Shoulder pain in Boxers & Martial artists: Part 1 – Identifying the Source
The shoulder is a complex ball and socket joint, comprising of the
- scapula,
- clavicle (collar bone) and
- humerus (upper arm bone)
These 3 structures must work together properly to keep your shoulders healthy. The shoulder joints are designed to be mobile and surrounding muscles are meant to be balanced in length and strength with good activation patterns. These things all work to ensure the ball moves smoothly in the socket. If something’s not working, nerve impingements, wearing of the shoulder capsule and supporting ligaments begin to occur.
This ain’t pretty!
So how do we identify what is the source of our shoulder pain?
The common culprits are:
- Rotator cuffs,
- Bursae or
- The labrum within the glenoid cavity
Lets Break Down these 3 pain producing structures and inform for you on what to look out for.
The rotator cuff is a collection of 4 muscles that overlie the humeral head in your upper arm. Your arm is kept into its socket by the rotator cuff. The rotator cuff is responsible for mobility of the shoulder and collectively they are responsible for three primary movements for boxers:
- Rotating the upper arm inwards (internal rotation)
- Rotating the upper arm outwards (external rotation)
- Moving the upper arm away from the body (abduction)
Rotator cuff tendonitis occurs when the rotator cuff muscles are strained and their tendons develop microtears. This is most often caused by overexertion of the shoulder joint and results in pain, weakness, and reduced mobility in the shoulder
Rotator cuff tears can occur either over time or as the result of a sudden traumatic incident. For boxers, these injuries tend to occur as a result of small micro-tears in the rotator cuff that begin to get larger over time. When the shoulder is not given time to properly rest, the tears in the tendons of the rotator cuff are not able to repair themselves which will weaken the entire shoulder.
However, these injuries can also occur suddenly as the result of a missed punch or over rotating of the shoulder. When rotator cuff injuries occur they are immediately followed by pain, weakness, and reduced mobility of the shoulder.
2. Subacromial Bursitis
This injury is caused by the inflammation of a small sac (bursa) that cushions the shoulder joint and allows the bones of the shoulder to slide smoothly over one another. In most cases, subacromial bursitis is the result of overexertion and lack of adequate rest for the shoulder joint (2).
3. Torn Labrum
The labrum is responsible for shoulder stability as it holds the head of the upper arm bone (humerus) in the shoulder socket. Any tear in the labrum can lead to instability and cause serious problems for boxers as movement of the arm can cause the shoulder to slip partially or completely out of the socket (dislocation). Typically tears can occur in the back of the shoulder at the posterior labrum as the shoulder is repetitively loaded with each punch (3).
Boxers are prone to shoulder dislocations
Lets not forget, boxers are commonly prone to shoulder dislocations. With missed punches, the speed and forces under which the rotator cuff is placed causes the shoulder joint to partially or completely slip out of its socket. Therefore strong shoulders are crucial to long term career success of boxers and martial artists.
In Part 2, we will begin to address the causes, treatment and exercises required to develop shoulder strength and keep it that way!
Stay tuned!
Share this post if you believe it may benefit others experiencing shoulder pain or if you’d like further information about shoulder pain and sports chiropractic.
References:
1) Bledsoe GH1, Li G, Levy F. Injury risk in professional boxing. South Med J. 2005 Oct;98(10):994-8.
2) T Zazryn, P Cameron, and P McCrory. A prospective cohort study of injury in amateur and professional boxing. Br J Sports Med. 2006 Aug; 40(8): 670–674.
3) Zazryn T, Finch C, McCrory P. A 16‐year study of injuries to professional boxers in the state of Victoria, Australia. Br J Sports. 2003 Aug;37(4):321-4.
