Myth busting: Shoulder Injuries in CrossFit

Taylor, our Summer 2019 intern, was interested by many of our CrossFit patients, especially those coming in for shoulder injuries. For her internship project, she decided to bust the biggest myth about shoulder injuries in CrossFit.

Let’s start with the basics!

Your shoulder has two moving parts: movement of the scapula (shoulder blade!) and the rotator cuff. The scapula moves forward, backward, upwards and downwards. The rotator cuff provides the shoulder to move the arm close to the body, away from the body: both from the forward plan and out to the side (think angel wings).

What muscles do we need involved?

  • Serratus anterior: *main (prime) mover of the scapula*
  • Trapezius
  • Pectoralis Minor and Major
  • Latissimus dorsi 
  • Deltoid
  • Teres major
  • Subscapularis, infraspinatus, supraspinatus, teres minor (rotator cuff muscles)

Stability factors

Since your shoulder is a ball and socket joint, it functions much like a golf ball on a tee. That’s not super stable! To provide stability, your rotator cuff and scapular muscles do the bulk of the work. The labrum provides cushion and seal for the humerus, the ligaments offer joint reinforcement, and the biceps tendon adds humeral depression.

What is CrossFit?

CrossFit is movement that is constantly varied, functional movements, and high intensity. It combines gymnastics, Olympic weightlifting, cardiovascular fitness, strongman, and powerlifting. The best part of CrossFit? It is for EVERYONE. You can be competitive or not, get fit, and be healthy!

Let’s look at the research!

Let’s take a look at some injury statistics from an article by Alicia Montalvo et al. In the above table, you can see that the five significant risk factors for injury in CrossFit is years of participation, weekly training hours, weekly exposure, height, and weight.

The longer the athlete participated in CrossFit, and the increased training hours/exposure led to a higher injury prevalence rate. It makes sense. The more often you go, the greater risk of injury you have.

In this study, Ryan J. Summitt et al. – Injuries in CrossFit and others, studied the injury prevalence rates of ALL activities, not just CrossFit. If you look above, you’ll see that CrossFit is towards the lower end of injury rates!

CrossFit has a reputation of ridiculous activity levels, where many of their members end up injured. The research plainly shows that this is FALSE!

In the above table, you can see that shoulder injuries happened most frequently.

Since there are not many research studies out there about CrossFit, we looked at the Elite weightlifting study by Raske and Norlin to see WHY the participants attributed injury to their shoulder.

What do the participants attribute the injury to in this study?

  • 33% to improper form
  • 12% to too much weight
  • 18% to fatigue
  • 3% to lack of guidance
  • 33% to exacerbation of previous injury

In Conclusion

The rate of general injury and shoulder injury in CrossFit is not significantly higher than that of other sports.

The rate actually lines up with those of the sports that contribute to CrossFit movements.

For most studies, the results are based from voluntary surveys and clearly more research needs to be conducted.

However, what we can say is that the majority of shoulder injuries in CrossFit are attributed to multiple different movements, not just from one specific exercise.

Overhead movements rely on shoulder ROM and stability, weightlifting and gymnastic movements specifically.

It is important to note that while weightlifting has around the same shoulder injury rate, the injuries are more from excessive weight/stress on the joint rather than sacrificed form from fatigue.

Are you struggling with shoulder pain? Give us a call at 614-850-0500 and schedule today!

References:

  • “The Role of the Scapula in the Rehabilitation of Shoulder Injuries”. Michael L. Voight, DPT, OCS, SCS, ATC; Brian C. Thomson, SPT
  • Summitt, R. J., Cotton, R. A., Kays, A. C., & Slaven, E. J. (2016). Shoulder Injuries in Individuals Who Participate in CrossFit Training. Sports Health: A Multidisciplinary Approach, 8(6), 541–546. doi:10.1177/1941738116666073
  • https://www.crossfitmatters.com/crossfit-methodology
  • Atlas of Functional Shoulder Anatomy; edited by Giovanni Di Giacomo, Nicole Pouliart, Alberto Costantini, Andrea de Vita
  • https://commons.und.edu/cgi/viewcontent.cgi?article=1565&context=pt-grad
  • Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit; Alicia M. Montalvo, PhD, LAT, ATC, CSCS,1,✉*Hilary Shaefer,1,*Belinda Rodriguez,1,*Tan Li,1,*Katrina Epnere,1,*and Gregory D. Myer2,*
    • Additional sources can be found referenced in the articles above.
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