Dr. Thomas Krueger, D.C., C.C.S.P.

Shoulder injuries are one of the most common injuries faced by weight lifting and exercise enthusiasts. Each year approximately four million people seek medical attention for a shoulder sprain, strain, dislocation or other problem. These problems stem from a variety of causes – from sports activities involving excessive overhead motions to daily activities like washing walls or painting. The activity we will take a look at in this article is weight lifting. More specifically, what are the common injuries, how to avoid them and what to do when you become the victim of a shoulder injury.

Let’s first take a look at the anatomy of the shoulder so we can better understand what we’re up against. The shoulder is a complicated joint designed to allow for maximum mobility. In actuality, it is four joints or articulations: glenohumeral, acromioclavicular, sternoclavicular and scapulothoracic. The main muscles associated with the shoulder girdle include the following: the trapezius, the latissimus dorsi, pectoralis major, serratus anterior, deltoid, biceps, triceps and the rotator cuff. The muscles of the rotator cuff include the surpraspinatus, infraspinatus, teres minor and subcapularis muscle. The primary function of these muscles are to stabilize the head of the humerus in the glenoid fossa. The major supportive ligaments of the shoulder include: the acromioclavicular, coracoclavicular, sternoclavicular and the anterior capule. The head of the humerus (proximal arm bone) fits in the glenoid fossa which is lined by a soft fibrous tissue rim called the labrum. The labrum deepens the fossa, hence, increasing the stability of the glenohumeral joint. Because of the increased mobility of the shoulder complex, there is a trade off in overall stability. To complicate matters more, the brachial plexus and brachial artery may also be involved in a shoulder injury.

Common Injuries

The first factor to assessing your shoulder problem is whether the injury is actually located in the shoulder or neck. That’s right, trauma or injury in the cervical spine can result in a referred pain in the shoulder. In many cases this type of injury will cause pain in both shoulders. Rotation of the neck or side flexion may often increase the symptoms.

One of the most common injuries to the shoulders is called impingement syndrome. This is caused by excessive rubbing of the supraspinatus tendon and the acromion. The overlying bursa will often become swollen, also resulting in the impingement syndrome. Frequently this pain is worse at night and interferes with sleep. If the aggravation continues, bone spurs can develop and surgery may be required.

Another common problem with the shoulder is a subluxuation. This type of injury usually involves a distinct “popping” sound. Keep in mind that any of the joints in the shoulder can become subluxated. This type of injury consists of a disarticulation (the bone is out of alignment) which results in the adjacent muscles becoming weakened. If left untreated, this type of injury can result in further injuries in the shoulder due to an asymmetrical motion pattern. Have you ever noticed your workout partner dropping one elbow more than the other? This could be due to compensation from an old injury.

Other common injuries to the shoulder include bursitis (inflammation of the lubricating sacs) and sprain/strain type injuries. These injuries are common because the shoulder joint never really gets a break. Let’s face it, the shoulder gets blasted indirectly on biceps, triceps and chest workouts, not to mention the primary work it gets on your shoulder workout day. (Recommendation: Insure at least one day of rest between shoulder day and chest/back day.) A common chronic injury many surgeons see in weight lifters is inflammatory acromiclavicular arthritis. This may progress to resorption (degenerative change) of the distal end of the clavicle.

What do you do?

1.  For the severe injuries which involve a “popping” sound, see your “sports” chiropractor, osteopath or orthopedic doctor as soon as possible.

2.  Working through these types of injuries can jeopardize your future lifting and isn’t worth it. Recognize the value of rest and schedule your workout to minimize excessive overuse to the anterior shoulder.

3.  Don’t ignore the posterior compartment of the shoulder. Train the rear deltoid, lower trapezius and rhomboid musculatures. Perform your pressing movements properly utilizing the lats and rhomboid musculature as stabilizers. This will minimize the incidence of shoulder injuries.

4. Get in the habit of putting ice on the shoulder after your chest and shoulder workout to decrease inflammation and manage muscle trauma.

5. Warm-up and cool-down properly with stretching to the shoulder.