The Shoulder part IV

The fourth and final part of coach Jason Highbarger’s essay on the shoulder.  Click for parts one, two and three.

PROGNOSIS:

Regardless of cause or duration, we all found marked relief in having the biceps tendon manipulated back into place and secured with Kinesio Tape while it healed.  This has worked very well, whether our injury was recent or chronic.  THAT is why I am writing this; because each of the athletes suffered significantly from their injury, yet each found immediate comfort (less pain, increased ROM) through this simple process and avoided both surgery and cortisone shots.  We were able to resume our normal training to some extent, if not completely, within 10 days.

Some of us, luckily, were only suffering for a few weeks and it was a relatively easy/fast fix that our tendon was put back into the bicipital groove.  Mine was reset within 5 minutes, though was quite sore for several days afterwards.  Two of the ten athletes, however, suffered with their shoulder injury for nearly a year.  One, Jason N., great athlete and local firefighter, had been going to physical therapy for several months with no relief whatsoever, and has since been counseled by his doctor to “just get a cortisone shot”.  I recommended he go see Sara, considering that physical therapy had been to no avail.  Sure enough, his bicep tendon was out as well.  Considering Jason’s tendon had been out for so long, it took Sara a good half hour to work it back into place, but when she did, he said he had immediately noticeable improved mobility and reduced pain.  As with mine, it was very sore for several days after (his, closer to a week).  The other athlete, Rachel S., who had been dealing with her injury for close to 9 months, had similar results as Jason’s.  She even called me afterwards and said, “Jason, I’m fixed.–It doesn’t hurt anymore.”  (That was the best phone call ever.)  Again, THIS is why I am writing this; some of these athletes have been dealing with their shoulder injuries for months with little to no relief, not even from physical therapy, yet each found marked relief once the tendon was put back into place.

For myself and the other athletes whose injuries were recent, our healing process was very steady once the tendon was put back into place, Kinesio Taped, and treated with some intensive and frequent cryotherapy.  We’ve all pretty much resumed our normal training.  However, for Jason N and Rachel S, their recovery has been a little slower.  Both suspect the tendon may have slipped back out, but are not sure to what extent (if at all).  Whether this is do to the fact their tendon was out of place for a much longer period, or is due to them having a more significant injury than the rest of us, will likely not be determined without further professional medical help.

PREVENTION:

Without knowing exactly how we sustained our injuries, it is difficult to outline exactly how to prevent it.  However, in a recent post, (and plenty of posts before it) Sam Radetsky mentioned several elements that can serve as surefire ways to minimize risk of injury:

Be conscious of good technique when driving hard during a WOD or trying to beat the person next to you.  A little care when chasing those exhilarating PRs or trying to obtain that sought-after “first place” title can help keep you in the gym over the long haul.

Consistent mobility work and proven recovery techniques such as PNF stretching, foam rolling, Trigger-Point Therapy, cryotherapy and the occasional ice bath, can all play a critical roll in helping you optimize the way your body moves, performs and recovers, not simply in a WOD, but in life.  Consider it as “basic maintenance” for the body.  Hot joints and muscles that are left untreated develop into injuries.  I HIGHLY recommend everyone follow Kelly Starrett’s MobilityWod.  4-10 minutes a day of disciplined mobility work will not only improve your performance and facilitate your recovery, but will minimize your risk of injury.

Nutrition plays a critical role in your health and fitness for more reasons than I can list here.  Nutrition serves as the absolute foundation for everything else we are trying to achieve, (Recall Coach Glassman’s “A Theoretical Hierarchy Of Development”, aka “the fitness pyramid”, in the June 2002 issue of the CrossFit Journal, What Is Fitness?).  If you have a weak foundation, whatever you build upon it will suffer.  Optimizing your nutrition will simultaneously maximize training results and minimize injury risks.

Every element within the realm of Prevention can be pivotal to your continued success, perhaps every bit as important as doing the WODs themselves.  Exercising diligence within these areas can all serve to minimize your risk of injury and help keep you participating in this sport of fitness that we’ve all grown to love.

CONCLUSION:

While it is true that each of the injured athletes are avid CrossFitters, most of us regularly engage in other physically demanding sports, activities, and occupations, and none of us can recall at what point exactly we sustained our injuries.  Some may jump to the conclusion that CrossFit must be the origin of our injury, and while that is possible, it should be noted that I have been CrossFitting for 15 years and had never before obtained this injury.  In reality, it is the fact that we all CrossFit and are a part of this amazing community that allowed us to network, seek the right path, and finally find a solution to our injured shoulders, and resume our normal training.  Had we not been a part of the CrossFit community, we may never have found a solution.

If you suffer from a “bad shoulder”, regardless of how long it’s been, consider having it checked for an LBT Subluxation before doing months of physical therapy or settling for a cortisone shot.  I’m not saying this will work for everyone.  The nature of your shoulder issue may be nothing at all like I am describing.  However, if it is the problem you are suffering from, a simple fix of having it put back into place can yield immediate and marked relief and may have you back to your regular training or sport within a very short time.

If you are local to Santa Cruz, or even semi-local, I highly recommend Sarah Bosinger of Touch Therapy; Certified Sports Massage Therapist and Certified Kinesio Taping Practitioner ([email protected], 831-818-0477).  She is absolutely amazing.

Jason’s essay on the shoulder can be found in its entirety on his blog.

Workout:

Jerk

8×1 @ 85%1RM

Then:

400m Run

21 Overhead Squats 115/75#

21 Pullups

400m Run

15 OH Squats

15 Pullups

400m run

9 OH Squats

9 Pullups