Good luck Leighna and Jared – Sun 10.08.17
Good Luck Leighna and Jared!
They are competing in the Hassle Free Fall Breaker 2017 at Crossfit Potrero Hill, San Francisco, CA. If you want to watch or need a reason to come to SF, more the that can cheer them on the better! Leighna is lifting at 12pm and Jared is lifting at 2pm.
Of all the movements in the CrossFit repertoire, few are criticized as often as the sumo deadlift high pull.
The movement was identified as foundational by CrossFit Founder Greg Glassman due to its transference of skill and high potential for power output, but critics of the sumo deadlift high pull (SDHP) challenge its efficacy and safety.
In this defense of the SDHP I will tackle the issue of safety.
To my knowledge, no scholarly studies have definitively examined injuries in CrossFit, but in my experience as a longtime affiliate owner, I think it’s safe to say shoulder injuries are some of the most common. Considering the number of overhead lifts and gymnastics movements regularly programmed, this really shouldn’t come as much of a surprise. A simple analysis of overhead sports will reveal that shoulder injuries are among the most common ailments.
To get a better understanding of why the shoulder is so susceptible to injury, let’s briefly review the anatomy and kinematics of the region. For a more in-depth analysis, please refer to the CrossFit’s online Anatomy Course.
The shoulder joint is formed by the union of the humerus—the long bone of the upper arm—and the scapula, aka the shoulder blade, in what is referred to as the glenohumeral (GH) joint. Just superior to the GH joint is the acromion process, a bony prominence that projects off the spine of the scapula. The tendon of the supraspinatus, one of your rotator-cuff muscles, traverses this tunnel formed by the acromion process and the glenohumeral joint (known as the subacromial space). Also located in this space are several bursae, which are small, fluid-filled sacs that serve to reduce friction.
As the humerus elevates during movements involving the upper extremities, the subacromial space can be compromised if the scapula doesn’t move in concert with the humerus. To observe the phenomenon known as scapulohumeral rhythm, simply watch someone as he or she abducts the arm to greater than 90 degrees. Initially, the movement will occur exclusively through the glenohumeral joint, but as the humerus reaches approximately 90 degrees you will see the scapula upwardly rotate to follow the humerus. This not only preserves the subacromial space but also ensures that the length and angle of the rotator-cuff muscles are maintained for optimal function.
Patients with shoulder injuries are often observed to have delayed or dysfunctional rhythm between the scapula and the humerus. Repeatedly encroaching upon the subacromial space can result in trauma to the supraspinatus tendon and/or the subacromial bursae, which is then diagnosed as impingement syndrome.
The SDHP is often cited as being particularly harmful to the shoulder—specifically to the supraspinatus tendon—due to the belief that the top position of the movement creates an impingement scenario.
A False Equivalency
SDHP naysayers often reference the top position of the lift as being similar to the position of the orthopedic provocation test known as the Hawkins-Kennedy (H-K) test. In the clinical setting, physicians and therapists will often perform the H-K test to determine if a patient has impingement of the supraspinatus tendon, the subacromial bursa or perhaps both.
While at a quick glance the two positions might look similar, it takes neither a very close investigation nor a doctorate in physical therapy to discern glaring differences.
When performing the H-K test, the clinician will passively flex a client’s shoulder forward to 90 degrees. Once the patient is in this position, with the elbow bent to 90 degrees, the clinician will then passively internally rotate the patient’s GH joint to greater than 90 degrees, with the goal being to impinge, or pinch, the tendon and/or bursa between the head of the humerus and the undersurface of the acromion process. When the test is performed properly, the patient is instructed to relax, especially through the upper trapezius because it is common for patients to reflexively contract the upper trapezius in anticipation of pain. If the initial test is negative, the clinician might then become a bit more aggressive by slightly adducting the arm across the chest—which protracts the scapula—to increase the likelihood of catching the potentially inflamed tissues.
A couple of important notes about clinical tests such as this:
- The clinical tests are designed to put people into positions that might indicate the person has the condition that is being tested for, but a positive test does not guarantee the person has said condition.
- The position tests for the condition; it does not cause the condition. Many orthopedic clinical tests resemble common daily movements or positions. This does not mean these positions or movements are inherently dangerous, but if you have an injury, these positions or movements might cause pain or discomfort.
Let’s now compare this to the top position of the SDHP (see below). The most obvious difference is that the shoulder is abducted with the humerus nearly in the frontal plane. This deviates from the H-K test position by almost 90 degrees. Additionally, the upper trapezius is not relaxed—in the proper execution of the SDHP, the athlete is instructed to “shrug the shoulders” up toward the ears, which requires a powerful contraction of the upper trapezius. This shrug of the shoulders accomplishes two things:
- The contraction of the upper trapezius results in elevation and slight upward rotation of the scapula, following the movement of the humerus. This elevation and rotation effectively preserve the subacromial space, thereby decreasing the likelihood of impingement.
- It also continues the core-to-extremity movement pattern, handing off the power from the hips to the less powerful upper extremities. Due to the explosive extension of the hips, the load realized on the shoulder during the pulling phase of the lift is significantly less than the actual load on the bar. The goal of the movement is to make the bar feel “weightless” as you pull it up toward your collarbones.
Finally, the movement is taught with the scapulae in a neutral or even slightly retracted position. This further helps to ensure that the subacromial space is preserved during the final pull of the bar toward the collarbones. Allowing the scapulae and subsequently the entire shoulder girdle to protract into a rounded position is a common fault and should be corrected.
It is my hope that this brief analysis of the anatomy and biomechanics of the shoulder as well as the kinematics of the movement will help you realize that safety concerns should not cause you to avoid the SDHP.
Proper execution of the movement does not place the shoulder in a compromised or dangerous position. As with any movement, it is failure to follow the CrossFit charter of mechanics, consistency and then intensity that is the most likely cause of injury.
Mindfulness of the alignment of the skeletal anatomy during the setup and execution of this and any other lift is the key to lifelong healthy movement.
About the Author: Dan Hollingsworth is a Certified CrossFit Coach (CF-L4) and a member of the CrossFit Level 1, Level 2, Kids and Masters seminar teams. He is also the founder and owner of Kitsap CrossFit, in Poulsbo, Washington, which he has operated along with his wife since 2009. Dan earned his bachelor of science degree in exercise science from the University of Wisconsin-Madison, where he also completed an internship in athletic training. He then went on to earn a master of science degree in physical therapy at the Army-Baylor University Physical Therapy Program, and he served as a commissioned officer and physical therapist in the U.S. Navy for 10 years. Dan currently resides in the beautiful Pacific Northwest along with his wife and two daughters and their obnoxious Taiwanese mountain dog, Alice.