In Medical/Injuries

October 01, 2005

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One of the paradigms in physical therapy is the notion that once range of motion (ROM) is restored, the patient is considered healthy. The American Medical Association quantifies the severity of back problems mostly on the loss of spinal ROM (McGill, 2002). While this is a laughable definition of “healthy,” we need not dwell on it because our goal is to pass by “healthy” faster than prunes through a goose.

Part of the definition of CrossFit is that sickness, health, and fitness fall into a continuum (see the “What is Fitness?” issue of the CrossFit Journal [October 2002]). A person with bad shoulders generally has weak, tight shoulders. A person with healthy shoulders (according to health codes) will have adequate range of motion, but not necessarily strength. Truly “fit” shoulders must be strong throughout the full range of motion. This article describes a progression of exercises that has been proven effective at restoring ROM and strength in the shoulders. A lot of doctors tell patients with shoulder problems to never lift anything over their heads. I disagree.

This article is not intended as medical advice. As always, we suggest that you consult a doctor, and then another doctor, until you find one who will sign off on this type of work.

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4 Comments on “CrossFit Shoulder Therapy”

1

wrote …

Greetings,
I just started Cross Fit. I'm a Marine and a PT fanatic. Been lifting for 20 years and really no appreciable differences. And I don't go easy. So I thought i would give this a shot. About 1.5 years ago I had shoulder surgery (rotator cuff and torn SLAP). Went to PT and tried to rehabilitate it myself and... well its been 1.5 years. I can do everything except any type of chest press (to include even pushups). Any time I do any type of chest press, my shoulder tightens up and then it will be a "bad" pain for a few days. Its been going on like this for about a year - and noone could help. Then I started Cross Fit. Was going through the journal articles and found this one. Decided to give it a shot. Well, these stretches and exercises seemed prett basic - but they were completely different than ANYTHING that I had tried before. Been doing this for the past week and my shoulder feels much much better. Still not 100% - mind you - so the jury is still out - completely - but I have noticed a huge difference! And I am thrilled. I hope it continues - but for now I am very grateful for the advice from this article - its the only thing that has helped since my surgery

Semper Fi,
Mike

2

wrote …

I found your article lacking some basic information. As a Physical Therapist and a Certified Athletic Trainer I know of NO paradigm where full ROM is considered healthy without a full evaluation of strength, associated joint mobility (for shoulders evaluating the cervical and thoracic spine), proprioception/kinesthetic awareness, athletic/activity specific mechanical evaluation. I think you may have misinterpreted some bogus inforamtion. While I am appreciative that your article put forth some information, Physical Therapists and Athletic Trainers are the recognized experts in the field of rehabilitation and prevention of injury. In future articles you would be better served to put forth you information without disparaging other highly respected professions.

3

wrote …

Jim,
I am an ATC, CSCS and ACSM HF/I with over 20 yrs of experience. Some of this experience includes conducting Functional Capacity Evaluations (FCE's). A key determinant in various disability rating methods is ROM of injured (or claimed to be injured) joints. Also a veteran of various outcomes studies geared towards proving that PT "works", ROM is a clear metric decided by some in PT to be a measure of how effective PT has been.

Thankfully I've had other experiences and am no longer in a setting where the measure of my success is on how many injured people I treat. It's sad that this continues to be the basis of PTs' livelihood. My focus now is on how many healthy people I keep that way along with enhancing their performance. CrossFit has been a key enabler in this. No Kool Aid drinker I, CrossFit in my professional view has emerged as an effective method to increase fitness, across a broad spectrum of physical capabilities.

Greg doesn't disparage professions writ large. He challenges antiquated/unproven dogma professed by some PTs and ATCs to be part of some proven (in their minds to be), or using a now trite term,"evidence based" system. I have witnessed this first hand and I've tried to help the upset PTs/ATCs. Sometimes it works, sometimes not.

Would recommend you attend a seminar, read the "What is Fitness?" journal,do some of the workouts yourself, and prescribe appropriate components of CrossFit for appropriate patients. Like McKenzie, Maitland, etc., not all of one single approach will help all people. But, like the methods I've mentioned, CrossFit has wide applicability and learning more about it will enable your professional growth.

The report by Mike in the first post in this thread is becoming more common.
Good Luck.

4

wrote …

As a PT, I think some of these ideas and several of the other CrossFit Articles on overhead lifting are very interesting. The biomechanical analysis in other articles that explains the purpose of using the upper traps to finish upwardly rotating the scapula makes a lot of sense. The only problems I see are that many people are only capable of elevating the scapula without upward rotation with the upper traps due to serratus anterior and low trap weakness. This is where I think Physical Therapy is key to progressing toward overhead activity.

My other concern is in individuals who lack glenohumeral motion and therefore will end up excessively stressing out their AC and SC joints with extreme overhead motions. I wonder how these people would respond to these exercises, such as hanging straight down?

Thanks for the great info and challenging the status quo.

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