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WHAT TO DO ABOUT SHOULDER PAIN WHEN WEIGHT LIFTING

 WHAT TO DO ABOUT SHOULDER PAIN WHEN WEIGHT LIFTING


exercise, Labral Tear, labrum, overhead, Rotator Cuff, shoulder, shoulder pain, weight training
SHOULDER PAIN


I have a good friend of mine who is in pretty good shape and has a long history of regular exercise.  Not a meathead by any means, just a guy that likes to workout regularly and stay in shape.  He said recently that he was having pain in his shoulder with bench pressing and that as he lowered the bar, he would get pain and some “popping” in the joint.


The pain and popping limited his power off of his chest, almost making him feel weaker.  He had no specific injury to speak of, and there was not one incident where he felt considerable pain or a “pop.”  He has no pain or issue with any other activities.  Well, what is it and what to do?


 It seems like I post these cases when I never actually get to evaluate the person.  That being said, I would say that about 90% of the time, I can figure out a reasonable hypothesis as to what’s going on and be in the ballpark on how to fix it without having to run to the physician or get expensive tests that may be unnecessary.


 My thought with him is that he has a soft tissue injury in his shoulder, likely the labrum but the possibility exists as well for a rotator cuff strain.  In people who have a long history of weight training, the repetitive motions can cause some degenerative fraying of the labrum in the shoulder.


In fact, it is believed that many football players have asymptomatic labral tears in the shoulder just from attritional wear and tear from engaging opponents and from heavy bench pressing their whole life.  Usually, as long as you are not having constant pain or problems with day-to-day activities (dressing, changing clothes, work duties), then you should leave these alone.  The best thing to do is make modifications in your weight training programs.


 I instructed my friend to do a few things.  First of all, I told him to limit overhead pressing, like the military press.  The main reason I told him to do that is because as he presses overhead, the rotator cuff gets “pinched” between the roof of the shoulder and the humerus.  Over time, that can cause more fraying of the cuff and either worsen the tear or lead to one. Really, it’s an exercise that is steeped in tradition that really isn’t that functional.


 He doesn’t have a job that requires him to lift overhead and he isn’t a professional Olympic weightlifter, so why do it?  There are other options to strengthen those muscles, and I encouraged him to do lateral and front raises with dumbbells.  Secondly, I told him that when doing bench press, push ups, or incline bench press to avoid letting the elbows drop below midline as he lowers the bar (midline being where your elbow meets your trunk).

 

 As you drop below midline, it causes more stress to the front of the shoulder and the labrum and can further irritate the shoulder.  Using the golf ball and tee analogy of the shoulder, when the elbow drops below midline, the “ball is starting to roll off the tee”.  Because of this, it places unnecessary and potentially damaging stress on the anterior shoulder soft tissues.

   

The more you let “the ball roll off part of the tee”, the labrum can fray or have microtears that lead to a full tear.  Ways to ensure that you stay above midline are to roll up a towel and place it on your chest and touch that with the bar as you lower it as opposed to touching your chest.  Or, he can just avoid going all the way to his chest.  Amazing how just that little extra motion can cause so many problems.


 I am happy to say that he is pleased with these modifications and now has no pain or popping in his shoulder when he lifts.  He has resumed his normal training and has reduced the amount of overhead activity that he was doing previously.

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