The shoulder joints are one of the most prone to injury. That’s because this joint is inherently less stable than others in the body. The reason? The shoulder is designed to be flexible and capable of moving in a variety of directions. Yet, this flexibility also makes it more prone to damage.
Your shoulder is made up of three bones – the clavicle, scapula, and the humerus. The shoulder joint, of which there are four, is the space between which the bones connect with one another. The main joint in the shoulder is the glenohumeral joint, also called the ball-and-socket joint, and is defined by where the top of the humerus, or upper arm, connects with the scapula. The other joints in the shoulder include the scapulothoracic joint, the sternoclavicular joint, and the acromioclavicular joint.
The bones in the shoulder are covered by muscles and tendons that help protect and stabilize the shoulder joint. Collectively, the tendons and muscles are called the rotator cuff. In total, there are four rotator cuff muscles and tendons that cover the shoulder joints and help to stabilize them. Underneath the rotator cuff, re bursa, fluid-filled sacs that help reduce friction when you move your shoulder.
Ideally, your shoulder joints work smoothly, and you enjoy pain-free movements. However, that’s not always the case. If you weight train, you are more predisposed to certain shoulder issues, including rotator cuff tears and tendinitis of the shoulder as well as wear-and-tear that can lead to osteoarthritis of the shoulder. One relatively common shoulder issue that doesn’t garner enough attention is weightlifters shoulder.
What is Weightlifter’s Shoulder?
We mentioned that there are three bones in the shoulder, the clavicle, the scapula, and humorous. The clavicle, also known as the collarbone, connects with the scapula, or shoulder blade, by a bony appendage called the acromion. You can feel the acromium if you rub the area where your collarbone meets your arm in the front. The point where the acromium meets the clavicle is the acromioclavicular joint.
In people who have weightlifters shoulder, the clavicle develops tiny fractures adjacent to where it connects with the acromium. The medical term for this condition is distal clavicular osteolysis, although weightlifters have coined the term weightlifter’s shoulder to describe this shoulder problem. The tiny fractures that develop in people who have it are due to overuse of the shoulders related to weightlifting. However, other athletes that use their arms, especially handball players are at risk as well. Unfortunately, weightlifters shoulder is often painful and may be confused with other shoulder conditions such as rotator cuff tendinitis.
Exercises most likely to cause weightlifter’s shoulder are those that involve shoulder extension. These include bench press and chest flies, especially if you hyperextend when you do these exercises. When you perform these movements without giving your shoulders enough time to recover between training sessions, it creates cumulative stress that can damage the tip of clavicle where it meets the acromium. Your body tries to repair the small micro fractures that form but this can lead to scarring. Some people with this condition go on to develop degenerative changes in the acromioclavicular joint over time.
What Are the Symptoms of Weightlifter’s Shoulder?
The most common symptom of this common condition is stiffness and pain around the acromioclavicular joint. If you press on the area where the acromium and clavicle meet in the front of your shoulder, you might feel a sharp pain. Another common symptom is feeling pain when you reach your arm across your body. In fact, physicians often ask people who they suspect have this condition to extend their arm across their chest to the opposite side. If it elicits pain, the suspicion that weightlifter’s shoulder is the cause of the discomfort is higher. You may find that certain upper body exercise are particularly painful when you have this shoulder condition. These include bench press, push-ups, and dips. The symptoms are usually most pronounced after weightlifting. You may also develop shoulder pain when you lie on the affected side of the body.
How Do You Know if You Have Weightlifter’s Shoulder?
An orthopedist can often make the diagnosis through a physical exam. One tell-tale sign is discomfort when you cross the arm on the affected side across your body. If the physical exam isn’t clear-cut, x-rays or imaging studies can often clinch the diagnosis.
Is There a Treatment for Weightlifter’s Shoulder?
The best treatment is to rest your shoulders until the symptoms subside. That might sound like a tall order but, in the bigger scheme of things, it’s a worthwhile trade-off. If you’re unwilling to stop weight training, eliminate exercises that aggravate the discomfort, particularly bench press, chest flies, and dips. If it hurts, don’t do it.
Rest will usually resolve the symptoms over several weeks, but if the discomfort persists, you have other options. Some orthopedists offer injections of a steroid agent into the joint to reduce inflammation. In severe cases that don’t resolve with conservative treatment, surgery is available. This surgery is called arthroscopic resection. It involves removing the damaged portion of the clavicle. In some cases, they can do the procedure arthroscopically, by making a tiny hole to enter the joint, rather than cutting the tissue. The recovery period with an arthroscopic approach is usually shorter.
Hopefully, you will never need to get a shoulder injection or shoulder surgery! That’s why it’s important to prevent shoulder problems, like weightlifter’s shoulder. The number one and two things you can do are to not over-train your shoulders and use good form when you do upper body exercises. Also, do exercises to strengthen the small rotator cuff muscles, as these muscles are easily injured as well.
Most importantly, don’t ignore shoulder pain and keep training through it. If you do an injury that might readily respond to rest could become a chronic problem that lingers and requires treatment, even surgery. So, give your shoulders a little TLC, and listen to them when they tell you they’re hurting!
Houston Methodist. “Weightlifter’s Shoulder”
Medscape.com. “Distal Clavicle Osteolysis”