you started working a labour-heavy job, you’d run into other musculo-skeletal problems.
So the more feasible (and easier) solution is to actively and regularly work on improving our upper body posture. We do this by:
Stretching and releasing tight muscles in the chest, like pectoralis major, pectoralis minor and subscapularis. You can do this by static stretching or using a foam roller/massage ball/tennis ball in order to break down scar tissue or release trigger points.
Strengthening the rhomboids and latissimus dorsi in order to pull the shoulder blades back towards the spine, opening up your posture and taking pressure off the rotator cuff muscles. Exercises that strengthen these areas include weighted bent-over rows, lat pulldowns, and pull-ups.
Incorporating proper warmups prior to all Crossfit sessions, paying particular attention to the shoulders when performing movements such as the snatch, front squat, overhead squat, muscle-up, pull-up, push press, split jerk, benchpress, pushups and strict press. Using a PVC pipe to perform ‘dislocations’, as well as doing some basic side and front lateral raises using small plates (1.25-2.5kg) is a good way to warm up, although there are literally hundreds of different shoulder exercises that you can do. Using resistance bands to warm up the shoulders is always a good addition too.
Other shoulder injuries that come into play can include thoracic outlet syndrome, ulnar nerve entrapment, frozen shoulder and rotator cuff tears.
Although many of these injuries differ symptomatically, their treatment method is typically the same, so you can follow the steps above and still see improvement in your condition, aside from frozen shoulders and rotator cuff tears.
Frozen shoulder, also known as adhesive capsulitis, really is an unfortunate thing to be on the receiving end of. This is a condition that comes on gradually, and has three main stages: the freezing stage, the frozen stage and the thawing stage. Sometimes, if you receive physical therapy treatment in the freezing stage, range of motion can be improved and sometimes the frozen stage can be avoided.
Unfortunately, if you’re in the midst of the frozen stage, there are light exercises and stretches you can do, but to some degree you will have to wait it out, which can last months.
The somewhat good news is that generally frozen shoulder only effects those over the age of 40 or have pre-existing systemic diseases like diabetes. As a result, it’s unlikely to be the reason why your shoulder hurts when doing Crossfit.
However, rotator cuff tears are more likely to be experienced through Crossfit. This is where the muscles that support the shoulder become damaged and frayed, leading to inflammation and pain around the shoulder. Often this occurs in the supraspinatus muscle, but it can occur in any of the rotator cuff muscles.
With this type of injury, you’ll tend to experience consistent pain throughout your daily activities and at night. You may feel weakness in the shoulder and arm when lifting your arm overhead or rotating the shoulder, and you’ll feel increased pain when lying or leaning on the affected area.
The best thing you can do when you have a rotator cuff tear is to REST. I cannot emphasize this enough. There have been far too many clients, far too many people who try to train through a muscle tear, and they end up making it worse, leading to needing to take even more time out from training than they initially would have needed to.
When I speak about resting the shoulder, I don’t necessarily mean avoid moving it altogether. Ideally you want to keep the shoulder mobile if possible, but you don’t want to be overloading it through resistance training. Seeing a physical therapist like a sports massage therapist or similar will help to improve range of motion in the shoulder, as well as increase local blood flow, which helps to speed up the recovery process
A sports therapist will also be able to prescribe appropriate exercises and stretches for you to do, and the massage techniques that they use will also break down scar tissue that may form from the tear.
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Please let us know if the information in this article has helped you in any way, and don’t be afraid to get in touch if you’ve got any additional questions.
If not, thanks for reading and we’ll see you next week!
Mehrab, M., de Vos, R., Kraan, G. and Mathijssen, N. (2017). Injury Incidence and Patterns Among Dutch CrossFit Athletes. [online] NCBI. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753934/ [Accessed 5 Feb. 2020].