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Shoulder Injuries: Treatment and Prevention of This
Common Weight Lifting Malady
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.
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Lets first take a look at the
anatomy of the shoulder so we can better understand what were 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.
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Common
Injuries
The first
factor to assessing your shoulder problem is whether the injury is actually
located in the shoulder or neck. Thats 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.
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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. Lets 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.
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What Do You Do?
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For the severe injuries which involve a
popping sound, see your sports chiropractor, osteopath or orthopedic doctor
as soon as possible.
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Working through these types of injuries can
jeopardize your future lifting and isnt worth it. Recognize the value of rest
and schedule your workout to minimize excessive overuse to the anterior
shoulder.
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Dont 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.
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Get in the habit of putting ice on the
shoulder after your chest and shoulder workout to decrease inflammation and
manage muscle trauma.
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Warm-up and cool-down properly with
stretching to the shoulder.
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