November 6, 2024
As we head into the warmer months, many of us in the southern hemisphere are putting in the final touches on our fitness routines, ready to reveal the summer bodies we’ve been working on all winter.
Weightlifting has become an increasingly popular form of exercise, and for good reason. It offers numerous benefits, such as:
- Building muscle, strength, and endurance
- Boosting metabolism, which supports fat loss
- Maintaining healthy bone density
- Enhancing mental well-being and self-confidence
However, despite its many benefits, weightlifting can sometimes lead to shoulder pain, a common issue we see among our patients at Beachside Physiotherapy. Before exploring the causes of this discomfort, let’s dive into the structure of the shoulder and understand how it functions.
The Shoulder Complex
The shoulder is a highly mobile but complex joint that comprises three main bones: the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). Together, they form four critical joints:
- Glenohumeral Joint – where the humerus meets the scapula
- Acromioclavicular Joint – where the acromion (a part of the scapula) connects with the clavicle
- Sternoclavicular Joint – linking the sternum (chest bone) and the clavicle
- Scapulothoracic Joint – between the scapula and the rib cage
The head of the humerus fits into a shallow socket on the scapula known as the glenoid fossa. While this setup allows for a remarkable range of motion, it also means the shoulder joint is less inherently stable, relying on various structures to keep it secure during movement.
To support and stabilise the shoulder joint, several structures work in harmony:
- Ligaments – add stability and restrict excessive or harmful movement.
- Joint Capsule – a fibrous covering that encloses the shoulder joint.
- Synovial Membrane – lines the joint capsule’s inner part, producing synovial fluid that lubricates the joint.
- Synovial Bursae – fluid-filled sacs that cushion and reduce friction between structures like tendons and bones.
- Rotator Cuff Muscles – a group of muscles that stabilise the shoulder, allowing it to perform a range of motions with strength and control.
Understanding these components is essential to identifying the causes of shoulder pain during weightlifting and finding ways to prevent or alleviate it.
Shoulder Pain When Lifting Weights in the Gym
Weightlifting is a fantastic way to build strength, but it also places a significant amount of stress on the muscles, tendons, and ligaments in your shoulders. While we know weight training can offer immense benefits, it’s crucial to ensure it’s done with proper form and adequate recovery to avoid injuries.
Here are some common mistakes that might contribute to shoulder pain and increase the risk of injury:
- Improper Technique – Poor form can lead to muscle imbalances and overuse of other areas, increasing the risk of injury.
- Lifting Too Heavy – Lifting more weight than your body is accustomed to can strain your muscles and connective tissues, particularly if they haven’t had time to adapt.
- Inadequate Rest – Rest days and recovery time between sets are vital to help your muscles rebuild and grow stronger. Without sufficient rest, injuries are far more likely.
Let’s explore some potential causes of shoulder pain commonly seen among weightlifters.
What Could Be Causing Your Shoulder Pain in the Gym?
Rotator Cuff Tear
A rotator cuff tear occurs when one or more of the tendons in the rotator cuff muscles are damaged. This can range from a partial tear to a full-thickness tear and can occur acutely (e.g., lifting a weight that’s too heavy) or due to wear-and-tear from repetitive shoulder movements.
Common Symptoms:
- Pain at rest or during the night
- Pain with shoulder movements
- Weakness in the affected arm
- Shoulder stiffness
Rotator Cuff Tendinopathy
Rotator cuff tendinopathy is often caused by repetitive shoulder movements, leading to inflammation (tendinitis) and gradual degeneration of the tendons over time. This overuse injury is common among weightlifters, especially when form or recovery is overlooked.
Symptoms of Rotator Cuff Tendinopathy:
- Pain in the shoulder and outer part of the upper arm
- Discomfort with overhead activities
- Difficulty lifting the shoulder forward or to the side
- Localised swelling
- Gradual weakness in the shoulder
Impingement
A common type of shoulder impingement seen in weightlifters is subacromial impingement, which occurs in the space beneath the acromion (part of the shoulder blade). This condition is often triggered by movements that reduce the space within the shoulder, causing pinching of the tendons or bursa.
Symptoms of Shoulder Impingement:
- Pain in the shoulder, especially with movement
- Pain when reaching behind the back or lifting the arm overhead
- Discomfort when lying on the affected shoulder
- Weakness in the affected arm
Biceps Tendinitis
Biceps tendinitis occurs when the tendon of the biceps muscle becomes inflamed, often due to overuse, repetitive motions, or lifting loads beyond the muscle’s capacity. This condition is frequently seen in weightlifters who may be pushing their limits too quickly without proper rest.
Symptoms of Biceps Tendinitis:
- Shoulder pain and tenderness
- Local signs of inflammation
- Sensation of weakness in the shoulder area
Subacromial Bursitis
Subacromial bursitis happens when one of the shoulder’s bursae (fluid-filled sacs that cushion and reduce friction) becomes irritated and inflamed. Overuse or excessive load on the joint can trigger this condition.
Symptoms of Subacromial Bursitis:
- Shoulder pain during most activities
- Stiffness in the shoulder
- Local inflammation
It’s common to detect mild bursitis in shoulder diagnostic ultrasounds; however, for the condition to be clinically significant, the inflammation typically needs to be pronounced. Many people experience short-term relief from injections in the bursa, but without addressing underlying strength issues, the pain often returns. Weakness in the shoulder muscles can cause instability in the joint, allowing the humeral head to move excessively, irritating the bursa. Thus, a targeted shoulder-strengthening program, guided by a qualified physiotherapist, is essential to prevent the recurrence of subacromial bursitis.
SLAP Tear or Lesion
A SLAP tear involves damage to the glenoid labrum, specifically in the area known as the superior labrum anterior and posterior (SLAP). This injury often occurs in weightlifters due to lifting weights that are too heavy.
Symptoms of a SLAP Tear:
- Painful clicking or popping in the shoulder
- Pain with overhead movements
- Difficulty turning the shoulder inward or pressing against the stomach
- Weakness in the shoulder
How to Address Shoulder Pain in the Gym with Physiotherapy
Many shoulder conditions present with similar symptoms, making it difficult to pinpoint the exact cause of pain. This is where a physiotherapist can play a crucial role. Physiotherapists have specialised assessment techniques to distinguish between various shoulder conditions, ensuring accurate diagnosis and targeted treatment.
An initial step in recovery is to reduce your lifting load or take a short break from weightlifting. Proper rest, combined with a physiotherapy-guided rehabilitation program, is key to a full recovery. At Beachside Physiotherapy, we’ve helped many patients manage shoulder pain with a combination of:
- Range of Motion Exercises and Stretches – to improve flexibility and reduce stiffness
- Strengthening Exercises – to target shoulder and scapular muscles
- Mobilization Techniques – to enhance joint mobility
- Taping – for support and pain relief
- Technique Assessment – to adjust lifting form and avoid future injuries
- Personalized Home Exercise Program – tailored to your specific injury and daily routine
By working with an experienced physiotherapist, you can ensure that your shoulder gets the care it needs, allowing you to get back to weightlifting safely and confidently.
