5 Reasons for Shoulder Pain in CrossFit Athletes

pain performance physical therapy Aug 02, 2021
Shoulder Pain
Some of the most common complaints we hear in CrossFit gyms are:
"I tweaked my shoulder.”
“My shoulders feel tight.”
“I can’t go overhead today.”
“It hurts when I kip.”
CrossFit is a sport known for its ability to push people to their limits and constantly challenge what one can achieve physically. In CrossFit, intensity is the name of the game. It can be easy to forget that our bodies need to be taught how to deal with the extreme stresses we are putting them under. Shoulders are put under stress in many different ways with CrossFit training due to the inclusion of gymnastic movements, Olympic lifting, and tons of overhead exercises. That may be why shoulders are the most commonly injured body part in CrossFit athletes.
There are a lot of reasons why someone may develop shoulder pain while participating in CrossFit. This list is not fully inclusive, but rather highlights 5 of the most common factors that can be addressed to reduce your risk of shoulder injury and pain.
5 Reasons for Shoulder Pain in CrossFit Athletes
#1: Weakness.
Think of this as just simply not having enough strength for a given task, like a strict overhead press. In CrossFit, we are asked to move a lot of weight. This is part of what makes the program so effective, but also increases the risk of the athlete putting too much weight on the bar or trying a movement their body isn’t ready for. Athletes should discuss shortcomings with their coaches to determine appropriate modifications and scaling options for workouts. This could be the single most important factor in keeping your shoulders healthy. You should develop a plan to improve your strength through accessory work if you are not able to Rx workouts but are hoping to do so. Do not just start adding weights without a proper plan in place.
#2: Lack of mobility.
We need to have adequate ranges of motion to get into safe positions for each movement. If you cannot fully elevate your shoulders, you will not be able to get into a kipping position. If you cannot achieve a range of motion without resistance, you have no business doing that movement with heavy resistance. Attempting to snatch bodyweight when you have difficulty getting a PVC pipe overhead may not be the best idea. Shoulder mobility can improve with consistently working on your limitations. Thoracic mobility may also be a limiting factor as you need an appropriate amount of thoracic mobility to fully get your arms overhead.
#3: Lack of stability at end range.
If you are shaky in a locked out position overhead, you may have a lack of stability at end range. Many people confuse this with mobility issues or weakness, but in reality you are strong enough and mobile enough to get to the end range of a movement (let’s say to snatch a barbell overhead) but unable to control the weight while holding it at end-range (holding the barbell overhead while moving into an overhead squat). Working on paused reps of breathing while in the end range of a position (overhead with a weight, locked out arms in a handstand push-up, active shoulder holds when hanging from a pull-up bar, etc.) can help with improving your stability at end range. To spice things up a bit, try using various pieces of equipment or holding a kettlebell with the bottom-up to further challenge your overhead stability.
#4: Poor kinesthetic sense or body awareness.
Having good body awareness or movement IQ is important in CrossFit due to the challenging nature of gymnastics and Olympic lifting. In addition to having the mobility and strength, you need to have coordination and consistency with your movements. Some common issues seen are pulling too early during cleans and snatches, pressing out instead of locking out overhead, and shifting your weight forward in a squat or when catching the weight during a clean or snatch. If a coach is telling you about these faults, but you have difficulty feeling them yourself then you may be lacking some body awareness. Taking videos of yourself and analyzing them yourself and with a coach is a good way to identify common faults in your mechanics as well as to improve your kinesthetic sense.
#5: Not taking enough rest days.
Proper programming means challenging your physical abilities, having a balance of training modes (i.e. cardio, strength, endurance, power), and ensuring proper rest. If you are the type of person that works out 6-7 days per week, then you may be pushing your limits (speaking to recreational CrossFitters here, not elite CrossFitters). It may be fine to do this every once in a while, but you want to make sure you are resting enough. The most recommended frequency of training would be 3 days on followed by 1 day off. During your off day, you should definitely still move, but not perform high intensity CrossFit. Off days are a great time to work on some of the things mentioned above: strength, mobility, stability, and kinesthetic awareness. Use your off days to make yourself a more well-rounded and complete athlete. This will actually yield much better results than just doing the programmed workout 7 days/week for 365 days/year.
When performing accessory work to deal with any of the above limitations, you should strongly consider tempo work. Tempo work means you are performing exercises in a purposeful manner that is slow and controlled. A common pattern is @3311. For a squat, this would mean a 3 second lower, 3 second hold at the bottom, 1 second rise, and 1 second pause at the top. Tempo exercises will increase your time under tension and thus yield enhanced results.
Shoulders are very complex joints and understanding the specifics of why you are in pain are even more complex. If you are dealing with a nagging shoulder pain or injury, it is time to get it checked out. Don’t let this pain get in the way of you exercising or performing normal daily tasks. Get it checked out by a professional and develop a plan to get better.
Corey Hall, PT, DPT

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