Note:
It is important to understand that all bodies are different and all injuries are different. My reason for these posts is to possibly open you eyes to alternative ideas for therapy. It is NOT to diagnose YOUR injuries. If you have similar pains, you should talk to a professional to verify that there is not further damage and you will not be causing permanent injury by treating it in some way.
Crossfit has a huge potential for injury, as it does for amazing results. Be smart with your training and you will last longer as an athlete and a human.
The problem:
As i get older i am challenged by not only motivation for training but also the challenges associated with aged cells and the fact that they are less willing to do what i want them to do. Specifically here i am talking about my shoulder. A very complex joint with many articulations and muscles controlling it. As is my nature, i like to simplify things as much as possible. My specific issue was a sharp pain in the anterior(front) portion of my shoulder just above the arm pit. It hurt when i snatched and jerked. It was a sharp pain and really hindering my training.
The fix
I was a little jammed up by this one for a while like the knees. It started to make sense after a visit to a local massage therapist who decided that i had tight lats and that was contributing to the malfunction in my shoulder. This makes sense with the huge volume of pullups in crossfit. Your lats are your pullups muscles. In an effort to simplify this we will consider 3 main muscles of the sholder. First is the Deltoid, the guy that covers the shoulder joint. The one that is superficial (outside) to all the other shoulder muscles and joints. The latissimus dorsi (lats) are under your arm pit and spread across your back like wings. They attach to your arm bone just outside the shoulder joint and pull the arm down (think pullup or row). The pectoralis is the third one i will talk about. It also attaches to the arm just outside the shoulder joint. It pulls the arm and shoulder forward (think push up or bench press). Now remember this is highly simplified.
After my visit to the massage therapist i started with stretching of the chest and lats. The chest stretch was the traditional “door stretch” think about placing the forearm against the door frame and turning away from the frame. This is coupled with rolling with a lacrosse ball or trigger point ball. I do it against the wall rolling from my sternum to my shoulder joint (you shouldn’t really roll across joints). I would stretch my lats by putting one hand on the pullup bar with feet still on the ground, or a box and relaxing into a stretch. Don’t force any of this. You can also play with contract and relax stretching to get a bit deeper. For those of you with shoulder flexibility issues this should help with the overhead position. My friend Darin has some good thoughts on this but i will let him explain them later. I also rolled the lats pretty hard core by using the wall and ball again. This time standing with my shoulder to the wall and arm by my ear like an overhead squat and the ball pressed against the lats under the armpit. Very painful but very effective.
I coupled this with some shoulder prehab work both before and after workouts. I did the traditional shoulder raises, flys and kick backs but with super light weight (nothing over 2 kg). This helped get my shoulders warm and ready to move each day. I also cut my volume of pullups since i think this was part of the malfunction. Too much of anything can be a bad thing so be careful with massive amounts of pullups if you have super tight shoulders.
I would be wary of anterior sharp pain.
Depending on which articulations hurt, and which tests are position, and given specific locations it can be any number of things.
The most common one you get with anterior delt is indeed anterior delt pain, but also long head biceps tendinopathy especially with a large volume of pullups. Most people I’ve seen have a huge amount of trigger points in the coracobrachial, biceps brachii, and brachioradialis.
Similarly, stuff like pec tendonitis can masquerade as anterior shoulder pain since the insertion is close by.
But in general, the problems with shoulder can be boiled down to:
1. Poor posture
2. Limited mobility
3. Muscle imbalances
And one to the extreme or combination of these 3 maladies can and will cause pain and injury. It’s just figuring out what you have to do to fix it.
Man, I hope you´ve been injured and fixed in more places!
Great reading, both post and comments!
Hey Dutch ~ You taught my Cert Level I class in August 2008 (San Diego). I’m quite sure you don’t remember me. I’ve been reading your blog a lot lately, as CrossfitNYC frequently links to it. Shoulder injuries are something I know a bit about, and I’m thinking my experience might interest some of your readers. About 6 months ago I thought I had injured my right shoulder from swinging kettlebells that were too heavy for me. I was in pretty severe pain with very limited mobility. Massage therapy was unsuccessful and so were a few rounds of prescription anti inflamatories, so I went the x-ray/MRI/CT Scan route, which showed some surprising things: a complete absence of cartilage, a lot of joint-specific arthritis, and even a benign tumor in the center of the joint – none of which I had felt before my fateful kettlebell swings.
I had a surgical procedure (called a debridement) to clean all of that out, but the pain and limited mobility persisted. The only thing that’s helped has been Synvisc, a synthetic cartilage that’s injected into the joint via guided ultrasound. I’m on my second of three injections, and finally, after 7 months, much of the pain is gone and a lot of mobility is restored. My doctors tell me this good result probably will last a year, provided I don’t resuming a lot of CrossFit type weight bearing stuff, which likely will undo a lot of the progress. So it looks like most things from here on in will be light and scaled for me. I can think of worse things. I’m just really grateful that a lot of the pain is gone and that I can move my shoulder almost normally (i.e. by normal standards, not CrossFit standards).
Another thing my doctors tell me about Synvisc: Results are varied, meaning that it only works with some people in some joints. When injected into the shoulder, only some people feel relief. It’s far more effective when injected into the knee (there’s a 95% success rate in knees). It’s also incredibly expensive and often not covered by insurance. One should look on-line for the best deal (the way it works at my hospital is that patients procure it themselves and bring it in to have it injected).
I hope some readers find this info useful. Best, Susan
Thank you Susan ans Steven both your posts are very helpful.
I have a short side story here too. My best friend in highschool/college has shoulder issues when he was young. As a freshman in college he picked up Handball and developed pain in his shoulder so much so that he couldnt use it. He went to the doctor and turns out he had bone cancer. Long story short, he is fine now but minus the entire shoulder joint. He has a metal rod that acts as his clavicle and upper humerus. It is very scary to think about issues like this so make sure if you have something that persitsts make sure to get it checked out by a profesional.
Hi i am an experienced olympic weightlifting coach recently I have been approached by a 30year old lady who does crossfit she would weigh 50kg I have been teaching her proper tecqnique in the snatch and clean &jerk I have been coaching her now for 4 weeks and her tecqnique has improved immensely but her shoulder has dislocated twice in 4 weeks it pops back in by itself but to me this is not normal do you feel maybe she should stop crossfit for a while so as to give me a chance to build strength back in her shoulder.