Lifting weights has many benefits which include improving cardiovascular health, bone density, metabolism, and restoring muscle lost with aging (1). The pump of a strong weightlifting session can make the obstacles and challenges of life manageable. Unfortunately, you can also develop shoulder pain from lifting weights. Why does my shoulder hurt when lifting weights? What helps shoulder pain from lifting weights? What muscles are the rotator cuff? How do I know if I tore my rotator cuff? Let’ dig in.
Why Does My Shoulder Hurt When Lifting?
There are multiple causes of shoulder pain from lifting weights which include:
Bursitis
A bursa is a fluid-filled sac that minimizes the friction of tendons and ligaments as they move across boney surfaces. Inflammation of the bursa is called bursitis. The subacromion-subdeltoid bursa (SASD) is a large bursa in the shoulder that is prone to inflammation and is a source of shoulder pain (2).
Rotator Cuff Injury
The rotator cuff is a group of four tendons that stabilize the shoulder and enable its wide range of motion. Repetitive overhead lifting and forceful pulling motions can overload and injure the tendons of the rotator cuff with resulting pain. Acute inflammation of the tendons is called tendinitis (3) whereas tendinosis is when there is chronic degeneration and microtears in the tendon. Rotator cuff tendons can also tear. There are three types of tears: partial thickness, full-thickness, and full-thickness with retractions. The most common treatment for a rotator cuff tear that doesn’t respond to physical therapy is surgery. Unfortunately, the analysis of eleven high-level research studies has demonstrated that surgery is not better than physical therapy in restoring function (4). At the Centeno-Schultz Clinic, we demonstrated that bone marrow-derived stem cells are an effective treatment for rotator cuff tears (5). To learn more about rotator cuff injuries and the five compelling reasons to consider stem cell treatment instead of surgery, please click on the video below.
AC Joint Inflammation and Instability
The acromion clavicular joint is where the collar bone (clavicle) meets the boney prominence from the scapula called the acromion. The AC joint allows the transmission of forces through the collarbone and enhances the range motion for both the arm and thorax. AC joint injuries account for more than 40% of all shoulder injuries (6). Injuries can occur with weightlifting. Pain is typically on the superior portion of the shoulder and aggravated with overhead and cross arm movements.
Poor Form
Weight lifting, when performed correctly, has a large number of benefits. The head, rib cage, and pelvis all need to be in alignment. Unfortunately, when performed incorrectly without strict adherence to form, injuries can occur which include shoulder pain. If you are new to lifting get a trainer or gym that is committed to proper form. Your body will thank you.
Neck Nerve Irritation
The spinal nerves transmit signals from the brain to our muscles to contract. These signals are essential to proper muscle function. If the signal is compromised the muscles get weak. Your neck is actually stabilized by a group of small muscles which include the multifidus, splenius capitis, and longissimus capitis. When the spinal nerve to these small muscles is irritated or compressed these muscles become weak. Remember the human body is an amazing machine with multiple compensatory systems. To compensate for neck weakness the larger muscles such as the trapezius, levator scapulae, and scalenes start stabilizing the neck – a job that they were not designed for. This, in turn, can lead to trapezius and shoulder pain and tightness. Irritation or compression of neck spinal nerves can occur as a result of disc protrusions, disc herniations, small joint overgrowth, thickened ligaments, and bone spurs. To better understand the neck nerve irritation and shoulder pain after lifting please click the video below.
Related: Levator Scapulae Massage
What Helps Shoulder Pain from Lifting Weights?
Treatment needs to be directed at the actual cause of the problem. Activity modification, physical therapy and safe anti-inflammatory medications such as curcumin and fish oil are first-line treatment options (7). When unresponsive to conservative treatment, shoulder pain is often treated with steroids which are power anti-inflammatory agents but toxic to orthopedic tissue (8). Tendinitis, tendinosis, partial-thickness rotator cuff tears can be treated with PRP and stem cells.
At the Centeno-Schultz Clinic, we have extensive experience in the evaluation and treatment of shoulder pain and spinal nerve irritation. Treatment options include precisely guided PRP and bone marrow-derived stem cells utilizing ultrasound, or intermittent x-ray, or both.
What Muscles Are the Rotator Cuff?
The rotator cuff is compromised of four muscles and their tendons: the supraspinatus, infraspinatus, subscapularis, and teres minor.
How Do I know if I Tore My Rotator Cuff?
Pain is the principal symptom which is aggravated by lying on the shoulder and overhead lifting. Weakness can be present when lifting and rotating the arm. Simple chores like combing your hair or grabbing something from the cabinet are oftentimes impossible. Not all rotator cuff tears, however, are associated with pain (9). The prevalence of a rotator cuff is 25% in those older than 50 years of age (10). Patients older than 60 are twice as likely to develop large massive tears (11). Consultation with your physician is important. Muscle strength testing and results from specific shoulder examinations are significant predictors of rotator cuff tears (12). Ultrasound and MRI are both effective in the diagnosis of a rotator cuff tear (13).
In Conclusion
Lifting weights has many benefits. Shoulder pain from lifting weights can arise from multiple sources which include bursitis, AC joint inflammation, poor form, and rotator cuff injury. Irritation or compression of neck spinal nerves can cause neck weakness. The trapezius, levator scapulae and other large muscles in the neck are then recruited to provide support which can result in muscle tightness and pain. Treatment needs to be directed at the actual cause of the problem. Steroids are toxic to orthopedic tissue. PRP and stem cells are safe effective alternatives in the treatment of AC joint injuries, tendinitis, tendinosis, rotator cuff tears, and spinal nerve irritation or compression.
________________________________________
1.Thomas MH, Burns SP. Increasing Lean Mass and Strength: A Comparison of High Frequency Strength Training to Lower Frequency Strength Training. Int J Exerc Sci. 2016;9(2):159-67.
2.Draghi F, Scudeller L, Draghi AG, Bortolotto C. Prevalence of subacromial-subdeltoid bursitis in shoulder pain: an ultrasonographic study. J Ultrasound. 2015;18(2):151-8. doi: 10.1007/s40477-015-0167-0.
3.Obaid H, Connell D. Cell therapy in tendon disorders: what is the current evidence. Am J Sports Med. 2010;38(10):2123-32. DOI: 10.1177/0363546510373574.
4. Nazari G, MacDermid JC, Bryant D, Athwal GS. The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. PLoS One. 2019;14(5):e0216961. Published 2019 May 29. doi:10.1371/journal.pone.0216961
5.Centeno CJ, Al-Sayegh H, Bashir J, Goodyear S, Freeman MD. A prospective multi-site registry study of a specific protocol of autologous bone marrow concentrate for the treatment of shoulder rotator cuff tears and osteoarthritis. J Pain Res. 2015;8:269–276. Published 2015 Jun 5. doi:10.2147/JPR.S80872
6.Sirin E, Aydin N, Mert Topkar O. Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures. EFORT Open Rev. 2018;3(7):426-33. DOI: 10.1302/2058-5241.3.170027.
7.Dong W, Goost H, Lin XB, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine (Baltimore). 2015;94(10):e510.DOI: 10.1097/MD.0000000000000510.
8. Wernecke C, Braun HJ, Dragoo JL. The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review. Orthop J Sports Med. 2015;3(5):2325967115581163. doi: 10.1177/2325967115581163.
9. Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br. 1995;77(2):296-8.Gumina S, Carbone S, Campagna V, Candela V, Sacchetti FM, Giannicola G. The impact of aging on rotator cuff tear size. Musculoskelet Surg. 2013;97 Suppl 1:69-72. DOI: 10.1007/s12306-013-0263-2
9.Jain NB, Fan R, Higgins LD, Kuhn JE, Ayers GD. Does My Patient With Shoulder Pain Have a Rotator Cuff Tear?: A Predictive Model From the ROW Cohort. Orthop J Sports Med. 2018;6(7):2325967118784897.doi: 10.1177/2325967118784897.
10.Itoi E. Rotator cuff tear: physical examination and conservative treatment. J Orthop Sci. 2013;18(2):197-204.doi: 10.1007/s00776-012-0345-2.
11.Gumina S, Carbone S, Campagna V, Candela V, Sacchetti FM, Giannicola G. The impact of aging on rotator cuff tear size. Musculoskelet Surg. 2013;97 Suppl 1:69-72. DOI: 10.1007/s12306-013-0263-2.
12. Jain NB, Fan R, Higgins LD, Kuhn JE, Ayers GD. Does My Patient With Shoulder Pain Have a Rotator Cuff Tear?: A Predictive Model From the ROW Cohort. Orthop J Sports Med. 2018;6(7):2325967118784897.doi: 10.1177/2325967118784897.
13. Rutten MJ, Spaargaren GJ, van Loon T, de Waal Malefijt MC, Kiemeney LA, Jager GJ. Detection of rotator cuff tears: the value of MRI following ultrasound. Eur Radiol. 2010;20(2):450-7. doi: 10.1007/s00330-009-1561-9.
14. https://centenoschultz.com/frozen-shoulder-manipulation-success-rate/
