Case Study: Shoulder Impingement Syndrome
Shoulder Impingement Syndrome is a condition where tendons of the rotator cuff are intermittently trapped and compressed during shoulder movements. This causes injury to the shoulder’s tendons and bursa, resulting in painful shoulder movements. Neer’s test (pictured here) can help diagnose Shoulder Impingement Syndrome.
Harold is a 30-year-old male with previous sports injuries. While playing football in high school, he injured his left shoulder with a failed tackle attempt. This injury was not allowed to heal properly, causing a deformity in his left collar bone. Because of this injury, his shoulder impingement is intensified. He states that he is able to perform certain Olympic lifts like the clean and jerk without difficulty but when it comes to the snatch lift the shoulder loses power, especially during the turnover portion of the movement. He also states that he loses power when hanging on the pull-up bar. This becomes a big problem when he needs to hang from a bar for toes-to-bar, pull-ups, and muscle ups.
If Only One Shoulder Hurts, You Probably Didn’t Get it At Crossfit
A majority of the unilateral shoulder injuries that present in my office because of Crossfit
are not caused by Crossfit. Crossfit is a bilaterally dominate activity, meaning that both extremities are needed to complete a movement. Crossfit’s greatest strength is that it will expose your weaknesses. That’s the nature of Crossfit. A complete history must be taken
to discover the cause of the initial injury. For example, did you previously injure one shoulder but not the other? Did you play sports like football or baseball? Do you sleep on your front, side, or back? Do you have kids that you lift or carry? The shoulder is used for everything. That’s why it has the greatest range of motion of all the other joints.
I’ll illustrate the methods of treatment from easiest to hardest and duration of time.
Easiest – Find a health care professional (HCP). A health care professional will do what you won’t. If this is only impingement syndrome, a HCP will employ methods to strip out the supraspinatus muscle to decrease swelling and inflammation and to break up adhesions and scar tissue. Sounds like dirty work. It is… and it’s painful. This has the shortest healing duration, but it does still take time.
Moderate – Do it yourself. Take a lacrosse ball and dig into the insertion of the supraspinatus and surrounding muscles. In my experience, this doesn’t work. People are not willing to mash hard enough to attend to the muscle properly. However, this method should used as a preventative measure. Least amount of pain. Time: months to years
Severe – Do nothing at all. Eventually structures become overloaded, break and snap. This has a relatively quick healing process post-surgery, but it hurts the most.
Shoulder injuries can often be prevented by following simple guidelines. This should include assessment and management of the following key areas:
Tightening up your technique: Poor performance and shoulder pain commonly originate in bad habits of technique.
Flexibility: Flexibility varies for the different muscles around the shoulder. It is important that the internal and external rotators are equally flexible. For the rotator cuff, another critical issue is the dynamic balance between the muscle strength of the muscles surrounding the rotator cuff.
Core stability: Core stability is critical. The inner core of the body provides a stable strong support for the shoulder to work. A good shoulder needs a good foundation. The core also provides the kinetic chain for overhead activities, allowing the trunk muscles to transfer energy and momentum to the shoulder for overhead sports.