Weightlifter shoulder, also known as distal clavicular osteolysis, is a common condition among weightlifters. It is typically treated with rest, ice, anti-inflammatory drugs, and physical therapy. Surgery is usually reserved for cases where pain persists.
Here, I will discuss a weightlifter’s shoulder, its diagnosis, treatment, and prevention.
What is a Weightlifter’s Shoulder?
Weightlifter’s shoulder is a common condition. It occurs when the distal end of the clavicle (the bone that connects the scapula to the clavicle) undergoes osteolysis.
Osteolysis is a process where the bone loses density and becomes weaker over time.
Weightlifter’s shoulder primarily affects the acromioclavicular joint (the AC joint), which is a vital joint for shoulder movement and stability. If left untreated, it can lead to serious long-term consequences.
You can’t stress enough how important shoulder health is for weightlifters. Once you understand how this condition develops, you can take steps to avoid it.
Anatomy of the Shoulder
The shoulder is a complex structure that consists of several bones, including the scapula (shoulder blade), humerus (upper arm bone), and clavicle (collarbone). The AC joint, which is primarily affected by a weightlifter’s shoulder, plays a vital role in shoulder movement and stability.
Ligaments such as the coracoclavicular ligament and the AC joint capsule help to maintain stability.
To maintain stability and prevent injury, you need strong rotator cuff tendons. The rotator cuff is a group of four main muscles and their tendons that stabilize the shoulder joint and allow for a wide range of motion.
Causes of Weightlifter’s Shoulder
Chronic inflammation from repetitive stress around the shoulder joint is the most common cause of weightlifter’s shoulder.
Weight training and heavy lifting can also cause a weightlifter’s shoulder, which is often accompanied by distal clavicular osteolysis.
Overuse injuries and repetitive trauma from heavy lifting are usually the cause.
- Excessive pull on the clavicle: This can happen during heavy lifts, especially if you’re not using proper form.
- Micro fractures: Repetitive stress from weightlifting can cause micro fractures and bone dissolution.
- Chronic inflammation and scar tissue: The changes in tissue that happen with a weightlifter’s shoulder often involve chronic inflammation and fibrosis.
If you leave these injuries untreated, they can escalate into degenerative joint disease. Therefore, it’s wise to address shoulder pain early and tweak your weightlifting techniques to avoid further damage.
Symptoms to Watch Out For
You may notice some common symptoms of weightlifter’s shoulder, like chronic inflammation and varying degrees of shoulder pain. The pain can start as a dull ache but can progress to sharp pain in the front of your shoulder.
Symptoms get worse over time, especially during weightlifting, and can be more uncomfortable after your workouts.
Here are the specific symptoms to watch out for:
- Dull pain: This is usually the first sign and can be felt during or after lifting.
- Sharp pain: As the condition progresses, the pain can become more intense and localized.
- Increased discomfort: Activities like bench press and overhead lifts can exacerbate the pain.
Weightlifter’s Shoulder Diagnosis
Diagnosing a weightlifter’s shoulder involves a thorough medical history and physical examination. Your doctor will move and feel the sore joint to assess pain and movement during the exam.
Methods used to diagnose this condition include physical examination and imaging tests like X-rays, which help assess bone density and detect issues like distal clavicular osteolysis.
If your shoulder pain persists for more than a few days, see an orthopedic specialist who can identify the source of the pain and start conservative treatment.
An orthopedic expert should evaluate shoulder injuries from falls or heavy lifting for proper diagnosis and treatment.
- Physical examination: This assesses pain, movement, and any abnormalities in the shoulder joint.
- Imaging tests: X-rays and other imaging tests will give you a clear picture of the bone structure and will detect any conditions.
Insider Tips: Limited mobility can be a big problem, so early evaluation is key to prevent further damage.
Conservative Treatment for Weightlifter’s Shoulder
Once you’re diagnosed with weightlifter’s shoulder, stop lifting and rest the joint. Recommended conservative treatment is to stop weightlifting, ice the area, and take anti-inflammatory medications.
These are usually effective and should be tried before surgery.
You can manage pain with ibuprofen and corticosteroid injections and physical therapy to strengthen your shoulder and improve its range of motion.
In most cases distal clavicle osteolysis can heal on its own, so conservative treatment is key.
#1 Rest and Activity Modification
Your recovery depends on resting your shoulder and modifying your activities. Ice the area after workouts to reduce pain. Avoid sleeping on the sore side during your recovery.
Limit shoulder extension exercises during this time to prevent injury. You can modify your bench press by using a closer hand placement or stopping higher above your chest to avoid shoulder injuries.
#2 Physical Therapy
A physical therapist can create a personalized program to strengthen your shoulder stability and mobility. Physical therapy will help you gradually return to activities without risking a relapse.
Blackburn exercises can strengthen your shoulder and prevent weightlifter’s shoulder from recurring.
Physical therapists can give you advice on how to modify your activities and create training plans to minimize the risk of re-injury.
#3 Anti-Inflammatory Medications
Corticosteroid injections can treat inflammation in a weightlifter’s shoulder. These injections will reduce inflammation and pain. Pain relief from a steroid injection into the AC joint will even confirm the source of your pain.
Ibuprofen and other anti-inflammatory meds will help with chronic inflammation and pain. Combine with other conservative treatments like physical therapy and rest.
Take Note: You shouldn’t use these medications without consulting your doctor or having a prescription. I strongly recommend getting your doctor’s advice before using them.
( Never use it directly)
Surgical Options for Chronic Pain
Sometimes conservative treatments just don’t work, and you may need to consider surgery for that chronic pain.
One common procedure is distal clavicle excision, where they remove the painful end of the clavicle. This can be done openly or arthroscopically through small holes.
And there’s another procedure where they transfer a ligament from a nearby area after cutting the clavicle during surgery.
Of course there are risks such as muscle injury, prolonged bleeding, infection, and clavicle fracture, but the benefits can be huge: pain relief and return of shoulder function.
1. Distal Clavicle Resection
In fact, distal clavicle resection is a procedure where they remove the end of the clavicle that’s commonly involved in weightlifter’s shoulder. They can do it open or arthroscopically through small holes. Of course, as you can see, they may also repair any soft tissue that’s torn during surgery.
By the way, they can transfer the coracoacromial ligament over the cut bone to stabilize the joint. This procedure is done to relieve pain and get you back to your activities without discomfort.
2. Arthroscopic Surgery
Now that we’re talking about options, arthroscopic surgery is a minimally invasive procedure that can treat many shoulder conditions, including distal clavicular osteolysis. It uses small instruments and a camera to do surgery through small holes, which means shorter recovery time and less scarring.
Because of this, arthroscopic surgery has less postoperative pain compared to open surgery. Good for weightlifters who want to get back to training ASAP.
Rehabilitation After Treatment
Anyway, rehabilitation is important after a weightlifter’s shoulder treatment. You’ll often hear that relative rest is recommended to reduce shoulder stress during recovery.
The goal of nonsurgical rehabilitation is to gradually eliminate those painful symptoms until you’re pain free.
Most people can go back to their normal activities within a week after surgery.
In fact, weightlifters can start training as early as 3 days post-op and be fully back to it by the end of the week.
Non-surgical Rehabilitation
At the beginning of your recovery, gentle shoulder shrugging and passive range of motion exercises are usually on the agenda.
Most people can start active range of motion exercises within 5-7 days post-injury. Light resistance exercises with elastic bands can start as early as the 2nd week of therapy.
A physical therapist will be your guide, will help design a training program, and give you specific advice on how to modify activities.
This way you can gradually get back to normal activities without aggravating your symptoms and have a smooth recovery.
Post-Surgery Recovery
Now recovery from shoulder surgery for a weightlifter’s shoulder takes about 6-8 weeks. Many can get back to normal activities within a week post-op; some can even get back to weight training as early as 3 days post-op.
Post-op pain relief helps weightlifters return to their pre-surgery lifting levels. Plus, since arthroscopic surgery is minimally invasive, it usually means shorter recovery time.
Ways to Prevent Weightlifter’s Shoulder Pain
Preventing a weightlifter’s shoulder injury is key to a long weightlifting career. By following these, you can reduce the risk of shoulder pain and injuries.
The acromioclavicular joint is the most prone to injuries, especially for those who lift overhead. A balanced training program and not overtraining can keep those shoulder injuries away.
Proper Technique
Narrowing your hand spacing on barbells can really reduce shoulder stress.
Ending your bench press 2 inches above your chest can also reduce stress on the shoulder joints. Modifying lifts like power cleans or power jerks can make lifting safer and injury-free.
Start each training session with a proper warm-up, and regularly refine your technique; this is key to healthy shoulders. This will help you modify your weightlifting technique to prevent weightlifter’s shoulder and related injuries.
Balanced Training
Doing 2 back exercises for every pressing exercise will maintain muscle balance. This will not only provide stability but also prevent imbalances that can lead to shoulder injuries.
In fact, variety in your weight training will ensure all muscle groups are developed equally, reducing the risk of overuse injuries. This balanced approach is all about healthy shoulders and athletic performance.
Adequate Rest and Recovery
Giving yourself time between training sessions is key to preventing overuse injuries in the shoulder.
In extreme cases you might need 6-12 weeks of rest to fully recover. Adequate recovery time after intense workouts will allow your muscles to heal, which is key to preventing shoulder injuries.
If you feel any pain during a lift, stop and take a break to prevent further injury.
See an orthopedic specialist.
It’s a smart move if you have persistent shoulder pain or injuries. Orthopedic specialists can diagnose the source of your pain and start conservative treatment.
They will explore all conservative treatment options before surgery.
During the consultation the specialist will do a physical examination and may order imaging tests to get a clear picture of your shoulder joint.
Bottom Line
Weightlifter’s shoulder pain is a common condition that can affect your performance and quality of life. Conservative treatment like rest, physical therapy, and anti-inflammatory medication will do the trick, but surgical options are there for persistent pain.
