Friday, December 24, 2010

...To all my friends at San Jose Police Department and the CrossFit SJPD Underground team, (a.k.a.; "CrossFit Nomad's");

...I love you and I miss you and I hope to see you all again soon.

...And thank you; have all added to my life significantly. I'm truly grateful that I had the opportunity to meet you, coach you, and get to know you. Our time together holds a special place in my heart. Thank you for making my life that much better. :)

Wishing you and your families a wonderful Holiday, my friends.

Merry Christmas and Happy Holidays. :)

Jason Highbarger

PS: ...Always remember, ..."Hone that mental focus!" :)

Friday, October 01, 2010

(Note: A shorter version (less technical anatomy stuff & sans references) can be found on the CrossFit West Santa Cruz Blog in four parts; Part I, Part II, Part III, and Part IV.)

Have a "Bad Shoulder?" Read this.

Any serious athlete, regardless of sport or training methodology, will get injured. These injuries can range from occasional minor discomfort to career ending maledictions. Lately, several local athletes, myself included, have struggled with shoulder injuries. Some of the injuries have been recently incurred; whereas others have been more chronic in nature. Now before we get too far along on our "bad shoulder" stories; we should pay respect to what an amazing and complex mechanism the shoulder really is.

The shoulder has the greatest range of motion of any joint in the human body. It can lift, pull, push, punch, throw, climb, brachiate, and do pretty much anything else we need it to. Comprised of 4 joints, 5 bone groups, 2 cartilage types, 11 muscles, and a complex interplay of tendons, ligaments, cartilage, nerves, blood vessels and bursae, the shoulder complex can abduct, adduct, rotate, raise and lower in front and behind the torso and move through 360° in the sagittal plane, allowing for complete global movement and positioning of the hand anywhere in space.

Through the dynamic mobility of the shoulder, we can accomplish truly remarkable feats; ...from Snatching 199 Kilos or achieving perfection on the Rings, perfecting a masterpiece on a cello, (part 2) or painting one on the ceiling of the Sistine Chapel (and here). ...The shoulder itself is a masterpiece.

However, ...the tremendous range of motion and complexity of the shoulder joint also make it inherently unstable and prone to injuries. Knowledge of this innate instability dates as far back as Hippocrates (ca. 460 BC – ca. 370 BC). Shoulder injuries can vary dramatically, but the injury I want to specifically address here is the bicep tendon slip phenomenon, or “Biceps Tendon Subluxation”. When the proximal tendon of the long head of the biceps brachi slips out of the bicipital groove and shifts either forward or backward, (usually forward) significant pain and decreased mobility ensues. But, for most people there is a relatively easy, non surgical, fix that can get you up and training again within a week or two, depending on the causal mechanism behind the subluxation.


To better understand this injury, some knowledge of shoulder anatomy and that of the biceps brachii muscle is needed. (For a short and very easy to follow CGI video of the inner workings of the shoulder, click here. It will provide a solid mental image when reading further.)

There are three primary bones within the shoulder girdle; the clavicle (collarbone), scapula (shoulder blade) and humerus (upper arm bone). The roof of the shoulder is formed by a part of the scapula called the acromion.

There are three primary joints within the shoulder complex; the Glenohumeral joint (GHJ), a ball-and-socket type joint where the humerus meets the glenoid on the scapula; the Acromioclavicular joint (ACJ), a gliding joint where the clavicle meets the acromial process; the Sternoclavicular joint (SCJ), formed by the joint space between the sternum (breastbone) and the clavicle and is particularly important in throwing and thrusting movements; and one false joint, the Scapulothoracic joint, where the shoulder blade glides against the thorax (the rib cage).--Though not a “true joint” in the sense that it has no capsule or ligamentous attachments, the scapulothoracic joint is important to the shoulder complex because it requires that the muscles surrounding the shoulder blade work together to help keep the socket lined up during shoulder movements (1,4,62,63,66).

Of particular interest, however, is the Glenohumeral Joint (GHJ). Considered to be the main shoulder joint, it is the most important of the shoulder articulations as it provides the greatest mobility. This joint allows the arm to move in a circular rotation as well as towards and away from the body and hinge out and up away from the body. Though commonly referred to as a “ball-and-socket” type joint, the GHJ is not a true ball-and-socket like the hip. The shoulder is different from the hip in that the hip is a weight bearing joint and the shoulder is a suspension joint. In the GHJ, the head of the humerus is quite large in comparison to the glenoid fossa and is closer to that of a golf-ball sitting on a golf-tee. The "ball" of the joint is the top, almost perfectly rounded, medial anterior head of the humerus, and the "tee" is formed by the small, very shallow dish-shaped glenoid fossa (cavity) on the lateral side of the scapula, into which the ball fits. Both articulating surfaces are covered with articular cartilage that is a hard, shiny cartilage which protects the bone underneath. True to the “golf ball on a tee” analogy, the socket comes in very little contact with the round head of the humerus, resulting in only one third of the head being in contact with the fossa at any one time. While adding to the joints mobility, this poor fit also makes the joint unstable. Thus, it is up to the soft tissues in the joint to maintain stability and mobility.

The soft tissues of the shoulder include the Articular Capsule, Bursa, Glenoid Labrum, Ligaments, and muscles and tendons of the Rotator Cuff.

Having a tough, fibrous outer membrane and lined by a thin, smooth synovial membrane, an articular capsule (joint capsule) is a soft tissue envelope that surrounds a synovial joint. In the shoulder, the articular capsule encompasses the GHJ and attaches to the scapula, humerus, and head of the biceps, though is loose enough to allow a wide range of motion.

Bursae are small pad-like sacs that secrete synovial fluid to help reduce friction and aid movement. In the shoulder, they cover the rotator cuff tendons and protect them from the overlying acromion process.

The glenoid labrum is a unique rim of circumferential fibrocartilage attached to the periphery of the glenoid cavity and plays a critical roll in the shoulder. It largely serves to increase the area and depth of the glenoid fossa, aiding in the joints stability, but also serves as the primary attachment site for the shoulder capsule, glenohumeral ligaments, and often the long head of the biceps tendon.

Ligaments attach bones to bones, and there are several important ligaments within the shoulder complex, including the Transverse Humeral Ligament (THM) and the semicirculare humeri, but I will address ligaments in a moment.

The stability of the glenohumeral joint (GHJ) depends on keeping the humeral head (“ball”) centered in the glenoid fossa (“socket”) of the scapula. The humerus is held in place with ligaments, tendons and muscles, mainly the muscles and tendons of the rotator cuff (1,5,39).

The rotator cuff is a group of four small muscles; supraspinatus (abducts the arm), subscapularis (internally rotates humerus), infraspinatus (externally rotates humerus), teres minor (externally rotates humerus) and their tendons that originate on the scapula and attach to the tuberosities on the humerus (1,5,39,63). These envelope the GHJ and function together as a unit to compress the head of the humerus into the glenoid fossa (keeps ball in socket), helping to add power and stabilize the shoulder while in motion (1,4,5,39,63). The rotator cuff muscles also allow the upper arm to move in all directions.

Another integral component to the power and stability of the shoulder is known as the Ligamentous Pulley System. This system consists of several ligaments and tendons that collectively serve as an important stabilizing complex and support structure within the shoulder. This system includes the coracohumeral ligament, glenohumeral ligaments (superior, medial, inferior, posterior), subscapularis tendon, and supraspinatus tendon (2,7,9,11,12,17,26,45,51,57).

The coracohumeral ligament and superior glenohumeral ligament form a U-shaped anterior suspension sling surrounding the biceps brachii tendon near its exit from the bicipital groove (21,49,51,55,56,64,65). These combine with the superior fibers from the subscapularis tendon and are believed to act as a pulley, which is critical in keeping the biceps tendon from subluxating (slipping) or dislocating (26,49,51,55,56,64,65). Injuries to this structure have been termed pulley lesions (1,16,26,51,65).

Tendon fibers from the subscapularis merge with the transverse humeral ligament and extend across the floor of the bicipital groove, fusing with those of the supraspinatus tendon into a sheath that encompasses the biceps tendon (2,49,57,64).

The biceps, (meaning “two headed”), muscle consists of a short head and long head and goes from the shoulder to the elbow on the front of the upper arm. The muscles forming the short and long heads stay separate until just above the elbow where they unite (1,20,21,24,25,63). Tendons attach muscles to bones; Two separate tendons (the proximal tendons) connect the upper part of the biceps muscle to the shoulder, and one tendon (the distal tendon) connects the lower part of the biceps muscle to the elbow. (Proximal refers to closer-to-body, or “upper”, while Distal refers to farther-from-body, or “lower”.)

The short head of the biceps connects at the shoulder on the corocoid process (a small bony knob of the scapula just in from the front of the shoulder) and passes under the deltoid (shoulder muscle) (14,51,63,64).

The long head of the biceps attaches to the top of the glenoid at the supraglenoid tubercle and the posteriorsuperior labrum, though the main labral attachment varies, arising from the posterior, the anterior, or both aspects of the superior labrum (14,20,21,51,63,64). Beginning at the glenoid, the tendon of the long head of the biceps (LBT) travels down the front of the upper arm and runs within the bicipital groove (between the greater and lesser tuberosities) on the proximal end of the humerus where it is held in place by the transverse humeral ligament (THL) (14,51,59,60,61,63,64). It is here that this “slip” phenomenon of the LBT seems to occur.

Of the ten local athletes who had this problem, (6 female, 4 male), in nine the tendon had slipped forward (anteriorly) and in one, a female, the tendon slipped behind (posteriorly).


A definitive cause is uncertain. None of us can recall a specific moment in which we “became injured.” While we are all avid CrossFit’ers, most of us participate regularly in other physically demanding sports, activities and occupations. We could have sustained our injuries through any number of means.

As for the actual “causal mechanism” that allows the tendon itself to shift out of place, that is unclear without an MRI, Contrast MRI or Arthroscopy. The exact nature and degree of injury to these athletes has yet to be diagnosed through such means, though I would suspect they vary.

Considering the LBT often predominantly attaches to the glenoid fossa at the labrum, this injury could be related to “SLAP tears” (superior labral tear from anterior to posterior) that sometimes afflict “throwing motion” athletes, such as Tennis, Baseball, Volleyball, Water Polo, or those who’ve suffered a bad fall. SLAP tears often occur where the biceps tendon anchors to the labrum. Tears in this region of the labrum are generally slow to mend as the superior and anterosuperior parts of the labrum have less vascularity than do the posterosuperior and inferior parts, and the vascularity itself is limited to the periphery of the labrum (21,52,51). What this means is less blood flow to the injured area and slower transport of needed healing elements carried within the blood, thus limiting the body’s ability to effectively and efficiently repair the injured area.

Certified Sports Massage Therapist, Sara Bosinger of Touch Therapy, suspects that the “tendon slip” phenomenon could be caused by a lesion, fray, tear or stretch of the superior labrum at the insertion point of the long-head biceps tendon, thus causing the tendon to “slip” since it’s not being held correctly. While this is perfectly logical and goes hand-in-hand with the SLAP tear phenomenon, it crossed my mind that since where the LBT sits in the bicipital groove is held in place by the transverse humeral ligament (THL), and the tendon slips out of this groove, that a lesion, fray, tear or stretch could also be at the THL. However, current research suggests the THL overlying the bicipital groove is no longer considered as a crucial stabilizing structure unless the medial coracohumeral ligament is torn (3,48,51). Some research even questions the existence of the THL altogether (53,59). Recent studies indicate there is no distinct THL (53,59,60,61), rather, support of the LBT within the bicipital groove is likely a fibrous tissue extension of the subscapularis tendon (53,59). Thus, if you choose to get a Contrast MRI to evaluate your subluxing LBT, examining the subscapularis along with the rest of the ligamentous pulley system and labrum should also be considered.

The bicipital groove itself has a wide variance in the angle of its walls, but 70% fall within a 60° to 70° range (14,23,25,26,50). During internal and external rotation of the arm, the biceps tendon swings from one acute angle to the other (19,20,21,50,51), thus, in a shallow bicipital groove, the possibility of the tendon slip is potentially greater as the tendon has a tendency to force it’s way over the greater or lesser tuberosity (34,35,40,50,51,53). In contrast, if the bicipital groove is narrow and tight, the constant pressure on the tendon may cause tendonitis or even rupture of the tendon (3,23,43,48,50).

As it turns out, this biceps tendon slip injury is not uncommon in athletes and is in fact one of three common injuries to the biceps tendon, including Biceps Tendonitis and complete Biceps Tendon Rupture. This biceps tendon slip phenomenon even has an official medical diagnosis; “Biceps Tendon Subluxation”. Subluxation of the long head biceps tendon (LBT) from the bicipital groove is a common causes of shoulder disability in the throwing arm of an athlete (50).

There is no single definitive precursor to Biceps Tendon Subluxation, there are several causes such as direct physical trauma (such as a fall or crash), repetitive throwing motions, SLAP tears and tears to the ligamentous pulley system of the shoulder, such as at the subscapularis tendon, coracohumeral ligament, superior glenohumeral ligament or supraspinatus tendon. All can lead to a subluxation. For the ten of us who had this injury, I’m sure the actual causal mechanism of the tendon slipping out of place varies athlete to athlete, as likely does the origin of the injury itself.


Generally speaking, subluxation of the long head biceps tendon from the bicipital groove has characteristic symptoms; pain, decreased range of motion, pain on throwing that is relieved by rest, a palpable snap at a certain point in the arc of motion, and pain with pressure to the front of the shoulder (50, 54). Common signs are tenderness over the bicipital groove, pain and occasionally tenderness or swelling over the front of the shoulder, pain upon pressure to the front of the shoulder and a reproducible pop in rotation of the humeral head (50, 54).

However, the symptoms of our injuries varied greatly. As is consistent with labral tears and other injuries to the shoulder, our symptoms ranged as far as pain, location, weakness, popping or clicking in the shoulder, decreased range of motion and loss of strength. In some, the pain was an occasional dull throbbing ache in the joint that could be aggravated by strenuous exertion or even mundane activities, yet in others the pain was constant and severe and we could physically press on areas that would hurt with pressure, usually in the front of the shoulder where the tendon had slipped, though in some, on the top of the shoulder. SLAP tears, in most cases, will also yield inflammatory changes around the biceps tendon origin. The degree of our impaired mobility varied just as much as the pain, and many of us had difficulty sleeping, especially on our side.


If you know exactly what to feel for, I suppose it’s possible to “self-diagnose” whether your tendon is out of place or not. Manipulating it back into place, however, is highly unlikely, otherwise you would have done it already. I would suggest going to a Certified Sports Massage Therapist or other such professional familiar with this problem. If they are good at what they do and know what to look for, they should easily be able to tell whether it has slipped or not. If it has, they will likely be able to manipulate it back into place.

As for diagnosing the the actual causal mechanism or root injury that leads to the subluxation, that will likely not be diagnosed without professional medical help. SLAP tears, for example, will likely not be diagnosed without a Contrast MRI or exploratory Arthroscopy. SLAP tears don’t show up well on standard MRI’s and the pain generated by them can mimic many other shoulder problems. Overall, they are very difficult to diagnose.


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 heals. 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 Nee, great athlete and local Firefighter, had been going to physical therapy for several months with no relief what-so-ever, 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. ...And so he did. Sure enough, his bicep tendon was out as well. Considering that Jason Nee’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, Jason said that 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 Sherer, 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 athlete’s 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 who’s injuries were recent, our healing process has been 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. I chose to lay off of pulling/pushing movements or any significant overhead work other than Push-Jerk and Handstands for a week to help facilitate the healing process. This seems to have worked very well so far and I have since reintroduced all my normal strength-&-conditioning movements with no problem thus far.

However, for Jason Nee and Rachel Sherer, their recovery has been a little slower. Both suspect that the tendon may have slipped back out, but are not really sure to what extent, (if at all). Whether this is do to the fact that 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. In Jason Nee’s case, a Contrast MRI or Exploratory Arthroscopy will likely be needed.


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 Radetski 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 PR’s 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. As Sam said, “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”; [a.k.a.; “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.

If you are prone to LBT subluxation; popular with swimmers and water polo players, this strap is designed to help keep the biceps tendon in the groove via compression:

For coaches, I would also suggest watching the Wellesley shoulder lecture:


While it is true that each of the injured athletes are avid CrossFit’ers, 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 CrossFit’ing 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 shoulder 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. ...Once again chasing all those “PR” goals you’ve set for yourself.

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

Jason Highbarger

The ten confirmed local athletes with this issue:

Jason Highbarger

Ronnie Boose

Jason Nee

Troy Miller

Danielle Winters

Melanie Desere Turowski

Rachel Sherer

Paige Nutt

Narine Kadekian

Helen O’Brien

I personally suspect seven others of having this same issue:

Beau Frasier

Ashley Collins (Now Confirmed)

Shawn Smith

John Van Every

Dan Pfeifer

Jesse Martin Ashe

Beth Albalos


1. Jost B, Koch PP, Gerber C. Anatomy and functional aspects of the rotator interval. J Shoulder Elbow Surg 2000; 9:336-341.

2. Bennett WF. Subscapularis, medial and lateral coracohumeral ligament insertion anatomy: arthroscopic appearance and incidence of “hidden” rotator interval lesions. Arthroscopy 2001; 17:173-180.

3. Slatis P, Aalto K. Medial dislocation of the tendon of the long head of the biceps brachii. Acta Orthop Scand 1979; 50:73-77.

4. Cooper DE, O’Brien SJ, Warren RF. Supporting layers of the glenohumeral joint: an anatomic study. Clin Orthop 1993; 289:144-155.

5. Clark J, Sidles JA, Matsen FA. The relationship of the glenohumeral joint capsule to the rotator cuff. Clin Orthop 1990; 254:29-34.

6. McFarland EG, Kim TK, Banchasuek P, McCarthy EF. Histologic evaluation of the shoulder capsule in normal shoulders, unstable shoulders, and after failed thermal capsulorraphy. Am J Sports Med 2002; 30:636-642.

7. O’Brien S, Neeves MC, Arnoczky SP, et al. The anatomy and histology of the inferior glenohumeral ligament complex of the shoulder. Am J Sports Med 1990; 18:449-456.

8. Ferrari DA. Capsular ligaments of the shoulder: anatomical and functional study of the anterior superior capsule. Am J Sports Med 1990; 18:20-24.

9. Burkart AC, Debski RE. Anatomy and function of the glenohumeral ligaments in anterior shoulder instability. Clin Orthop 2002; 400:32-39.

10. Nobuhara K, Ikeda H. Rotator interval lesion. Clin Orthop 1987; 223:44-50.

11. Edelson JG, Taitz C, Grishkan A. The coracohumeral ligament: anatomy of a substantial but neglected structure. J Bone Joint Surg Br 1991; 73:150-153.

12. Neer CS, 2nd, Satterlee CC, Dalsey RM, Flatow EL. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop 1992; 280:182-185.

13. Harryman DT, Sidles JA, Harris SL, Matsen FA. The role of rotator interval capsule in passive motion and stability of the shoulder. J Bone Joint Surg Am 1992; 74:53-66.

14. Vangsness CT, Jr, Jorgenson SS, Watson T, Johnson DL. The origin of the long head of the biceps from the scapula and glenoid labrum: an anatomical study of 100 shoulders. J Bone Joint Surg Br 1994; 76:951-954.

15. Bennett WF. Visualization of the anatomy of the rotator interval and bicipital sheath. Arthroscopy 2001; 17:107-111.

16. Walch G, Nove-Josserand L, Levigne C, Renaud E. Tears of the supraspinatus tendon with “hidden” lesions of the rotator interval. J Shoulder Elbow Surg 1994; 3:353-360.

17. Itoi E, Berglund LJ, Grabowski JJ, Naggar L, Morrey BF, An KN. Superior-inferior stability of the shoulder: role of the coracohumeral Ligament and the rotator interval capsule. Mayo Clin Proc 1998; 73:508-515.

18. Field LD, Warren RF, O’Brien SJ, Altchek DW, Wickiewicz TL. Isolated closure of rotator interval defects for shoulder instability. Am J Sports Med 1995; 23:557-563.

19. Nidecker A, Guckel G, Von Hochstetter A. Imaging the long head of the biceps tendon: a pictorial essay emphasizing magnetic resonance. Eur J Radiol 1997; 25:177-187.

20. Itoi E, Kuechle DK, Newman SR, Morrey BF, An KN. Stabilising function of the biceps in stable and unstable shoulders. J Bone Joint Surg Br 1993; 75:546-550.

21. Rodosky MW, Harner CD, Fu FH. The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med 1994; 22:121-130.

22. Neer CS, 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 1972; 54:41-50.

23. Warner JJ, McMahon PJ. The role of the long head of the biceps brachii tendon in superior stability of the glenohumeral joint. J Bone Joint Surg Am 1995; 77:366-372.

24. Ting A, Jobe FW, Barto P, et al. An EMG analysis of the lateral biceps in shoulders with rotator cuff tears. Presented at the Third Open Meeting of the Society of American Shoulder and Elbow Surgeons, San Francisco, Calif, January 21–22 1987.

25. Yamaguchi K, Riew KD, Galatz LM, Syme JA. Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop 1997; 336:122-129.

26. Weishaupt D, Zanetti M, Tanner A, Gerber C, Hodler J. Lesions of the reflection pulley of the long biceps tendon. Invest Radiol 1999; 34:463-469.

27. Rowe CR. Recurrent transient anterior subluxation of the shoulder: the “dead arm” syndrome. Clin Orthop 1987; 223:11-19.

28. Rowe CR, Zarins B. Recurrent transient subluxation of the shoulder. J Bone Joint Surg Am 1981; 63:863-872.

29. Gartsman GM, Roddey TS, Hammerman SM. Arthroscopic treatment of anterior-inferior glenohumeral instability: two to five-year follow-up. J Bone Joint Surg Am 2000; 82-A:991-1003.

30. Schenk TJ, Brems JJ. Multidirectional instability of the shoulder: pathophysiology, diagnosis, and management. J Am Acad Orthop Surg 1998; 6:65-72.

31. Selecky MT, Tibone JE, Yang BY, McMahon PJ, Lee TQ. Glenohumeral joint translation after arthroscopic thermal capsuloplasty of the rotator interval. J Shoulder Elbow Surg 2003; 12:139-143.

32. Warner JJ, Deng XH, Warren RF, Torzilli PA. Static capsuloligamentous restraints to superior inferior translation of the glenohumeral joint. Am J Sports Med 1992; 20:675-685.

33. Le Huec JC, Schaeverbeke T, Moinard M, et al. Traumatic tear of the rotator interval. J Shoulder Elbow Surg 1996; 5:41-46.

34. Sethi N, Wright R, Yamaguchi K. Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg 1999; 8:644-654.

35. Walch G, Nove-Josserand L, Boileau P, Levige C. Subluxations and dislocations of the tendon of the long head of the biceps. J Shoulder Elbow Surg 1998; 7:100-108.

36. Berlemann U, Bayley I. Tenodesis of the long head of the biceps brachii in the painful shoulder: results in the long term. J Shoulder Elbow Surg 1995; 4:429-435.

37. Chung CB, Dwek JR, Cho GJ, Lektrakul N, Trudell D, Resnick D. Rotator cuff interval: evaluation with MR imaging and MR arthrography of the shoulder in 32 cadavers. J Comput Assist Tomogr 2000; 24:738-743.

38. Ho CP. MR. Imaging of rotator interval, long biceps and associated injuries in the overhead-throwing athlete. Magn Reson Imaging Clin N Am 1999; 7:23-37.

39. Grainger AJ, Tirman PF, Elliot JM, Kingzett-Taylor A, Steinbach LS, Genant HK. MR anatomy of the subcoracoid bursa and the association of subcoracoid effusion with tears of the anterior rotator cuff and the rotator interval. AJR Am J Roentgenol 2000; 174:1377-1380.

40. Farin PU, Jaroma H, Harju A, Soimakallio S. Medial displacement of the biceps brachii tendon: evaluation with dynamic sonography during maximal external shoulder rotation. Radiology 1995; 195:845-848.

41. Rokito AS, Bilgen OF, Zuckerman JD, Cuomo F. Medial dislocation of the long head of the biceps tendon: magnetic resonance imaging evaluation. Am J Orthop 1996; 25:314, 318-323.

42. Seeger LL, Lubowitz J, Thomas BJ. Case report 815: tear of the rotator interval. Skeletal Radiol 1993; 22:615-617.

43. O’Donoghue DH. Subluxing biceps tendon in the athlete. Clin Orthop 1982; 164:26-29.

44. Zarins B, McMahon MS, Rowe CR. Diagnosis and treatment of traumatic anterior instabilty of the shoulder. Clin Orthop 1993; 291:75-84.

45. Boardman ND, Debski RE, Warner JJ, et al. Tensile properties of the superior glenohumeral ligament and coracohumeral ligaments. J Shoulder Elbow Surg 1996; 5:249-254.

46. Cole BJ, Rodeo SA, O’Brien SJ, et al. The anatomy and histology of the rotator interval capsule of the shoulder. Clin Orthop 2001; 390:129-137.

47. Ozaki J, Nakagawa Y, Sakurai G, Tamai S. Recalcitrant chronic adhesive capsulitis of the shoulder: role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am 1989; 71:1511-1515.

48. Petersson CJ. Spontaneous medial dislocation of the tendon of the long biceps brachii: an anatomic study of the prevalence and pathomechanics. Clin Orthop 1986; 211:224-227.

49. Werner A, Mueller T, Boehm D, Gohlke F. The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval: a histoanatomic study. Am J Sports Med 2000; 28:28-31.

50. O’Donoghue, Don H. M.D. Subluxing Biceps Tendon In The Athlete, Clinical Orthopedics and Related Research, April 1982, Volume 164, pp:2-312;

51. Yoav Morag, MD Jon A. Jacobson, MD Gregory Shields, MD Rajiv Rajani, BS David A. Jamadar, MB, BS Bruce Miller, MD Curtis W. Hayes, MD, MR Arthroscopy of Rotator Interval, Long Head of the Biceps Brachii, and Biceps Pulley of the Shoulder Radiology RSNA, 2005

52. DE Cooper, SP Arnoczky, SJ O'Brien, RF Warren, E DiCarlo and AA Allen, Anatomy, histology and vascularity of the glenoid Labrum. An anatomical study, Hospital for Special Surgery, Cornell University Medical College, New York City, N.Y. The Journal of Bone and Joint Surgery, Vol 74, Issue 1 46-52, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc

53. Robert W. Pettitt, PhD, ATC, CSCS*; Scott R. Sailor, EdD, ATC†; Gary Lentell, DPT†; Cary Tanner, MD ‡; Steven R. Murray, DA § Yergeson's Test: Discrepencies in Description and Implications for Diagnosing Biceps Subluxation, Athletic Training Education Journal, Volume 3, Number 4, Oct-Dec 2008

54. Elsevier Science (USA), 2003

55. Joseph P. Iannotti, Gerald R. Williams, Jr., Disorders Of The Shoulder, Diagnosis & Management, 2007.,

56. Jon J. P. Warner, Joseph P. Iannottie, Evan L. Flatlow, Complex and Revision Problems in Shoulder Surgery, 2005.

57. William F. Bennett, M.D., Subscapularis, medial, and lateral head coracohumeral ligament insertion anatomy, Arthroscopy, The Journal Of Arthroscopic And Related Surgery, Volume 17, Issue 2, Pages 173-180, February 2001


59. MacDonald K, Bridger J, Cash C, Parkin L, Transverse Humeral Ligament: does it exist?, PubMed Clinical Anatomy, New York, NY, 2007, August 20 (6):663-7

60. Gleason PD, Beall DP, Sanders TG, et al. The Transverse humeral ligament: a separate anatomical structure or a continuation of the osseous attachment of the rotator cuff? Am J Sports Med 2006:34(1):72-7

61. MacDonald K, Bridger J, Cash C, Parkin I. Transverse humeral ligament: does it exist? Clin Anat 2007;20(6):663-7.

62. Richer, Paul, M.D., Artistic Anatomy, 1986

63. Martini, Frederic H, Ph.D., Timmons, Michael J, M.S., Human Anatomy: Second Edition, 1997

64. Zlatkin, Michael B., MRI Of The Shoulder, Second Edition, 2003

65. Yoav Morag, MD, Jon A. Jacobsen, MD, Gregory Shields,, MD, Rajiv Rajani BS, David A Jamadar, MB, BS, Bruce Miller, MD and Curtis W.Hayes, MD, MR Arthrography of Rotator Interval, Long Head Biceps Brachii, and Biceps Pulley of the Shoulder, Radiology RSNA, 2005

66. OrthoPod, Shoulder Anatomy; A Patient's Guide to Shoulder Anatomy

Sunday, August 29, 2010

CrossFit West Santa Cruz

...It’s an amazing feeling to be a part of something that you really believe in. I can’t tell you how good it feels to be working with people I truly believe in, and for something I truly believe in. CrossFit West Santa Cruz is really an amazing place. ...The coaching, ...the programming, ...the blog, ...the devotion to the clients, ...the CrossFit West community itself, ...everything. There is definitely a commitment to excellence that shows in everything they do here. ...And I do not say that lightly. I’ve been coaching for close to 15 years. I came up under Greg “Coach” Glassman and was mentored by the man himself. Glassman’s commitment to excellence, attention to detail, and devotion to his clients was unparalleled. ...I learned many a valuable lesson from that man and I am forever grateful.

I truly feel that we have some of the best coaches (and owners) around. The coaches here are amazing. They are great at what they do. I have quietly observed them for a long time, they coach, they interact with each other, they engage the clients, etc, and they have each impressed me on many levels. They are constantly studying and honing their craft, always striving to better themselves as coaches. They have each developed an outstanding “eye”, catching the smallest details, even in advanced lifters. They’ve each developed a profound understanding of efficacious programming. I love the fact that every coach here is willing, and able, to develop great programming for clients based on the clients needs and goals, such as understanding what sport they play and at what point of the season they are in, or if the client is injured in some way and needs modified, yet effective, programming. I feel this speaks not only to the coaches abilities, but to the overall approach, mindset and motivation behind everyone here. It’s an insight into the greater vision that is CrossFit West.

What I really love, is that every coach and owner here is absolutely devoted to the clients, every bit as devoted as I am. ...I can’t tell you how good it feels to be working with people like that. It’s quite refreshing, really. I would, in a heart beat, tell my sister, father or best friends to train with any of the coaches here, and I would feel totally comfortable doing so. I know they would be in good hands. ...I’ve had several friends, clients and people ask me “when do you run classes at CrossFit West?” and my reply is simply, ...”It doesn’t matter when I run classes.--Every coach here is amazing.” ...And that’s how I honestly feel. Anyone who has ever worked with me knows my style of coaching and knows how devoted I am to my clients and to anyone I have the opportunity to work with. ...Well, the coaches here very much remind me of myself in that way. It is such a great feeling to be working with people like that. ...Genuinely devoted and extremely capable.

Last I heard, there was 2000 or so CrossFit Affiliates, and just as many CrossFit websites/blogs. I most definitely have not seen them all, (nor will I ever even endeavor to do so). I have, however, looked at a few hundred over the years, and there are several I check regularly. There are some great blogs out there. CrossFit West Santa Cruz is most definitely one of them. I feel Sam, Jocelyn and Cliff have produced one of the best CrossFit blogs around. Their commitment to excellence can easily be seen when looking at the quality and consistency of their blog. It is very clear the level of care and thought that they each put into their posts. The guest writers and contributors to the blog are every bit as good. Their posts are just as insightful and inspiring and are written with an equal amount of care and thought. I love it.

The overall attitude of everyone here is so uplifting, positive and pure of heart. It’s genuine. It’s wonderful, and I love being a part of it. It’s just a great place to be. The community that has been developed here at CrossFit West Santa Cruz is outstanding. Forged through a commitment to excellence and devotion to the clients, the strength of camaraderie amongst the CrossFit West community is empowering. I love the community events that we do, such as the “Paleo Potlucks”, and how the entire CrossFit West community get’s together for such gatherings. The yearly party’s with, and for, all of the clients are always great fun too. ;)

Since I started coaching here, there has been many many things that I have loved about CrossFit West and that have made me proud to be a part of it.

...Now, ...Sam Radetski, Cliff Hodges, Jocelyn Forest and CrossFit West Santa Cruz, along with John Van Every and CrossFit Longevity, offers to it’s amazing and loyal clientele, and to the entire Santa Cruz County CrossFit community, a brand new, world class CrossFit Strength and Conditioning facility. The new CrossFit West is a facility like nothing you've ever seen. At 10,000 sq ft, it is the largest CrossFit that has ever been built. With 14 Olympic Weightlifting platforms, well spaced, and the all-new Rogue Fitness SPX pullup/squat-rack systems, the Santa Cruz CrossFit community finally has a world-class gym that is worthy of this town - the birthplace of CrossFit. Complete with new Prowlers, a Heavy-Bag, New OD-Green Rogue Fitness Sand-Bags (the same ones used in the 2010 CrossFit Games), New OD-Green “Slam” Balls, an awesome kids area, and 4 indoor sprinting lanes made from the same high quality Artificial Football Turf as used in the NFL. ...And there is still more to come! :) ...The new CrossFit-West/CrossFit Longevity facility will prove to be an outstanding place to train.

Even with it's size, CrossFit West remains absolutely dedicated to our clients and the community we've developed, which is why we are also offering amenities that no other gym has: an awesome gated children's play area, two showers, and a front desk with an all-paleo snack bar and drink counter.

This is an amazing new chapter in the life of CrossFit West Santa Cruz. We are all very excited for the future and we will continue to give you the best quality and care in service that you have all come to know and expect.

Thank you Sam Radetski, Jocelyn Forest, Cliff Hodges, John Van Every and Kyle Haynes for this amazing new facility!

Thank you to all the amazing and loyal CrossFit West Santa Cruz clients who made it possible. This facility is for you! :)

I strongly encourage everyone to come by and check us out! Stop by for a free class, any class! :)

For anyone who would like to train with me or is trying to get ahold of me:

I train solely at CrossFit West Santa Cruz now.

My phone numbers are;

(831) 359-6609

(831) 254-0426

My email is

I run classes at CrossFit West Santa Cruz, Monday, Tuesday, Wednesday, Thursday, at 6:00 am and 7:00 am, and on Friday afternoons at 5:00 and 6:00 pm, though I’ll be at the gym pretty much all day, every day.

ALSO, I will be CO-Instructing in almost every class for the next three months!--Especially the afternoon classes! :) I would LOVE to see you there!!! :)


Saturday, August 21, 2010

I’ve thought a lot about whether to do a post on this subject or not. I am choosing to do so in order to clear up any misunderstandings that clients may have as to why I left NSC, as well as to give “my side of the story” and clear my name, since I’ve been accused of lying. This will be the one and only time I speak on this subject publicly. After this post, I’ll never address the subject again. I have much much more important things to do and projects that require my attention and energy.
...There seems to be a lot of confusion regarding my departure from CrossFit North Santa Cruz.
Just so there is no misunderstanding, I was definitely not “asked to leave” NSC or “forced to resign”. ...However, nor did I simply just “leave to pursue other opportunities”.
I left of my own free will and volition, as a direct and immediate response to what I was told during a private meeting with one of the owners as to his feelings about me as a coach and a person. I most definitely quit.
I was told, directly to my face;
“You want to know how I really feel? Generally speaking, you really offer nothing to the clients as a coach, and I think you really have no business even being on the floor. Yeah, occasionally, if the workout suits you or interests you, then yeah, you may step up & get involved and coach a bit. Otherwise, I think you really offer the clients nothing as a coach. And that’s how I really feel. ...Are we clear?!”
That is what I was told. I did not misconstrue the message. I did not take it out of context. It was very direct, and it was very clear. It was said with contempt. It was said with malice. It was said with conviction. He even closed with, “Are we clear?!”.
I could not continue to work for, or with, someone who actually thinks that about me as a coach or a person. Period. I have spent the last 15 years of my life absolutely devoted to my clients and to everyone I have the opportunity to work with. It is my commitment and devotion to my clients that fuels my existence. One of the biggest driving forces in my life and my primary objectives in life is to help and empower as many people as I can. That is how I live my life. ...He was directly attacking my credibility and character and was discounting everything I’ve done as a coach for the last 15 years of my life. At what point do you not stand up for yourself anymore?
I know his comment was absolutely untrue, but it still pissed me off. He said it with conviction and purpose, as though, either; ...a.), That’s honestly how he felt (for which I give him props for actually having the balls to say it to my face), ...b.), He just said it out of anger and wanted to elicit a reaction out of me, (for which he did), or ...c.), I slept with his ex-girlfriend and he found out about it. (...Things happen.)
This was, however, a private conversation between myself and only one owner of CFNSC. Thus, logically, I know and fully understand that what this individual feels about me as either a coach or a person does not necessarily accurately reflect the consensus of the rest of the ownership or management team at NSC. Even with that being so, I could not continue to work for him, and so I quit.
One of the only reasons I am bothering to write this post is because since all of this occurred, this same individual is denying that it ever happened and telling people that I am making false accusations about him. He is saying that I am lying about the whole thing. Hearing this only strengthens my resolve as far as my decision to leave. And yes, it kind of pisses me off. Again he is attacking my credibility and character. ...If you are going to have the balls to say something like that to someone’s face, then I would think you would have the balls to stand buy it. If you think I’m an asshole when other people don’t, then stand by your convictions and tell them why you think I’m an asshole. ...I really don’t understand it. But whatever. So be it, I guess.
If you are a client of NSC, and are reading this, I hope you know and understand that I did not abandon you. I stayed for as long as I could. But after being told such a thing to my face, I just couldn’t continue to work there and still retain any self respect or look myself in the mirror every day. To put it bluntly, it was simply “the last straw”.
Long ago when I was considering leaving NSC, it was Randy Reynolds & Craig Parks, (who are now both co-owners), along with many of the regular clientele, who asked me to stay and try to make it a better place. I remember hearing the words, “Please don’t abandon us, Jason.” Those words resonated deep within me, and so I stayed. That memory sticks with me to this day. ...I hope you don’t feel that I abandoned you. I did not.
It was you, the clients, and my devotion to you that fueled my enthusiasm when I was on the floor and was why I stayed at NSC for as long as I did. It was my regular engagement with each of you that compelled me to stay. You have all been a very important and beloved part of my life, and I really do miss all of you dearly. I am certainly truly grateful that I had the opportunity to coach each and every one of you and get to know you as individuals. You have all touched my life deeply and helped me grow as both a coach, and as a person. I am forever grateful for that, well as for NSC in even providing me that opportunity to begin with.
...Regardless of whatever disagreements that have occurred between myself and NSC, I think everyone who is currently a part of CFNSC ownership and management, ...even the one whom I had the private conversation with that initiated my departure, wants to see their gym and the community for which it serves, and for which support it, grow into the vision that we all had of what CFNSC could be. I was a part of CFNSC from it’s inception and I am sincerely grateful to have been provided that opportunity so many years ago.
I truly feel that Craig Parks, Randy Reynolds and Helen Cavender buying in to CrossFit North Santa Cruz has been a Godsend for that establishment. Not only have they each contributed a significant amount of money towards the betterment of the business and facility, but they have each contributed countless hours of their time and energy, working incessantly towards their endeavor of making CFNSC a better experience for everyone involved, especially the clients. I know they will continue to do so until the greater vision of what we all know CFNSC could be comes to fruition.
While this is not an ideal situation for anyone involved, I liken it to that of a painful breakup. Initially, it is very difficult for all parties involved. However, through time, both parties come to the realization that while it was a difficult, or even painful, experience to go through, the transition ultimately proves to be a very healthy and positive change for all parties involved. I honestly feel that everyone will grow from this, even myself.
Through the difficult transition of my departure, I encourage you and everyone within the CFNSC community, the clients, to pull together and find strength in each other. ...After all, it is the CFNSC community,, ...the clients, that truly make CrossFit North Santa Cruz a beautiful place.
Jason “J-Dog” Highbarger