If you start observing the WODs at your box, many of them include some element of overhead movement. Whether these involved pushing, pulling or hinging movement patterns, one thing is clear. To have some level of success (and especially to be competitive), athletes need to have sufficient mobility and control in an overhead position.
This blog post will form the first component of a series that is published together with our new overhead mobility program for the WODconnect PRO subscribers. The series takes a look at the common injury areas and the different structures that can affect overhead range of motion and control.
CrossFit and shoulder girdle injuries
The shoulder girdle is one of the most moveable areas in the human body. It is a complex structure, including your collarbone and scapular, and is influenced by a number of muscles. Due to the complexity and manoeuvrability, it is also one of the most vulnerable. In CrossFit athletes, the shoulder appears to be the most common injury location, followed by the knee and lower back. Improper form appears to be the most common cause of injury. This could potentially be associated with insufficient range of motion or control throughout the range of a movement available, poor technique, or loss of form due to fatigue. One study looking at shoulder injuries in CrossFit athletes identified a fairly even split between weightlifting and gymnastics movements as the primary causes of injury. In overhead athletes, the most reported shoulder injuries are strains, implicating a process over time where long-term overloading can lead to injury.
It’s not all about the shoulder!
Contributors to injury may be due to sport-specific adaptations, in addition to changes in strength, flexibility and posture. These risk factors are not limited to the shoulder itself, and also include other links in the chain. We will be going into some of these in more detail over the coming series of articles, but in particular, risk factors can include rotator cuff weakness or strength imbalance, shoulder range of motion deficits (in particular, internal-rotation), stiffness or excessive rounding in the upper back, poor trunk control, and even strength or flexibility issues around the hip.
Although shoulder injuries are the most common, not being able to get into a stable, controlled (and safe) overhead position can be contributing to some of your other aches and pains. For example, if you need to extend you lower back to help get your arms into an overhead position, you won't be using the full range of motion of your shoulders. The same also works in reverse. If you have restrictions in overhead mobility, many people will make up for this lack of range by compensating somewhere along the chain. They might arch (hyperextending) their lower back, or allow their ribs to flare out, or tilt at their hips to help get overhead. In time, this can lead to feelings of tightness and pain in the muscles of the mid to lower back, for example, as athletes are having to work overtime to make up for these restricted movement patterns.
A quick test
For a quick assessment of your overhead range of motion, you can give this simple test a try. I should mention that this clearly isn’t a comprehensive testing procedure, but it will highlight general gaps in range of motion. In addition, if you feel any sharp pain or discomfort during this process, I would recommend that you contact a physiotherapist for more thorough analysis.
Test 1 – Overhead range - Start with your feet against the wall, knees and hips bent to 90 degrees. You can begin with arms at shoulder height, thumbs up. Having your legs elevated in this position will help to flatten your back. From here, while keeping your arms straight, attempt to bring your arms over your head towards the floor. If you are unable to touch the floor with your hands, then this suggests you have some range restrictions (for example, tight lats). In particular, if you need to bend your arms, or arch your back to touch the floor, then this counts a failed attempt.
Test 2 – External rotation – For ease, this test can be performed in the same position (or against the wall). With your arms lifted 90 degrees to the side and elbows bent 90 degrees (like a cactus), begin by lowering the back of your hands towards the floor. Ideally, your hands and elbows will reach the floor. If you are unable to keep your hands and elbows against the floor, or you need to arch your back or flare your ribs to keep contact, then this counts as a failed attempt. This position is important when back squatting for example. If you have insufficient range then you will need to compensate somewhere in the chain to get into position, potentially increasing injury risk and reducing performance (making it difficult to keep tight throughout the movement).
Summing it up
There are many factors that can limit our range of motion around the shoulder girdle. Restrictions in range or reduced motor control throughout available range will mean you need to use compensations to fill the gap. This can lead to aches, feelings of tightness and potentially even put you at increased risk of injury.
If you struggled with these quick tests or felt any sharp pain, I would recommend seeking help to prevent potential issues down the road. More information on fixing some common issues caused by or restricting overhead movements is coming soon in this series. Happy training! 😊
Research
Montalvo, A. M., Shaefer, H., Rodriguez, B., Li, T., Epnere, K., & Myer, G. D. (2017). Retrospective injury epidemiology and risk factors for injury in CrossFit. Journal of sports science & medicine, 16(1), 53.
Summitt, R. J., Cotton, R. A., Kays, A. C., & Slaven, E. J. (2016). Shoulder injuries in individuals who participate in CrossFit training. Sports health, 8(6), 541-546.
