The rotator cuff is made up of 4 muscles that attach to the ball of the ball and socket joint known as the shoulder. There is a space between the rotator cuff and the bone that lies directly above it. On top of the muscle is a bursa that allows the muscles to glide against the bone easily. When the bursa becomes inflamed it is called bursitis.
Here is the shoulder with its 4 muscles.
When you lift your arm overhead, there is a tendency for the rotator cuff to get pinched against the acromion, which is the bone above it. It is also part of your scapula or wing blade. As we can see there are different shapes of acromion ranging from Type 1 to Type 3.
Some research has shown that a severe bone spur can dig into the rotator cuff.
If someone has a Type 3 acromion, research has shown that over time the bone can rub against the rotator cuff and dig into it. Also if you landed on your shoulder at some point in your illustrious career of sporting activities, then there is a chance that the acromion impacted against your cuff and bursa. This can develop into a partial tear of your cuff or bursitis, where there is bleeding and swelling in the bursa.
The bursa which used to be smooth becomes thickened and swollen, and turns into a substance that looks like cotton candy.
This is what a bursitis can look like:
The rotator cuff, acromion, and bursa will then rub against one another, causing a painful condition known as impingement. Each time the arm is raised, the tendons and bursa rub against the bone leading to inflammation.
Impingement may become a serious problem for some people and disturb their normal activities. This is when treatment is needed.
Treatment is usually in the form of physical therapy exercises to strengthen the cuff, decrease the risk of bursitis becoming worse. If no relief is seen, then a one-time cortisone injection into the bursa can be very effective. If these don’t work then shaving the acromion and removing the bursitis is often very helpful for this shoulder pain. The diagram below shows a shaver flattening out the acromion and its spur.
So with all this how do we prevent it from happening? First and foremost don’t get born with a Type 3 acromion:) If you can’t control that, then here are some tips.
In CrossFit with overhead maneuvers we have to be aware of the scapula and its rotation. Rotating the scapula back and pinching the shoulder blades together with overhead lifts is helpful. Locking the scapula helps to rotate the acromion posteriorly away from the cuff. This then prevents the acromion from digging in and decreases the chances of impingement.
Mat is rotated and locked in as seen here:
I would say if you have shoulder pain, that isn’t going away the most important thing is not to push through it. Modify your workouts and allow things to quiet down. Listen to your body and get it checked out because your body and your shoulders are trying to tell you something. Pushing through pain when your shoulders are talking is not beneficial. To prevent bursitis, keep your EARS open and your SHOULDERS back.