Think of all the weight your shoulders have to bear – big shoulder bags filled with too much stuff and all the heavy things you bend over to pick up. No wonder shoulder aches and pains are so common! If you play certain sports like tennis or do a lot of swimming, the repetitive overhead motion of your arms places stress on your shoulders.
If you lift weights using bad form, you also put your shoulders at risk for injury. On the other hand, weight training with good form may help to prevent shoulder problems and injuries by strengthening the muscles in your shoulders and upper back.
Shoulder Anatomy
Your shoulders are made up of three bones – the humerus, or upper arm bone, scapula, or shoulder blade, and the clavicle, or collarbone. On top of your humerus and scapula is a group of four muscles and tendons that connect your upper arm to your scapula, or shoulder blade, called the rotator cuff. As the name implies, this group of muscles makes it possible to rotate and lift your shoulders. The rotator cuff also keeps your arm stable inside your shoulder socket.
The rotator cuff muscles have tendons attached. The muscle itself attaches to the scapula while the tendon at the other end connects to the humerus or arm bone. Underneath the rotator cuff muscles and tendons lies a fluid-filled sac called the bursa that helps your shoulder move smoothly. When everything is working properly, your shoulder moves smoothly through its full range of motion without pain – but sometimes things go wrong due to injury or overuse.
Shoulder Problems: Tendonitis
Tendonitis or tendon irritation is one of the most common shoulders complains and is usually related to overuse. Tendonitis usually starts out as mild shoulder pain you feel when you raise your arm above your head. If you continue to aggravate the symptoms with repetitive lifting, the pain can worsen to the point where it’s difficult to raise your arm. In some cases, the bursa also becomes inflamed too, a condition known as bursitis.
One cause of tendonitis is an impingement, also caused by overuse and repetitive overhead arm movements. Impingement refers to tendon irritation. It comes from the bony prominence at the top of the scapula called the acromion rubbing on the muscles and tendons when you lift your arms. Some people are predisposed to impingement because they have a “hooked” acromion that easily rubs against the tendons in the shoulder.
Shoulder impingement and tendonitis are a relatively common problem among weightlifters. It usually comes from using improper form when doing exercises that target the shoulders like overhead presses and anterior and lateral raises. In fact, your first symptom of tendonitis and impingement may be pain when doing these exercises.
Shoulder Problems: Weight Lifter’s Shoulder
Weightlifter’s shoulder is another overuse injury that causes shoulder pain. As the name implies, this condition is more common in people who lift weights. The repetitive stress of weight training causes tiny fractures to form at the tip of the clavicle or collarbone where it attaches to the acromion, the top of the humerus or arm bone. When you have weight lifter’s shoulder, you may feel pain when you do exercises involving your upper extremities such as dips and push-ups. The tenderness is usually most intense where the clavicle touches the acromion. In many cases, weightlifter’s shoulder will improve if you modify your weight lifting activities and take steps to reduce the inflammation.
Shoulder Problems: Frozen Shoulder
Frozen shoulder is a painful condition where a shoulder becomes progressively more painful. As the pain worsens, the shoulder gradually becomes stiffer and the joint becomes harder to move. With frozen shoulder, the connective tissue that surrounds the bone thickens and tightens around the shoulder joint, making the movement of the joint painful.
Frozen shoulder, also known as adhesive capsulitis, is most common in females between the ages of 40 and 60 and in people who have certain medical conditions like diabetes and thyroid disease. If you’ve had a shoulder injury or had your arm immobilized in a cast, you’re at higher risk. Frozen shoulder often gets better over time but it may take several months up to a year to resolve completely. With frozen shoulder, it’s important to keep moving the arm and shoulder to reduce stiffness.
If you develop shoulder tendonitis and minimize movement or your arm and shoulder to avoid pain, your risk for frozen shoulder goes up. That’s why physical therapy and rehab exercises are so helpful when you have shoulder pain.
Shoulder Problems: Rotator-Cuff Tear
A rotator cuff tear can come from a sudden injury like a fall but a milder tear can make its appearance more gradually. Milder tears are usually the product of repetitive motion. Doing a shoulder exercise like overhead presses using sloppy form puts you at higher risk for a rotator cuff tear. Rotator cuff tendons tend to degenerate with age, making rotator cuff tears more common in people over the age of 40.
A rotator cuff tear not due to sudden injury usually causes discomfort around the top of the shoulder that radiates into the arm. The pain may be present at rest and when you move your arm. Mild rotator cuff tears often respond to anti-inflammatory medications, ice, and physical therapy. More severe cases may require surgery.
Shoulder Problems: Preventing Shoulder Injuries
The best way to prevent shoulder injuries is to strengthen your shoulders through regular resistance training – using good form of course. Bad form puts you at greater risk for shoulder problems. Good shoulder-strengthening exercises including overhead presses, rows and lateral raises. Strengthening other muscles in your upper body including the muscles your arms, neck, and back also helps by taking some of the stress off your shoulders. Don’t forget to stretch your shoulders and arms after a workout too.
Another way to lower your risk for shoulder injuries is to keep your workout balanced. Devote as much time to working your upper back as you do your shoulders. When you do a “pulling” exercise, balance it out by doing one where you “push” against resistance.
When you train your upper body, wait at least 48 hours before working it again. You use your shoulders when you work your biceps, triceps, and chest too. Training these muscles too often exposes your rotator cuff tendons to excessive trauma, putting you at greater risk for tendonitis.
The Bottom Line
Shoulder problems are common among weight lifters. Work on strengthening your shoulders and upper back to take some of the stress off your shoulders when you train.
References:
J Am Acad Orthop Surg; 14:205-214. April 2006.
Clin. Sports Med. 20:491-504. (2001)
American Academy of Orthopedic Surgeons. “Frozen Shoulder”
Up to Date. “Rotator Cuff Tendinitis and Tear”
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