Shoulder pain is one of the main reasons people come into clinic and can be very debilitating and affect your gym workouts. We treat a lot of clients who go to the gym so we have a solid insight into gym injuries. At worse you may have to stop doing weights completely and let the injury rest. Finding out exactly what is wrong with your shoulder is important in understanding how to best treat it. When this is known you can then know exactly what you can do in the gym without aggravating your pain also improving your form.
These are the most common injuries we see in clinic in order of frequency:
1) Shoulder impingement.
A shoulder impingement is a broad term for shoulder pain that gets worse when you raise your arm generally beyond 90 degrees. Most commonly pain can occur through a painful arc of 90-120 degrees where either the supraspinatus tendon (rotator cuff), joint capsule, bursa, ligament or biceps tendon can get pinched under the acromion (side of the shoulder blade). Generally if you are told you have a shoulder impingement it will be the Supraspinatus tendon.
Causes can include repetitive pushing motions like push ups, bench press, over head press. Often the reason these actions cause pain is due to instability in the shoulder girdle, muscle imbalances (tightness in the pectoralis major and minor pulling the scapula forward, weakness in the stabilises and the rhomboids mid trapezius), winging scapula or poor posture.
Having good form, setting the shoulders and making sure the shoulder doesn't come forward when lifting is important as this forward movement of the shoulder means that the humerus comes into a position where the tendon can get pushed up against the acromion of the shoulder.
Posture sitting at the desk will also contribute to your shoulder impingement as if your shoulders are forward and rounded it means when you lift your arm above your head your humerus will pinch against the acromion. Try this yourself. Slump your shoulders forward and then try to lift your arm above your head, out to the side or out in front. You should notice that you feel a pinching in the shoulder. This is an example of if your shoulders are forward and you are lifting weights above your head you will be constantly pinching the tendons and other soft tissues against the acromion.
Stretching out the chest, focussing on having the shoulders set (back and down) as well as working on shoulder stability exercises will be your best bet in recovering from shoulder impingement and also preventing yourself from getting there in the first place.
As we age the acromion can become hooked which means that the bone will close
2)Rotator cuff tear
A tear in the rotator cuff tendon can cause pain in the shoulder. Generally this pain can be felt in the side/back of the shoulder joint. A tear in the rotator cuff muscles can be caused by trauma such as falls onto the outstretched arm or shoulder. Over use or heavy weights with poor form can also cause a tear. Usually you will feel the shoulder “go” when lifting something heavy. Generally this will be felt as a dull ache in the back/side of the shoulder with pain in movements above the head or any rotation of the shoulder. If a shoulder impingement goes untreated then it can lead to a tear in the supraspinatus tendon.
Improvement of posture, form, stability of the shoulder and releasing tension in the soft tissues can help this injury recover.
3) Long head biceps tendonitis