What causes shoulder pain when lifting weights and how to fix it?
It's that time of the year where those of us who live in the southern hemisphere are getting ready to show off those summer bodies we’ve been working on all winter.
Weight training has become one of the most popular forms of exercise in recent years - and for good reason as it helps with:
Building muscle, strength and endurance.
Burning fat (by increasing your metabolism).
Maintaining healthy bone density.
Mental health and confidence.
As good as weight training can be for your health and fitness, we see many patients who experience shoulder pain while weight lifting.
Before we get into the various causes of the pain, we first need to understand the shoulder itself, namely the structures and how they work.
The shoulder COMPLEX:
The shoulder consists of your humerus/upper arm bone, scapula and clavicle/collar bone and has 4 joints:
Glenohumeral joint ( between the humerus and scapula).
Acromioclavicular joint (between the acromion and clavicle).
Sternoclavicular joint (between the sternum and clavicle).
Scapulothoracic joint (between the scapula and thoracic rib cage).
The head of the humerus fits into the glenoid fossa, which is a section of the scapula bone that forms a “socket” for the humerus. The part of the glenoid fossa that forms the “socket” is quite flat.
This is both a good and a bad thing - it allows for more movement than any other joint in the body, but it also has less stability. That's where all the other structures come in - to give that extra bit of stability that the joint itself lacks.
There are many ligaments that help to add stability and prevent an excessive amount of movement that would be harmful to the joint.
The joint capsule is a fibrous covering which encloses the joint. Then there’s a synovial membrane which lines the inner park of the capsule and produces synovial fluid which helps to reduce friction during movement. There are also many synovial bursae (sacs filled with synovial fluid) which form cushions between the structures (tendons etc.) and help smooth movement.
Then there are the muscles, specifically the rotator cuff muscles which add stability and strength during movement of the shoulder.
Weight lifting puts quite a bit of stress and strain on your muscles, tendons and ligaments. As discussed above, it’s a very beneficial form of exercise, but it is vital that it is done in a proper and safe way.
Some things you could be doing that is causing your pain and lead to injury includes:
Lifting too heavy.
Lifting too often.
Improper technique can lead to overcompensation of other parts of your body, leading to injury. Lifting too heavy can result in injury if your muscles are unable to and haven't adjusted to lifting heavy loads yet.
Resting days and even resting between sets is vital in the recovery process which aids in building muscle, and without this, injury is definitely waiting around the corner.
What could be causing your SHOULDER pain IN THE GYM?
Rotator cuff tear:
This occurs when the tendon of one or more of your rotator cuff muscles is torn. The tear can be partial or full thickness and can be acute (lifting something too heavy) or degenerative (stress due to repetition of the same shoulder movements).
A condition where the tendon of your biceps muscle becomes inflamed. This is also caused by overuse, repetitive movements or loads that are too much for the muscle to handle.
Shoulder pain and tenderness.
Signs of local inflammation.
A feeling of weakness.
Subacromial Bursitis occurs when one of the many bursa sacs becomes irritated and inflamed. The cause of this is also overuse or overloading the joint too much.
Shoulder pain with most activities.
Signs of local inflammation.
Note: on shoulder diagnostic ultrasounds, it is extremely common to see an inflamed shoulder bursitis. For this to actually be clinically relevant, it needs to a very large bursitis, not just mild.
Often people have an injection into the bursa, and feel some short term relief, only for their shoulder pain when lifting weights in the gym to return a few weeks later.
This is often caused by a weakness in the shoulder, allowing the ball to move slightly and uncontrolled in the socket, causing rubbing and irritation to the bursa.
Hence, whilst the injection may cause the pain to reduce in the short term, if the underlying strength deficits aren't addressed with specific shoulder strengthening regime via an experienced sports physiotherapist, then the sub-acromial bursitis problem often reappears.
This happens when there is a tear or lesion to the glenoid labrum and the name stands for - superior labrum anterior and posterior. The most common cause in weight lifters is lifting too heavy.
Painful clicking and popping of the shoulder.
Painful overhead movements.
Difficulty turning your shoulder inwards (or pressing your stomach).
How to fix your shoulder pain IN THE GYM With THE HELP OF A PhysioTHERAPIST
As you have probably noticed from a few of the conditions above, many of them present with very similar symptoms, which will make it extremely difficult for you to be able to identify exactly what has happened. The above mentioned diagnoses are also just a few of the more common ones - there are more.
This is why it is so important to make an appointment with your physiotherapist, as we know special tests and examination techniques which can differentiate the conditions.
Taking a break or decreasing your load of lifting weights is an important step in your recovery process.