CrossFit and Shoulders
CrossFit, developed by Greg Glassman, is described as constantly varied functional movements performed at high intensity. The functional movements reflect the best aspects of numerous sports, including gymnastics, running, rowing and weightlifting.
While CrossFit is a great (and highly addictive!) form of exercise, there may be injuries associated with participation. A rotator cuff injury is one of the most common causes of shoulder pain in the CrossFit community. However, many rotator cuff issues can be avoided with simple strengthening exercises and proper workout form. If an injury to the rotator cuff does occur, Dr. Getelman is experienced in diagnosing and treating this injury within the CrossFit community.
How the Shoulder is Challenged in CrossFit
CrossFit involves various exercises that target the shoulder joint. Common movements that place stress on the joint include overhead squats, snatches, push presses, thrusters and push jerks. The shoulder joint is designed as a largely non weight-bearing joint and is the most mobile joint in the human body. Crossfit exercises put increased forces on the shoulder particularly when performing overhead lifting and some gymnastic movements, such as handstand walks and pushups where a large load is placed on the shoulder. The additional stress, particularly at points of fatigue when proper technique can change or break down, can lead to injury that causes shoulder pain and may sideline a Crossfit athlete.
Shoulder Pain Associated with a Rotator Cuff Injury
The rotator cuff is a critical structure within the shoulder joint composed of four muscle-tendon units. These units help provide stability to the joint, as well as overhead arm movements. The rotator cuff is responsible for stabilizing the shoulder during any lifting activity or overhead motion involved in CrossFit.
Without proper form or with inadequate muscle conditioning, one or more of these units can become injured and lead to shoulder pain and other troublesome symptoms. The most common conditions that affect the rotator cuff include subacromial impingement, tendinopathy/tendinosis and tears of the rotator cuff tendon. A rotator cuff injury may also be caused by repetitive use associated with overtraining and not allowing the structure to properly recover and heal after each workout session.
How CrossFit Athletes can Avoid a Rotator Cuff Injury
CrossFit athletes can reduce the risk of a rotator cuff injury by maintaining proper form for each exercise at all times. The rotator cuff and scapular musculature provide dynamic stability to the shoulder joint and strengthening these muscles reduce the risk of injury. The scapular stabilizers should be emphasized with external and internal rotation exercises with resistance, as well as pull downs and rows. Many CrossFit enthusiasts believe performing these simple exercises a few times a week before or after class can make a large difference in overall shoulder stability and strength.
Rotator Cuff Injury Treatment Options
If a CrossFit athlete experiences shoulder pain caused by a rotator cuff injury, the athlete is strongly encouraged to discontinue the painful exercises until a thorough physical examination is performed by a trained physician and a treatment plan is prescribed. Having to take time off is often difficult for Crossfitters, but allowing full recovery from the injury when it is mild is an investment in not having to take a lot more time later to recover from a serious injury.
In approximately half of patients, non-surgical measures such as rest, activity modification, anti-inflammatory medication, physical therapy and steroid injections relieve pain and improve function following an injury to the rotator cuff. The overall goal of non-surgical treatment is to reduce inflammation, as well as to strengthen the shoulder joint.
If non-operative measures fail or if the rotator cuff injury is more significant, an outpatient surgical procedure may be recommended to help the athlete to return function and stability to the shoulder joint. A minimally invasive, arthroscopic procedure is extremely successful at repairing damaged rotator cuff tendons.
Have you experienced shoulder pain or a rotator cuff injury from CrossFit? Need advice? Want to know more about how to prevent these injuries? Please leave a comment below!
I often have mild pain in my shoulder that I just try to ignore during my workouts. Since it is not sharp pain and doesn’t really bother me at other times, I have not seen a doctor. Are mild aches and pains like this normal for a 47 year-old body trying to keep up with the twenty-somethings, or should I have it checked out by a doctor?
Thank you for your question. Occasional aches and pains after working out is not uncommon. If there is pain during specific exercises, then those maneuvers should be avoided. Even dull pain can be an indication of injury. If sharp pain, weakness or pain at night develops then I would would recommend you get evaluated.
Mark Getelman, MD
I recently found that I have a rotator cuff injury, not a tear. I found that the full snatch movement is what has really bothered it so far. With trying to get it back to normal what other exercises should be avoided?
Thank you for your question, Tammy. I would recommend strengthening the shoulder blade stabilizing muscles with Seated Rows, Lat pull downs and Theraband Internal and External rotation exercises and avoid heavy and overhead lifting like military presses, pull ups, etc.