Shoulder pain is the most common complaint in CrossFit gyms around the world. The shoulder is the most mobile joint in the body, which also makes it the most vulnerable to injury. The purpose of this article is to give you the tools necessary to identify, target, and correct the majority of shoulder pain issues you may be experiencing.
Since the shoulder is so complex, there are dozens of reasons your shoulder may hurt. Without knowing the exact specifics of your case, it’s impossible for this article to address every scenario. If you’d like specific advice on YOUR shoulder injury, do not hesitate to reach out! I’d love to help.
Before you can pinpoint the root cause of the shoulder pain, you must first attempt to identify whether or not it is actually injured.
IMPINGEMENT OR INJURY?
An impingement is when a specific muscle has gotten tight, stiff, and/or inflamed. A trickle effect occurs and this one tight muscle is now “pulling” on other muscles close in proximity, creating a restriction in movement. The restriction in movement often coincides with pain and inflammation, which “pinches” when moved.
An injury is when a muscle is torn, sprained, or strained to a degree that reduces strength and power. Injuries will often times be accompanied with inflammation, pain, and loss of range of motion.
How can you tell if it is an actual injury or an impingement? Impingements are usually painful, but with no real loss in strength. Injuries typically have both pain AND a loss in strength. For the purposes of this article I will refer to impingements as injuries because, if left untreated, they often turn into long lasting injuries.
Without further ado, here are the top 3 most common shoulder injuries in CrossFit, along with how to prevent and treat them. For these shoulder issues, the prevention and treatment is the exact same. Do the prevention and treatment before and after your workout for optimum results.
“THE FRONT OF MY SHOULDER HURTS”
Symptoms – Pain primarily in the front of your shoulder when raising your arm in front of your body. You may also feel pain doing any other overhead movement or raising your hands/elbows above your chest.
Many people will think there is something wrong with the actual shoulder muscles, which would make sense since that is where you feel the pain. Pain in the front of your shoulder is also a classic symptom of a tight, inflexible, or injured bicep muscle/tendon. Your bicep muscles runs from the inside of your elbow all the way up into your shoulder socket (if you feel your bicep all the way up your arm, you will feel how deep it goes into your shoulder).
CrossFitters do a ton of pulling movements. Pull ups, muscle ups, cleans, snatches, and ring rows, just to name a few. When you perform a lot of pulling exercises, your biceps get really tight. When your biceps get tight, the muscle shortens. When the muscle shortens, it starts to pull on your bicep tendon, which then pulls on your shoulder.
All of this pulling on your shoulder causes pain in the front of your shoulder. So although you feel the pain in your shoulder, it stems from your bicep muscles and tendon. Don’t be fooled!
Prevention and Treatment – This includes keeping the bicep muscles loose and flexible. My two favorite ways to do this are a simple wall stretch and mashing your bicep. You can do the stretch anywhere a wall is, and need either a kettle bell or barbell for the mashing.
When left untreated without stretching and mashing, this can turn into a bicep muscle or tendon tear. This is a very serious injury that may require surgery if not properly addressed early on.
For the stretch, all you will need is a wall. Here is a photograph demonstrating how to do this.
For mashing the biceps muscles. Find a kettle bell to use in order to apply enough pressure to the muscle. I recommend in between a 25-35 pound kettle bell. Lay on your back, extend the target arm out by your side, opening up your bicep towards the ceiling. Place the kettle bell on top of your bicep and let the weight dig in to your muscle.
This will be a bit painful because your bicep muscles are tight! Use the kettle bell as your way of giving yourself a deep tissue massage. Roll the kettle bell around on the muscle for approximately 2 minutes, and try to avoid staying on one specific spot of the muscle for longer than 10-15 seconds. Here’s a picture of what this looks like.
“I FEEL PINCHING DEEP INSIDE MY SHOULDER PRESSING OVERHEAD”
Symptoms – Pain described as a pinching deep inside the shoulder. This is a hard one to describe because there never seems to be a specific area where the shoulder hurts. It just feels like a dull pain “deep inside” the shoulder. Sometimes, this one can be pinching felt right under the arm pit area.
You may feel this pinching while pressing overhead or holding a front rack position in the clean or front squat. There is a tendency to feel pain whenever you reach for something behind you. Imagine driving your car and needing to reach for something in the back seat. Does the thought of that sound painful with this type of shoulder injury?
These symptoms are very consistent with a supraspinatus muscle injury or tightness. Your supraspinatus muscle is a very small muscle that is buried underneath your trap muscle (trapezius), and in between your clavicle and scapula. This muscle makes up one of the four rotator cuff muscles.
Thankfully, most rotator cuff problems are simply an impingement and can be treated with mobility exercises that I will discuss below. It is a difficult muscle to stretch because it is so small and hard to get to.
Prevention and Treatment – My favorite way to loosen this muscle up is by mashing it using a barbell in a squat rack or using the TheraCane. After you mash the muscle, you can stretch it by placing your hand behind you, near the small of your back. If this pain is left untreated without utilizing mashing and stretching, it can lead to a tear which may require surgery.
For the TheraCane mashing, simply apply the end of the TheraCane on top of your trap muscle. Apply as much pressure as possible in a downward angle. Remember, the supraspinatus is deep underneath the trapezius muscle, so you have to press HARD. This will hurt, but stick with it. Massage this area for approximately 2 minutes, and try to make gentle strokes back and forth the whole time.
For the barbell mashing in the squat rack. Set up a barbell in a squat rack and position your trapezius underneath the barbell. Stand into the barbell so the weight of the barbell drives down into the supraspinatus. You may have to stand into the barbell at an angle in order to prevent the barbell from lifting off of the rack. Here’s what it looks like.
Here is a video on how to mash the supraspinatus using a TheraCane.
“IT HURTS WHEN I DO PUSH UPS AND DIPS”
Symptoms – Pinching in the back of your shoulder (near your scapula, aka “wing bone”), under the arm pit, or the front of your pec muscle. This pain usually occurs when doing dips, pushups, muscle ups, or any forward pressing movement. These are clear signs of tight pectoralis muscles.
In my experience, the pectoralis minor is the root cause of tight pecs because it is a much smaller muscle. The problem with these smaller muscles is that, although small, are used for stability in all of the major lifts. Because it gets used a bunch, and is a lot smaller, they have a tendency to get over used. In general, I would focus your prevention and treatment towards the pec minor.
Prevention and Treatment – First, mash the pec minor by using a kettle bell or lying on a foam roller. Once the muscle is loosened up by mashing, elongate and stretch the muscle using a very basic chest/shoulder stretch. Think loosen, then elongate.
If left untreated, a pec minor injury can turn into a tear which will require surgery. DO NOT let this muscle get too tight!
To mash your pec with a kettle bell, you’ll need a weight between 25-35 pounds (heavier for some bigger athletes). Lay on your back and place the kettle bell on the upper outside area of your pec. Avoid the actual shoulder joint, you want to be on the pec muscle. Only moving about an inch or two, you want to go side to side and front to back very slowly. Heres a picture of what this looks like.
Other simple, yet effective stretches are these doorway and pvc pipe stretches.
WHEN IN DOUBT, ROLL IT OUT!
With the shoulder being so complex, sometimes you have to throw everything and the kitchen sink at the problematic shoulder in order for something to work. If the above mobility exercises don’t alleviate the pain, grab a foam roller and get to work. When in doubt, roll it out!
Start by rolling out your lats and upper back muscles. Target the scapular and rear shoulder muscles. Then, extend your arm over your head and foam roll your arm pit region.
Finally, lay on top of the foam roller and place your pec muscles on the foam roller. Slow and controlled motion over the foam roller as opposed to fast motions. Do not stay on one spot for longer than 10-15 seconds, this will reduce blood flow to the area and may cause more damage.
PREVENTION IS KEY
There you have it, the three most common shoulder problems related to CrossFit training. Thankfully, most of the time they are very preventable and very treatable. Use the mobility exercises before and after any shoulder intensive training session and you will reduce the likelihood of long term injury.
If you feel any of the above symptoms, start mobilizing IMMEDIATELY. The longer you wait, the worse it will get. Remember, most shoulder “injuries” are actually impingements that have the potential to turn into injuries later. This only happens when the impingement is ignored and left un-mobilized.
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