Are you wondering about CrossFit Shoulder Injury myths and facts? Well, I’ve decided (as a health professional and CrossFit Coach down at CrossFit Richmond in Victoria) to do some research and study the movements and prevalence of Shoulder Injuries in CrossFit. I'll also list 5 strategies you can start using today to prevent common CrossFit shoulder injuries.

In fact, in what we believe is a first for all CrossFit gyms, we’ve started running a class on Friday afternoons at the CrossFit gym, where members can bring their own rehabilitation programs that I’ve made for them or strength programs to work on some of their body weaknesses or issues to prevent this exact issue.

The reality is that CrossFit has surged in popularity over the past 10 to 15 years, captivating fitness enthusiasts with its dynamic blend of gymnastics, weightlifting, traditional strength exercises, and endurance training. This multifaceted approach promises not just physical benefits like improved cardio-respiratory fitness, strength, power, stamina, and flexibility but also an invaluable sense of community that many athletes cannot find in a normal cold, quiet, sterile 24/7 gym, with its swipe cards, boring equipment, awful lighting, annoying members hogging equipment and lack of atmosphere.

Research shows that movements like kipping pull-ups, ring muscle-ups, snatches, and overhead work are the most frequently reported causes of shoulder injuries in CrossFit. Is this the reality? Or are there other factors like someone’s previous injury history that can lead to a CrossFit shoulder injury? Let's dive into the research to uncover the truth about CrossFit and shoulder injuries and explore effective prevention strategies.

What Does the Evidence Say About Shoulder Injuries in CrossFit?

Scientific studies reveal that the incidence of general injuries in CrossFit is comparable to, or even lower than, that in sports like Olympic weightlifting, distance running, track and field, rugby, soccer, and gymnastics. Specifically, the most frequently injured areas are the shoulder (24-26%), spine (14-24%), and knee (13-18%). Moreover, the types of injuries sustained in CrossFit tend to be less severe and more manageable compared to those in high-contact sports like rugby and soccer.

Several risk factors contribute to these injuries, including older age, male sex, higher body mass index, previous injuries, lack of coach supervision, CrossFit experience, and participation in competitions. Focusing on shoulder injuries provides deeper insights into why this area is particularly vulnerable in CrossFit. The repetitive and high-intensity nature of CrossFit workouts, combined with the complex movements required, places significant stress on the shoulder joints, making them more susceptible to injury without proper precautions.

CrossFit Shoulder Injuries: A Closer Look

A study by Summit and collaborators analysed shoulder injury rates in CrossFit, identifying the exercises most often associated with injuries. High-skill movements requiring extensive range of motion and stability were common culprits. The researchers emphasized the importance of ensuring proper range of motion with low loads before increasing external resistance.

In this study, 44 participants (23.5%) reported shoulder injuries over six months, with 17 (38.6%) of these injuries being exacerbations of pre-existing conditions. Another study by Bernstoff and collaborators used MRI imaging and clinical examinations to assess shoulder injuries in 51 active CrossFit athletes. The most common CrossFit Shoulder injuries were partial tears of the supraspinatus tendon and labral lesions, followed by partial tears of the subscapularis tendon, pulley lesions, and partial lesions of the infraspinatus muscle.

Interestingly, CrossFit athletes with shoulder pain generally showed good shoulder function and stability but often had reduced activation of key stabilising muscles, particularly the lower trapezius, lower rhomboids, latissimus dorsi and serratus anterior for shoulder stabilisation at end range.

5 Strategies to Prevent Shoulder Injuries in CrossFit

Preventing injuries entirely in any sport is impossible, but you can significantly reduce the risk with the right strategies: Here are 5 strategies to prevent shoulder injuries during CrossFit.

1. Proper Warm-Up

Firstly always perform a targeted warm-up tailored to your workout. For Olympic lifting or high-skill gymnastics, ensure your shoulders are mobilised through the required range of motion.

• Dynamic Stretches: Incorporate dynamic stretches like arm circles, shoulder dislocations with a PVC pipe, and scapular retractions. These movements increase blood flow to the muscles and enhance joint mobility.

• Activation Exercises: Use activation exercises such as band pull-aparts, scapular push-ups, and face pulls to engage the shoulder stabilizers. These exercises help activate the smaller muscles around the shoulder, preparing them for more intense activity.

• Gradual Load Increase: Start with lighter weights and progressively increase the load. This allows your muscles and joints to adapt gradually, reducing the risk of strain or injury.

2. Prioritise Technique Over Ego

Secondly to prevent shoulder injuries in CrossFit, avoid lifting weights or attempting gymnastics movements that compromise your technique. Progress gradually, focusing on skill development before adding volume or intensity.

• Quality Over Quantity: Emphasise the quality of each movement. Proper form ensures that you are using the correct muscles and reduces undue stress on your joints.

• Coach Feedback: Regularly seek feedback from a qualified coach to refine your technique. A coach can help identify and correct any form issues that might lead to injury.

• Step-by-Step Progression: Follow a structured progression plan. For example, master the basics of a movement before advancing to more complex variations. This approach builds a solid foundation and minimizes the risk of injury.

3. Listen to Your Body

Be mindful of your body's signals. Avoid overloading your shoulders, especially if they are already sore. Consistency and patience are key to long-term success in CrossFit.

• Pain vs. Discomfort: Learn to distinguish between normal discomfort and pain that signals potential injury. While it's normal to feel muscle fatigue, sharp or persistent pain is a warning sign to stop and reassess.

• Rest and Recovery: Prioritize rest and recovery. Ensure you are getting enough sleep, and incorporate rest days into your training schedule to allow your muscles to repair and grow stronger.

• Adjust Workouts: If you experience soreness or fatigue in your shoulders, modify your workouts accordingly. This might mean lowering the intensity, reducing the volume, or substituting exercises to avoid aggravating the area.

4. Build Shoulder Resilience

Incorporate accessory work focusing on shoulder stability and rotator cuff strength at least once or twice a week. Strengthening these areas can help mitigate the risk of injuries.

• Rotator Cuff Exercises: Include exercises such as external rotations, internal rotations, and shoulder raises to strengthen the rotator cuff muscles, which play a crucial role in shoulder stability. This will help prevent a CrossFit Rotator Cuff Injury.

• Scapular Stability: Work on exercises that enhance scapular stability, such as scapular push-ups, scapular retractions, and overhead shrugs. A stable scapula provides a strong foundation for shoulder movements.

• Functional Movements: Integrate functional movements that mimic everyday activities, such as farmer's carries and Turkish get-ups. These exercises build overall shoulder strength and resilience.

5. CrossFit Modifications for Shoulder Injuries

If you're already dealing with a shoulder injury, consider modifying your CrossFit workouts to avoid aggravating the issue. Substitute high-risk movements with safer alternatives and focus on rehabilitation exercises that enhance shoulder stability and strength.

• Low-Risk Movements: Replace high-risk exercises like kipping pull-ups or heavy overhead presses with safer alternatives such as ring rows, dumbbell presses, or landmine presses. These modifications reduce strain on the injured shoulder while allowing you to maintain your fitness.

• Rehabilitation Focus: Incorporate rehabilitation exercises such as banded shoulder external rotations, scapular wall slides, and prone Y raises. These exercises help improve shoulder function and accelerate recovery.

• Professional Guidance: Work with a health professional and/or a knowledgeable coach to design a rehabilitation program tailored to your specific injury. This ensures that you are performing the right exercises with proper form to facilitate healing.

By implementing these strategies, you can significantly reduce the risk of shoulder injuries and maintain a healthy, strong upper body, allowing you to continue enjoying your workouts safely.

Summary of CrossFit Shoulder Injuries

CrossFit offers numerous physical and community benefits, but it also presents risks, particularly to the shoulders. Research indicates that while common CrossFit shoulder injuries are prevalent, they can be managed and mitigated through proper warm-ups, technique prioritisation, listening to your body, and targeted resilience training. By adopting these strategies, CrossFit athletes can enjoy the sport while minimising the risk of injury.

Stay tuned for our next blog, where we will delve into specific exercises designed to strengthen and stabilise your shoulders, making them more resilient for your CrossFit journey.