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CrossFit Shoulder Health Through The Eyes Of A Physio

Posted 7th August 2013 by Josh Schouten

CrossFit-Shoulder-PainOne of things I love about CrossFit is its ability to make the invisible visible!  If correctly used it can be an excellent tool to uncover an athlete’s weakness, and improve it.  A good coach can soon spot inefficient movements and limited ranges of motion. An even better coach has the ability to improve the movement. The CrossFit prescription of both gymnastic and weightlifting movements require excellent range of motion and stability, especially in the primary joints of the hip and shoulder. When designing the CrossFit Hackney training programme, I’m always conscious of the amount of overhead work our athletes are doing.

Shoulder mobility is an essential component of good human movement and effective training programmes. Successfully training the upper body to pull and push in multiple planes through a full range of motion fundamental to good shoulder health.  It’s not uncommon to see CrossFit athletes sacrifice their midline position (neutral spine) in an effort find tension and work around the limitations of the shoulders.

Overloading athletes with lots of pressing in front of the head and grinding kipping pull-ups is a recipe for injury. For many people, it is not a matter of if, but rather when they will injure their shoulders.

I’m always looking to increase my knowledge and learn from other experts in different areas of our industry.  So I’ve asked Emerson to share his thoughts on common shoulder issues he tackles deals with as a physio.

Through the eyes of a physio…

Far too many of us have poor posture and our desk based lifestyles cause an imbalance between the anterior and posterior muscles on the shoulder.  There are many different exercises we can do in the gym to help improve this structural balance issue, but each individual athlete needs to make the effort to improve their posture outside of the gym.

Awareness is key and understanding your posture and what you can do about it is a good place to start. I’ve asked our in-house physio Emerson to share his advice about posture and common shoulder issues:

CrossFitters, like all other athletes can pick up niggles and injuries. It’s inevitable! The three common types of shoulder pathologies I see, associated with training, are:

– Rotator cuff (Bursitis, impingements, sprains and tears)

– Acromioclavicular joint problems (sprains, degeneration)

– Postural dysfunctions (structural, instability, postural)

… and then of course there are issues in the neck, which can present themselves as shoulder pain.

Our shoulder is a ball and socket joint that allows for almost 360 degrees of movement.  Many different muscles are involved in the movements and stability of the shoulder joint. Tightness and/or weakness of the muscles around the shoulder can soon cause a restricted range of motion, shoulder impingement, pain and discomfort.  If you are very protracted (shoulders forward) you will inevitably be tight in you pec-minor, have over-active upper traps, and put unnecessary stress on the posterior shoulder and rotator cuff. This ultimately causes compression of the sub-acromial space, acromioclavicular joint, wear and tear and leads to restriction and pain.

When I start treating people with shoulder issues, the first port of call is to address posture and start to gain an awareness of how you sit, stand and move. A lot of problems are due to our modern day activities on phones, iPads, laptops, being sat at a desk, driving and cycling to name just a few. Remember you may train or exercise for maybe one or two hours a day but sit at a desk for over eight hours!

So here are some tips to help improve your posture.

Desk ergonomics – three easy things to look at:

  1. 1. Make sure your chair allows your knees to be at a 90 degree angle
  2. 2. Make sure the middle of your screen is at eye level when you sit tall. If you work from a laptop, get a stand and mobile keyboard.
  3. 3. When sitting tall, do a sweep with the arm extended (semi-circle) and everything you use (phone, pens, paper, mouse, etc) should be within that arc.

And try this exercise:

  1. 1. In sitting, start slumped
  2. 2. Tilt your pelvis forwards, so you are sitting tall (in extension)
  3. 3. Ease off slightly, so you are neutral (in the Lumbar spine). You should feel your deep abdominals kicking in to brace you and not feel much tension in the lower back.
  4. 4. Draw your shoulder blades back, down and together – gently squeeze
  5. 5. Retract your chin slightly (double chin)
  6. 6. Hold this position for 10 seconds. Repeat ten times, hourly!
  7. 7. Set a reminder on your watch, phone or put a post-it in corner of your screen!

To check you are doing this correctly, get a friend to see how much tension you have in your upper traps in slumped sitting and then again in this improved postural position (it should be a lot less).

There’s a very informative video to watch

Try this for a week at work and see how you feel.

Emerson will be doing a functional session on specific shoulder problems and mobility / strengthening drills in September.  Stay tuned for more information soon. If you have any questions or would like to make an appointment with Emerson please contact him on: