If you do upper body resistance training you may have had the misfortune of experiencing shoulder pain. Shoulder injuries are common among athletes of all types that do repetitive overhead lifting – not just weight lifters – but volleyball players, tennis players, and swimmers are at risk for shoulder injuries.
Shoulder Overuse Injuries
Shoulder discomfort due to overuse is often caused by inflammation of the tendons, ligaments or muscles that stabilize and support the shoulder. With repetitive lifting, tendons that attach to the muscles in the shoulder or fluid-filled sacs called bursa can become inflamed. When tendons are inflamed, it’s called tendonitis whereas inflamed bursa is a condition called bursitis. These inflammatory conditions are common among weight lifters.
There are four muscles in your shoulder called the rotator cuff that stabilize your shoulder and allow you to raise your arms overhead. The muscles that make up the rotator cuff are the teres minor, subscapularis, infraspinatus and supraspinatus. Just as tendons and bursa can become inflamed due to overuse or injury, the muscles in your rotator cuff can too. In some cases, the rotator cuff can tear leading to more severe shoulder pain and restricted range of motion. A torn rotator cuff needs evaluation by an orthopedist.
Risk Factors for Shoulder Injuries and Pain
There are a few reasons why shoulder injuries are common. The shoulder is a ball-and-socket joint with the greatest range of motion of any joint in your body. This wide range of motion increases the risk of shoulder injury. Sometimes tendons and ligaments are looser than they should be, further increasing the risk for shoulder problems.
Shoulder tendonitis and bursitis are commonly caused by overuse, for example, too many overhead presses, lateral raises or bench presses, especially if you’re using poor form. Never raise your arms much above 90 degrees when doing lateral raises. This can cause impingement of the tendons creating additional stress. If you have muscular imbalances in the muscles in your shoulder it also puts you at greater risk for shoulder injury. Aging is a factor too. With age, tendons become less elastic and flexible.
A joint like the shoulder with a wide range of motion needs strong muscles to give it stability, especially if the ligaments and tendons are lax. To protect your shoulders from injury focus on strengthening all the rotator cuff muscles in your shoulders as well as the muscles in your upper back that stabilize your shoulders. This helps to correct any muscle imbalances. Don’t focus too much on “pushing” exercises at the expense of “pulling” ones.
There are specific exercises you can do to strengthen your rotator cuff muscles. Since the muscles in the rotator cuff are small, use lighter weight especially if you have a history of a recent rotator cuff injury. Also, focus on strengthening the muscles in your upper and mid-back with exercises like dumbbell rows and exercises that work your rear deltoids like bent-over lateral raises and reverse flies.
It’s common to focus too much on the front and medial parts of the deltoids and underwork the muscles in the back. This leads to muscular imbalances that put you at greater risk for injury. Resistance bands are a good way to strengthen the muscles in your shoulder since they allow you to work the muscles from a number of different angles.
Other Ways to Reduce Your Risk for Shoulder Injury
Always warm up before lifting to increase your core body temperature and send more blood to the muscles you’re about to work. Do a warm-up set using light weight to increase flexibility before moving to heavier weights. Don’t lift through the pain. If you experience discomfort in your shoulder when lifting, modify your routine immediately by stopping exercises that cause discomfort. Trying to “lift through the pain” will worsen the problem and alter your form, further increasing the risk for injury.
How Can You Tell if You Have a Rotator Cuff Injury?
The most common signs of rotator cuff injury are a pain when lifting your arms above your head or reaching for something. You may have discomfort in the affected shoulder at night when you sleep on it. If one of your rotator muscles is torn you may experience weakness when you reach your arm out to the side. A torn rotator cuff is a more serious injury that sometimes requires surgery.
If you feel like your shoulder slips out of place when you raise your arm above your head, you may have instability in the shoulder joint. In some cases, the shoulder can partially or completely slip out of its socket. This is another serious injury that may require physical therapy or surgery.
Another Cause of Shoulder Injuries and Pain
Wear and tear on the shoulder can lead to another common cause of shoulder pain, osteoarthritis. Symptoms include pain and shoulder stiffness. This comes from a breakdown of the joint cartilage over time. As the joint cartilage gradually erodes away, it increases friction within the joint as bone rubs against bone. This leads to pain, stiffness and decreased mobility. Previous injury to a shoulder increases the risk of osteoarthritis.
The Bottom Line?
Strengthening the muscles of the rotator cuff and upper back stabilizes the shoulder and reduces the risk of shoulder injury. It’s important to work the shoulder muscles in a balanced manner, executing both “push” and “pull” exercises with excellent form. Don’t use a weight that’s heavier than you can control with good form. You can find some bonus 100 rep challenges that will help you strengthen your rotator cuff and shoulders in my XTrain workout series.
Always, warm up with lighter weights before moving to heavier ones. Show respect for your shoulders. They have great range-of-motion but are less stable than other joints in your body. Treat them kindly.
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WebMD. “Shoulder Problems and Injuries”
American Academy of Orthopedic Surgeons. “Common Shoulder Injuries”
Am Fam Physician. 2008 Sep 1;78(5):605-611.
UW Medicine: Orthopedics and Sports Medicine. “Shoulder Arthritis”
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