Tuesday, October 8, 2013

KinetiFix Exam #2 - Scapular Upward Rotation

KinetiFix Exam #2 – Scapular Upward Rotation

Before we go into the second self-movement test let’s briefly review the two most common CrossFit shoulder injuries:

Two Most Common CrossFit Shoulder Injuries

1.)    Impingement - Proper shoulder strength and flexibility will give you the best chance of avoiding wear and tear injuries.  The two most common injuries that we see in CrossFit athletes, weight lifters and overhead athlete’s shoulders are impingement and labrum tears.  Impingement occurs when the muscles of the shoulder that keep the arm bone (humerus) down are too weak or too tired, allowing it to move upward and rub on the roof of the shoulder.  This causes soft tissue trauma, inflammation and pinching in the shoulder.  If you feel this, it is time to stop and get it looked at by a musculoskeletal therapist.  This wear and tear can lead to more serious problems like rotator cuff tears and an arthritic shoulder. 

General Rule for all injuries:  You have to let the healing outweigh the injury.  Outpacing your body’s ability to recover and repair the tissues you have broken down through training will cause injuries.

2.)    Labrum Tears - Because the shoulder socket (glenoid fossa) is so shallow it allows for a great range of motion.  To improve the depth of the shoulder socket we have a fibrocartilaginous ring called the labrum.  The labrum adds stability to the shoulder while allowing it to keep its great mobility.  The labrum tends to get torn in weightlifters as well as other overhead sports.  Most small labrum tears can be rehabilitated but the larger ones may need surgery to correct. 

KinetiFix Exam #2 – Scapular Upward Rotation

Because CrossFit relies heavily on the health of your shoulders, I find it important to keep our self-movement exam on the shoulder for a while.  My last post had you assess your shoulder’s internal and external range of motion.  Did you have any notable findings?

*A lack in shoulder internal rotation - can be influenced by posterior shoulder musculature.

 *A lack of shoulder external rotation - can be influenced by tightness in your lats, pecs, subscapularis and anterior deltoid. 

Our next test is scapular upward rotation:

To perform this self-exam stand facing a wall with your arm overhead in 90 degrees of flexion.  

Next lift your arm off the wall.  Normal is about 135 degrees of motion without shrugging your shoulders or arching your lower back.  Scapular upward rotation is influenced by serratus anterior strength, lower trapezius strength, pectoralis major muscle length and shoulder external rotation range of motion.

By identifying suboptimal range of motion you will help yourself prevent injuries.  A decrease in scapular upward rotation may cause CrossFit athletes to compensate by hyperextending their lower backs on their overhead lifts.  Lower back hyperextension can cause serious injuries such as fractures, facet syndrome and disc herniations.  Work to improve scapular upward mobility and you can even reduce your risk for these lower back issues.

How did you do?

Please email me at DrToddRodman@aim.com if you found an inability to perform this test.  I can set you up with a specific treatment program consisting of therapies, stretching and exercises that will help to avoid injury and optimize athletic performance.

Stay Strong,

Dr. T-Rod
Sports Medicine Chiropractor, FAU Official Team Chiropractor, CrossFit level 1 coach, Director of CrossFit SE Regional Athlete Services, Certified Strength and Conditioning Specialist (CSCS)