PURE PHYSIO AND BRUNSWICK EAST CROSSFIT PRESENT

THE “SHOULDER WORKSHOP”3rd September 2014

“δῶς μοι πᾶ στῶ καὶ τὰν γᾶν κινάσω”

“Give me a firm spot on which to stand, and I shall move the Earth”

(Archimedes)

OVERVIEW

• Anatomy of the Shoulder

• Posture/Lifestyle

• Common problem areas involving the shoulder in CrossFit

• How/why you get injured or lack optimal performance because of issues with:

• Mobility

• Stability

• Integrating movement

SHOULDER ANATOMY

The shoulder complex consists of three bones:

1) Shoulder blade

2) Arm bone (humerus)

3) Collar bone

• The shoulder attaches to the trunk through muscle and connective tissue…. Therefore the postural position of the spine has a huge influence on shoulder positioning and function

POSTURE

Our posture is important to consider during our daily activity……

And during our sport & leisure time as well

Consider this…. 8-9 hours sitting at desk 5 days/week

vs1 hour of CrossFit 3 x/week!

COMMON COMPLAINTS

• Pain!!– Front, Back, Neck, ‘inside the joint’, Armpit

area/under, referral into upper arm, sore elbows/wrists

• Unable to lock out the arms in an overhead position

• Unable to perform overhead sit ups or overhead squats without losing neutral trunk positioning

• Excessive arching of the back when going into the overhead position (lack of shoulder range)

• Unable to get a good rack position and also to keep this rack position at the bottom of a squat

• Excessive internal rotation of shoulders and rounding of the back (Oly lifting, Deadlifts)

• Unable to keep ‘active shoulders’ during pulls ups, toes to bar (hanging off rig)

POOR POSTURE & POOR SHOULDER POSITIONING- “MOBILITY” ISSUES

Increased tightness of:• Chest and Neck muscles, connective tissue/fascia

• Joints of the spine – especially the lower cervical spine and thoracic

• Shoulder joint

• Neural tissue/nerves:

– Stiffness or irritation of the nerve roots will alter nerve firing times and therefore alter muscle activation/timing.

– Nerve root irritation or stretch/tension can cause pain, P&N, numb, weakness.

* 8% stretch = tension/tightness

*12% stretch = symptoms (pain, pins and needles and weakness)

The resting positions that you spend the most time in during the day can affect how you perform in

CrossFit……

MOBILITY DRILLS/EXERCISES

POOR POSTURE & SHOULDER POSITIONING-“STABILITY” ISSUES

Weakness or poor activation of:

• Rotator Cuff Muscles “Ball and Socket centering”

• The shoulder blade stabilisers and core/trunk muscles “The Base”

• Deep neck stabilising muscles

STABILITY DRILLS/EXERCISES

INTERGRATING STABILITY AND MOBILITY INTO CROSSFIT

• Upper limb “Dissociation”

– Programming correct sequencing of movement vs “all or nothing” movement patterns

• Rotator Cuff muscle activation

– pre activity/pre WOD

– Actually helps to improve range of movement as you are moving in a more structurally centered position when cuff is turned on

Rotator Cuff

Shoulder blade stability

Trunk stability

SUMMARY

MOBILITY- DAILY ROUTINE• Trunk Mobility & Flexibility exercises • Chest/anterior stretching & flexibility and

release work

STABILITY• Trunk Posture & Stability muscle retraining!• Shoulder blade re-education• Deep Neck Flexor retraining• Rotator Cuff Activation & Strengthening

INTERGRATION OF MOVEMENT

• Upper limb “Dissociation”

• Integrating Rotator Cuff muscle activation into fundamental CrossFit movements

• Combining Trunk stability + Shoulder blade stability + Rotator Cuff Function into daily activity as well as CrossFit

• Let the Coach coach you!

REHAB/PREHAB

By permission, thanks Matt McInnes from CFU!

QUESTIONS??

Jac jacindagruebner@purephysio.com.auRoy roydookia@purephysio.com.auClaire claire@brunswickeastcrossfit.com