How to deal with mild weight lifting related shoulder pain

April 11, 2010 7:13 AM

I'm experiencing moderate tenderness in my right shoulder from weight lifting. There's clicking and what feels like tendon snapping but no severe or deep pain. Still, I know this is a sign that things could get much worse. What is the right strategy from here on out?

I'm wondering when I should begin a shoulder strengthening routine, how much rest is necessary, and if I must discontinue some basic upper body weight exercises like push ups, pull ups, and dips.

Of course I'm anxious to return to the gym but I certainly do not want to make this problem any worse. Any advice is appreciated.

posted by mizrachi to Health & Fitness (9 answers total)

IANAD, much less YD. I don't think you need an actual doctor, but a physical therapist would be a wise choice, and they'll know if you need a doctor. It sounds like you've done a bunch of strength training already - if what you're feeling is unusual, it's probably a bad sign. See a medical professional.
posted by contrarian at 7:22 AM on April 11, 2010 [1 favorite]

You definitely need to go to a physical therapist - I did a co-op placement in a physiotherpist clinic, and don't remember enough nor am I qualified enough to offer you any kind of medical advice, but I can tell you this - it's quite a relatively common problem amongst people who do heavy lifting, weight lifting or other repetitive shoulder movements, and if left untreated can require surgery.

The solution isn't just about strengthening your shoulder either. What the physio needs to diagnose is whether it's a strength problem, or whether it is your tendon getting caught on your shoulder bone or rotator cuff.

A doctor can give you a referral if you can't find one on your own.
posted by scrute at 8:01 AM on April 11, 2010

I am not a doctor, but I am a lifter. I disagree that you definitely need to go to a physical therapist. Sometimes joints pop and click. A noisy joint is not necessarily an injured joint. If you have a sudden pain while lifting, that's an injury. Shoulder problems are common in guys who do a ton of bench-pressing but neglect to do any overhead work, as is popular these days. The appropriate amount of volume and rest, and exercise selection will depend on your level of training advancement and your goals. If you posted your program, I might be able to tell you if there's something wrong with it that could cause injury.
posted by ludwig_van at 8:37 AM on April 11, 2010 [2 favorites]

I'd actually advocate doing more push ups, pull-ups (you alternate between palm out/palm in pull/chin ups, right?), and dips as they work a lot more muscle groups than stuff like bench press, curl, skull-crushers. Like ludwig_van says, add more overhead stuff.

Are you doing high intensity, low rep? It might make more sense to do lower weight, increased repetitions in order to work on your form for a while. Alternate between the two.

Since you go to a gym, are there any trainers there you can hit up with your situation? Improving your form (and working on complex muscle groups instead of focused ones) might just be the solution.
posted by porpoise at 8:45 AM on April 11, 2010

Response by poster: There was no sudden onset of pain...in fact there is really very little pain if any at all...but, as I mentioned, there is certainly a kind of tenderness that I'm not used to, and there's popping, which is not the typical joint grinding but feels more like the tendon is getting caught up on the bone. I can feel and hear the snap of the tendon if I swing my arm in a backstroke motion. But, again, I don't really hurt. It feels more mechanical in nature, perhaps an alignment issue rather than a tear or a deeply injured rotator cuff.

I suspect this tenderness is the result of curling too heavy a weight, which led to improper form, and to squatting while holding a 25 lb plate at arms distance. I'm also guessing my delts are not as strong as they should be. But, I've also recently increased my pull ups and push ups, though I'm not sure this would lead to a shoulder injury.

I will rest the shoulder and reevaluate and make an appnt. with a PT. But, if the tenderness abates, can I at least resume push ups and pull ups?
posted by mizrachi at 8:51 AM on April 11, 2010

This happened to me once when I focused too much on isolation exercises. I ended up straining one part of my shoulder and experienced the symptoms you describe. Solved it by doing lots of compound shoulder stuff, particularly overhead presses.
posted by teedee2000 at 9:30 AM on April 11, 2010

What you describe happens to me, too-- and I'm a smaller female who doesn't do much heavy upper-body stuff. When I do the "backstroke" movement with my arm, there is that same feeling of tendon "popping" across the bone/joint. If I throw my arm up straight away from my side, it almost feels like the joint itself is "popping" back into place. It's only a dull ache until I try to sleep on my side, and then it's pretty intense.

It happens every three or four months for me. It always just resolves itself within 2-3 days. Just another data point.
posted by mireille at 10:07 AM on April 11, 2010

How's your joint mobility? Do you have any idea? Here's a quick test: can you straighten your arms over your head and see your ears without arching your back? Another quick test: Can you do a full wall slide? If not, you probably need to work on your shoulder mobility a bit. Here's a decent list of things to do for thoracic mobility. If nothing else I would get on a foam roller and roll the hell out of your upper back and shoulder area.
What you should not do is simply stop exercising that area. Rest and ice it for 24 hours if you want, but after 24 hours start moving it through some exercises. As long as they don't hurt when you do them, and you don't feel any injury (as opposed to simple muscle soreness) pain 24 hours later, they are probably fine to do.
A mildly sore shoulder does not need a PT or a doctor, but it's never too early to pay attention to your mobility.
posted by ch1x0r at 2:01 PM on April 11, 2010

Slight injuries are gone after a couple of days to a couple of weeks. You'll be able to tell that they aren't anything to worry about by way of a decreasing feelings of "pain".

I can feel and hear the snap of the tendon if I swing my arm in a backstroke motion.

Yeah, don't do that. It may look like it, but your shoulders don't actually have a 360 degree range of motion.

I suspect this tenderness is the result of curling too heavy a weight, which led to improper form, and to squatting while holding a 25 lb plate at arms distance. I'm also guessing my delts are not as strong as they should be. But, I've also recently increased my pull ups and push ups, though I'm not sure this would lead to a shoulder injury.

It's doubtful it would be from curling, or that you would feel it in your shoulder area if you did something wrong while curling. If anything is causing you shoulder problems it is because you are doing to many pushing exercises (Push Ups or Bench Pressing) and not enough pulling exercises (Rows). Pull Ups don't balance out Push Ups as well as people think.

The problem with going to a doc or PT is that they often will diagnose it blindly as something when it isn't. Of course that will depend on who you see and how good and knowledgable they are.

But it doesn't sound like you have any actual pain, just worried about something that sounds normal. So you should be fine to start including some shoulder exercises.

Here is a quick way to find out if you have internally rotated shoulders and if your rotator cuffs are in danger or stressed.
Go ahead and stand up as you would in a relaxed neutral position. Now look down. Where are your hands at in relation to hips/side of your legs. If your thumbs point out from your hands which way do they point? Across your body or forward? Now move your awarness to your upper back and shoulders. Are they slumped and "forward"? Pull them back. Now how do your hands sit? As you incorporate new exercises into your workout, try this out every once in awhile and try to be aware of how your shoulders sit.
I've seen "healthy" young guys with a fully rounded upper back with their hands fully resting on the front their thighs, and then they mention shoulder problems. It's kind of a no brainer when you see this.
posted by P.o.B. at 3:52 PM on April 11, 2010 [1 favorite]