I’ve seen a great deal of CrossFitters all over the Baltimore area. If there’s one thing I’ve noticed about CrossFit (and even experienced myself), it is a very competitive workout regimen.  Every WOD ends with, “How many rounds?” and “What was your time?” What some athletes may not realize is that lack of muscle mobility can limit their ability to lift more and move faster. Lack of muscle mobility leads to things like shoulder pain, shoulder impingement, shoulder bursitis, etc.

NOTE: Overhead mobility CAN Be limited by the lower body and is outside the scope of this article. For a detailed look at hip mobility during overhead movements, take a look at our blog post titled Why do I pinch when I squat.

Proper muscle mobility is key for optimal performance. Lucas and colleagues found that muscle knots in the rotator cuff change activation patterns of both the shoulder blade AND muscles further down the arm. Once the knots were removed, the normal pattern was restored. The question you need to ask yourself is... are muscle knots affecting your WOD?

Shoulder pain after overhead workout

The purpose of this article is to:

  1. Identify the most important stability muscles of the shoulder
  2. Discuss how mobility affects their function
  3. Show you 4 pre-WOD exercises to perform to maximize performance.

NOTE: If your symptoms do not improve after these exercises, send us an email through our contact page to discuss your issues further.

Stability muscles of the shoulder: The Rotator Cuff

We’ve all heard of it. We all know someone that has torn it or strained. The rotator cuff takes often takes beating, especially in the CrossFit world. So let’s take a minute to dive into the specifics of what the rotator cuff actually is.

The rotator cuff consists of four muscles (in the back of the shoulder: supraspinatus, infraspinatus, and teres minor; in the front: subscapularis). he names are not important, but where they are located is! Make a mental note as to where they are in your body, as this will be vital when performing exercises to loosen them.

The rotator cuff (all 4 muscles) directly supports the arm by acting as asuction cup. The white area above (in the picture?) compromises the tendons of these said muscles, and each muscle has one. As you can see, the 4 tendons form a circular cup around the top, front, and back of the arm bone, adding to its supportive nature

Dysfunction of the Rotator Cuff

CrossFit involves a great deal of overhead work, whether that is overhead squats, cleans, thrusters, push-presses, chest to bar pull-ups, muscle ups, etc. The rotator cuff is constantly required to stabilize an overhead shoulder. Dysfunction in the rotator cuff is common in CrossFit athletes, leading many to experience chronic shoulder pain.

Case Study: I recently performed an evaluation on a CrossFit athlete who was experiencing shoulder pain in both arms. In high school, he injured his shoulder, tearing his labrum. He contributed a lot of his pain to this previous injury and was unable to lift more than 95 lbs overhead. Very strong guy, 185 lbs, 6”2, 9% body fat. After careful examination, his labrum and AC joint were not painful when provoked, nor were they irritated. His rotator cuff, however was extremely inflamed. I gave him four exercises (the four I will list below) to do while at his beach house for a month. When he returned, he was overhead squatting 145 pain-free.

As the arm begins to lift overhead, equal pull of all muscles of the rotator cuff add for a stable and supported shoulder. What happens when one muscle is tighter than the other and things aren’t in perfect alignment? Unequal pull causes dysfunction in in the movement pattern. The nervous and muscular systems recognize dysfunction, which will limit the amount of weight that you can safely lift. Continuing to load a dysfunctional pattern will lead to shoulder pain and potential injury, similar to the case study above.

Improving muscle mobility will improve function of the shoulder. This will allow you to safely load without shoulder pain, leading to faster WOD times while also aiding in injury prevention.

Treatment of the Rotator cuff: The 4 Essentials.

Testing and retesting are important components of an evaluation. Not only will it assist you in determining if rotator cuff restriction is limiting performance and increasing shoulder pain, but it will also encourage you to continue the activity when mobility/strength improve. Think of yourself as your own experiment- just like scientists need measurements, you need to constantly assess and re-assess what’s working and what’s not.

Test/retest:

For mobility, raise your arms overhead, elbows straight, attempting to tuck your arms on the sides of your ears.

For strength: use an overhead squat, push-press, muscle up, etc. to determine comfort with the movement and comfort with load.

Rotator Cuff Exercises

Infraspinatus/Teres Minor Stretch

Infraspinatus stretch, Crossfit, mobility, shoulder, physical therapy, shoulder pain, shoulder tendinitis, bursitis shoulder, rotator cuff pain

Lie on your back, with a lacrosse ball behind your shoulder blade (use a tennis ball if lacrosse ball is too much). Place a lacrosse ball or tennis ball over the muscle illustrated. Move the ball over an area of muscle restriction (confirmed with soreness/achiness). Bend arm 90 degrees at the shoulder and 90 degrees at the elbow. Rotate the arm like a windshield wiper, attempting to get the back of your hand and the front of your hand to hit the floor. Repeat 10 x, move to a new area, and repeat 2x, for a total of 3 sets.

Need a video?: https://www.youtube.com/watch?v=rLeRnuVnT4g

Subscapularis stretch

Subscapularis Stretch, Crossfit, mobility, shoulder, physical therapy, shoulder pain, shoulder tendinitis, bursitis shoulder, rotator cuff pain

Use your thumb to identify the subscapularis on the front of the shoulder blade. While lying on your back, use your thumb to press this muscle in an area of restriction (confirmed with soreness/achiness). Be careful not to cause any tingling or numbness with where you are pressing. Bend arm 90 degrees at the shoulder and 90 degrees at the elbow. Rotate the arm like a windshield wiper, attempting to get the back of your hand and the front of your hand to hit the floor. Repeat 10 x, move to a new area, and repeat 2x, for a total of 3 sets.

Need a video?: https://www.youtube.com/watch?v=k0_1Y2bNmRY

Supraspinatus stretch

Supraspinatus stretch, Crossfit, mobility, shoulder, physical therapy, shoulder pain, shoulder tendinitis, bursitis shoulder, rotator cuff pain

Begin by identifying the muscle on the top of the shoulder blade. Pin a lacrosse ball or tennis ball in this area either by using your opposite hand or an object above the shoulder. Move your arm in a semi-circular pattern toward the opposite shoulder, and return to the starting position. Repeat 10 times, move to another sensitive area, and repeat for two more sets, for a total of three sets

Need a video?: https://www.youtube.com/watch?v=k0_1Y2bNmRY

Sleeper stretch

sleeper stretch, Crossfit, mobility, shoulder, physical therapy, shoulder pain, shoulder tendinitis, bursitis shoulder, rotator cuff pain

Lie on your side, on one shoulder, with your weight stacked vertically on that shoulder. Slide your arm up 90 degrees at the shoulder, and 90 degrees at the elbow. Using your opposite hand, slowly rotate your arm so that your palm faces down toward the floor. Move to a mild/moderate stretch, and return to the starting position. That’s one rep. Perform 30 reps.

Need a video?: https://www.youtube.com/watch?v=MOCwuKq5PLE

References:

Lucas KR, Polus BI, Rich PS. Latent myofascial trigger points: their effects on muscle activation and movement efficiency. J Bodyw Mov Ther. 2004;8:160-166

Wondering if Glackin Physiotherapy is the right fit for your CrossFit needs? Then our FREE discovery visit may be what your looking for.

This visit is a 100%, no obligation visit. No copay, no money collection. During this visit YOU get to ask YOUR questions, YOU get the opportunity to see our clinic, and, most importantly, YOU get the opportunity to know your therapist to help make your decision.

If physical therapy is not right for you, we will do everything we can to find the best solution.

The button below links to our Contact Page:

Physical therapy for shoulder pain related to overhead workouts in Columbia and Baltimore, Maryland

If you have shoulder pain reach out to our office today!

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