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By Anthony Pribila, PT, DSc, CMPT, CMP, CEAS
The shoulder is the most mobile joint in the body and frequently prone to injury during weight training. Unfortunately, the shoulder’s incredible mobility is sacrificed for stability, making injury a possibility. Shoulder injuries frequently result from sports that involve excessive sudden resistance and repetitive overhead motion, such as swimming, tennis, baseball, and weightlifting. With the rise in popularity of intense cross-fit style workouts, shoulder injuries are becoming more prevalent. Injuries can even occur during everyday activities such painting, cleaning, hanging curtains, and gardening.
Warning Signs of a Shoulder Injury
If you start experiencing shoulder problems, answer these questions:
Are you experiencing shoulder pain?
Are you feeling shoulder stiffness? Is this limiting mobility?
Does it feel like your shoulder could pop or slide out of the socket?
Are you experiencing shoulder weakness causing limitations with daily activities?
If you answered “yes” to any one of these questions, you should consult your physician and physical therapist for an examination.
No Pain all Gain
When it comes to avoiding shoulder injuries in weight training, it’s all about executing movement with proper biomechanics and not sacrificing form for weight. This can overstress the shoulder and result in rupture of ligaments, tendons, labral tears and injury to the shoulder capsule.
Although rotator cuff injuries can happen with any exercise, they most commonly occur during dips, a clean and press, bench pressing and overhead (military) pressing. Not that you should completely omit these lifts, but just make sure your form is on target, such as keeping your elbows at an angle in front of your body instead of directly out to the sides when you’re pressing. Going too wide will allow you to press more weight but add additional stress to your rotator cuff. The common report I often hear is how the individual lost control during an exercise due to fatigue resulting in sacrificed form causing compensation and stress to the rotator cuff causing a tear. We also recommend our client’s avoid behind the neck pressing and lat pulldowns due to stress on the A/C (acriomioclavicular) joint. Close grip upright rows and side laterals with a thumbs down position are other exercises that can lead to a sudden or gradual injury. We often recommend client’s focus more on dumbbell work and even try a neutral grip with any overhead pressing motion.
Determining dysfunction
A sports medicine doctor or physical therapist is your best bet for evaluation of shoulder issues once they occur. When looking to prevent shoulder injuries a physical therapist skilled in sport medicine and movement screening should be your first choice. A functional movement screen (FMS) or selective functional movement assessment (SFMA) is a great examination for those looking to minimize potential injury, recover faster and prevent re-injury. Movement screenings are a comprehensive break down of the movement dysfunction which can be treated accordingly. At Therapeutic Rehab Specialists we often perform these screenings on adults and children participating in sports pre-season and even recommend a 1-2x a year check up for injury prevention.
A full examination consists of evaluating range of motion, strength, posture, palpation of tissue for pain and trigger points, biomechanics, spinal function, neurological screening and special testing for tissue compromise. During examination it is crucial to evaluate the scapulothoracic region for proper mechanics. After all, this joint is responsible for up to 1/3 of overhead arm elevation. The scapulothoracic joint is not a true anatomic joint but an area composed of the acromioclavicular and sternoclavicular joint articulations. In countless patients with shoulder injuries we often find neuromuscular or joint dysfunction related to movement of the scapulothoracic joint and/or dysfunction of the thoracic spine, rib (costo-sternal, costovertebral) and A/C and S/C joints.
A Plan of Action
While weightlifters often train the large muscle groups such as the deltoids, pecs, upper traps and lats, they often overlook smaller support muscles such as internal/external rotator cuff muscles, mid and lower traps, rhomboids, levator scapula, serratus anterior and pec minor. While it is best to rest after an injury to decrease acute inflammation and pain, the next step is to regain range of motion and joint mobility and then start strengthening weakened areas. This can be done through minimizing painful exercises and making modifications to an exercise routine through altering positioning, decreasing weight on exercises and even changing to static contraction exercises while recovering.
A skilled physical therapist will evaluate your shoulder, free up stiff joints, improve mobility, improve your strength and modify your exercise program and bring back neuromuscular balance into your life. Therapeutic Rehab Specialist’s therapists are certified in movement screening and manual therapy. Call us today at (813) 876-8771 whether you already sustained a shoulder injury requiring physical therapy care or are looking to prevent injury by completing a physical performance evaluation.
Therapeutic Rehab Specialist
Brandon
Physical Therapy Office
1129 Professional Park Drive
Brandon, FL 33511
813-876-8771
Lakeland
Physical Therapy Office
1826 N. Crystal Lake Drive
Lakeland, FL 33801
813-876-8771
Pinellas Park
Physical Therapy Office
6231 66th Street North
Pinellas Park, FL 33781
727-470-6070
