The Top 5 Causes of Shoulder Pain in Paddlers and CrossFitters

Being an overhead athlete, whether you’re a paddler, CrossFitter, swimmer, or tennis player,  places a tremendous strain on your shoulders. Unfortunately, physical demands, heavy load, and repetitive motions can lead to shoulder pain and discomfort. Let’s dive into the top five causes of shoulder pain in overhead athletes and how to find relief.

1. Rotator Cuff Tendinopathy:

The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint, allowing for full range of motion. Overuse and repetitive overhead motions can cause inflammation or small tears in these tendons, leading to rotator cuff tendinitis or tendinopathy. Athletes often experience pain, weakness, and limited range of motion. To find relief, it’s crucial to restore mobility and control of the shoulder and surrounding joints, to work with a Doctor of Physical Therapy who can guide you through the right process to calm down the irritation and gradually build capacity and resiliency to prevent the issue from returning.

2. Labral Tear:

The labrum is a cartilaginous structure that deepens the shoulder socket, providing stability. Overhead athletes are prone to labral tears due to the high demands placed on their shoulders. Common causes include repetitive throwing motions, sudden forceful movements, or dislocation. If you experience deep shoulder pain, clicking or catching sensations, or a feeling that your shoulder is “giving way,” it’s essential to consult with a Doctor of Physical Therapy to determine the best next steps for you. Many times these are able to be treated non-operatively by improving strength, stability, and control of the shoulder and gradually returning to sport. 

3. Biceps Tendinitis:

Biceps tendinitis is another common cause of shoulder pain in overhead athletes. It occurs when the long head of the biceps tendon becomes irritated or inflamed. Athletes may experience pain in the front of the shoulder, which can radiate down the arm. It’s crucial to work with a Doctor of Physical Therapy to reduce pain and irritation, improve mobility, and treat the root cause – whether it’s overload of the biceps tendon due to poor movement patterns, lack of strength in surrounding muscles, or simply reduced capacity of that tissue to handle the load it’s been put under. 

4. Impingement Syndrome:

Impingement syndrome is a condition wherein the tendons of the rotator cuff become pinched or compressed between the shoulder blade and the head of the humerus (upper arm bone). This can cause pain, weakness, and loss of strength in the shoulder. To address impingement syndrome, it’s important to work with a Doctor of Physical Therapy to improve mobility for optimal humeral head positioning, as well as improve movement patterns, control, stability and strength at the rotator cuff. 

5. Shoulder Instability:

Repetitive overhead motions, such as paddling, throwing or serving, can gradually result in shoulder instability. This condition occurs when the structures that support and stabilize the joint become stretched or torn, causing the humeral head to move excessively within the socket. Athletes may experience pain, a feeling of looseness or “catching” of the shoulder, and decreased performance. Physical therapy aimed at repositioning the humeral head, then strengthening the muscles around the shoulder joint, as well as proprioception exercises for better joint control, can be highly effective in managing shoulder instability and preventing further injury.

Shoulder pain is a common challenge faced by overhead athletes. By understanding the top causes of shoulder pain and taking appropriate action, such as seeking expert help by a Doctor of Physical Therapy and modifying training and activities, athletes can find relief, prevent further injury, and improve performance. It’s crucial to consult with a Doctor of Physical Therapy who specializes in your sport and fitness-forward rehab  to develop an individualized treatment plan tailored to your specific needs.

Remember, as an overhead athlete, your shoulder health is vital for continued success in your sport! Incorporate proper warm-up exercises, listen to your body’s cues, and seek proactive treatment whenever you notice pain or discomfort. With the right knowledge and care, you can keep your shoulders in good shape and continue pursuing greatness in your athletic endeavors.

If you’re struggling with pain or injury, and would like to work together, book a free call  to discuss your situation with a Doctor of Physical Therapy, and learn what the best next steps are for you.


February 7, 2024

Alex Langford

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