What is CrossFit?
In 2000, Greg Glassman developed CrossFit as a form of fitness training that focuses on performing functional movements at high intensity. These functional movements include gymnastics, weightlifting, running, rowing and more. While CrossFit is an excellent (and highly addictive!) form of exercise, CrossFit shoulder injuries can occur during training particularly in older CrossFit athletes. Dr. Mark Getelman is available to treat CrossFit athletes in Van Nuys, Thousand Oaks and Greater Los Angeles communities who have sustained a rotator cuff tear or biceps strain or tear.
Shoulder Injuries in CrossFit
Compared to the hip or knee joint, the shoulder is designed to be highly mobile and as a largely non-weight bearing joint. CrossFit commonly involves various exercises that utilize the shoulder and place increased force across the joint. These include:
- Overhead Squats
- Push Presses
- Push Jerks
- Handstand walks and pushups
When performing these overhead and gymnastic movements, excessive force may be placed on the shoulder joint. This additional stress, particularly for athletes over the age of 40, can result in a significant shoulder injury, sidelining a CrossFit athlete.
Rotator Cuff Anatomy
The shoulder anatomy is a ball and socket joint. The arm is kept in the shoulder socket by the bony contour and the soft tissues that surround the joint including the rotator cuff. The rotator cuff is made of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff attaches to the humerus and helps to maintain the relationship to the glenoid and shoulder blade and helps to elevate and rotate the arm.
A Rotator Cuff Tear in CrossFit Athletes
The rotator cuff is responsible for stabilizing the shoulder joint during overhead lifting and certain gymnastics movements. A rotator cuff tear can occur due to an acute injury, repetitive stress associated and tendon degeneration. Degenerative tears are more commonly seen among older CrossFit athletes. Several factors contribute to rotator cuff tears:
- Repetitive stress – repetitive or sustained overhead movements at a high repetitions, or heavy weight can lead to tearing of the rotator cuff.
- Lack of blood supply – as athletes get older, the blood supply to the rotator cuff naturally declines. Without abundant blood supply, the body’s natural ability to repair tendon damage is impaired.
- Bone spurs – bone spurs (bone overgrowth) can often be present on the underside of the acromion bone. When lifting the arm, these bone spurs can rub on the rotator cuff tendon causing a tear.
Due to natural aging and wear and tear on the shoulder joint, athletes over the age of 40 are at a greater risk of sustaining a rotator cuff tear.
Shoulder Biceps Tendon Anatomy
Along with the rotator cuff, the biceps tendon helps keep the shoulder joint in place. The upper end of the biceps muscle has two tendons that attach to bones within the shoulder. The long head attaches to the top of the shoulder (glenoid) and the short head attaches to the coracoid process on the shoulder blade.
A Biceps Tear in CrossFit
Biceps tears can either be partial or complete. Just like rotator cuff injuries, biceps tendon injuries occur more commonly due to degeneration and repetitive stress than acute injuries. These injuries are seen when athletes apply too large of a load during overhead weightlifting movements, such as a snatch or push jerk. Athletes over the age of 40 are more susceptible to a biceps tear.
Shoulder Injury Treatment Options
When a CrossFit athlete begins to experience shoulder pain due to a rotator cuff tear or biceps tendon injury, Dr. Getelman encourages him or her to discontinue the painful exercise until a thorough physical exam is performed by a trained physician and a treatment plan is prescribed.
In approximately half of patients, non-surgical treatment such as rest, activity modification, anti-inflammatory medication and physical therapy can help relieve pain and improve overall shoulder function. If non-operative treatment techniques do not alleviate symptoms particularly for acute full thickness rotator cuff tears, arthroscopic rotator cuff surgical repair may be recommended.
Have you experienced a rotator cuff tear or biceps tear during CrossFit? Do you need advice on how to recover? Do you want more information on preventing Crossfit shoulder injuries? Leave a comment below!