Similar to other types of pain and injury, shoulder pain has many different forms and causes. Let’s dive into shoulder pain as a whole, and discuss how weight training can contribute to shoulder pain. We’ll share the common symptoms and causes of shoulder pain, prevention strategies, recommendations on treating shoulder pain, and more.
We’ll answer the following questions:
There are many different types of shoulder pain and each can cause a range of symptoms that people experience. Your pain may be sharp with certain movements, you may experience an achiness while at rest, or a combination of the two. You may also have pain when lifting your arm, doing overhead activities, participating in sports, or while doing exercise movements such as push ups or rows.
One subtype of shoulder pain, commonly known as impingement, is a pinching sensation experienced when you raise your arm into overhead positions in front of your body or out to the side. Impingement pain can also be felt when doing any of the above in combination with rotation movements. More often than not, this pain occurs at the front of your shoulder, but it can also be felt on the side of the shoulder joint itself. Impingement can also coincide with an achy pain, and may linger after you have completed the aggravating movement.
Shoulder pain can also present as a strong aching sensation that may be localized to one area of the shoulder, throughout the entire joint, or even radiating towards the elbow. You might feel this after doing certain movements or workouts such as weight-training, or at the end of the day and into the night.
Additionally, you might experience a weak feeling in your shoulder, like it’s heavy, doesn’t feel strong in certain positions, or as though there is a lack of control with certain movements. Maybe it feels like your shoulder is going to give way or pop out, leaving you feeling like you can’t lift heavy things. These vulnerability-type symptoms are quite common for people with shoulder-related issues and shoulder pain. You might also experience these sensations in combination with impingement-type symptoms, depending on the movement you’re doing.
As you can tell, the symptoms and presentation of shoulder pain can differ widely between patients. It can be difficult to narrow down the structure and problem causing various symptoms of shoulder pain by yourself at home. We recommend you come into our physiotherapy clinic, Endeavour, and work with our in-house experts, who will use their skills to pinpoint your symptoms and guide you through a comprehensive plan to address your specific pain.
In terms of what exercises or physical habits contribute to shoulder pain, especially as it relates to weight training, there are a couple of key areas we look at.
At their core, most shoulder movements can be categorized as pushing or pulling. Pushing movements are things like push ups, bench presses, fly-type movements, and overhead movements. Pulling movements include activities such as pull-ups, chin-ups and rowing-type movements. This is important to remember when it comes to weight training, as a good functional exercise program will involve both pushing and pulling exercises. When a plan does not fully address both of these two counterparts, it can lead to the development of shoulder pain.
When it comes to workout related shoulder injuries, overhead movements tend to be the most common cause of shoulder pain and injury. Alternatively, the safest activities for your shoulders tend to be ones where your hands or forearms are anchored to the ground while bearing weight, such as push-ups or planks.
While talking about the causes of shoulder pain and injury, it is important to understand shoulder blade mechanics—the ability to stabilize your shoulder blade within the movements you put your shoulders through. The shoulder blade is the main source of stability in our shoulders: the ball and socket of our shoulder joint is there, and we only have one bone-to-bone joint (the collarbone) connecting our shoulder blade to the torso. Most of the other attachments of your shoulder blade and shoulder are soft tissue and muscle tissue, so if your shoulder muscles aren’t well-coordinated or strong enough to handle the forces put on them, it can result in imbalances and other issues. With this in mind, it’s plain to see how shoulder blade mechanics are so critical when it comes to preventing shoulder injuries and pain.
The first being protraction—bringing your shoulder blade around the spine and forward. Next is retraction, bringing your shoulder blade backward. Elevation refers to raising your shoulder blades upwards, and finally, depression is bringing the shoulder blade down. If the muscles required to do those four movements aren’t strong or coordinated enough, problems can occur.
Another contributing factor to shoulder injuries from weight training are training errors, which can present in a few different ways. We call them training errors because they are mistakes people often make when they aren’t aware of how to properly design an exercise program.
One common error is working the muscles into fatigue. Another is loading more weight than the different regions of your shoulders can handle. Another error is directing our focus to the larger muscles such as the pec (pectoralis major and minor) muscles and lat (latissimus dorsi) muscles, without paying attention to accessory, stabilizer muscles such as the rotator cuff, resulting in an imbalance. As previously mentioned, another common error is focusing only on one aspect of the movements we’ve talked about (push without pull or protraction without retraction of your shoulder blade and shoulder). For example, exclusively doing bench press and ignoring the pull counterpart to this movement can result in an imbalance and can cause shoulder issues. We have also seen pain and injury caused by an imbalance of strength in the front and back of the body as a result of over training certain areas while neglecting others.
At Endeavour, our strength and conditioning coaches and expert rehab team can help prevent these issues by designing a program specifically for you that is well-rounded and addresses all the different areas of your body. A program like this will not only help you achieve your goals, but also lower the chances of injuries happening.
Acute and previous injuries are also a common factor in someone experiencing shoulder pain. There’s shoulder tendonitis (inflammation of your rotator cuff or bicep’s tendon), as well as injuries from sports, slip-and-fall injuries where you land with your arm out, dislocations, broken collarbones, or shoulder separation (a sprain of the acromioclavicular ligaments that hold the collarbone to the top of the shoulder blade). Even upper back or neck-related injuries are going to leave some degree of vulnerability in your shoulder. While it may seem like some of these injuries aren’t closely associated with shoulder pain, they can impact your soft tissues, muscles, and nerves related to the region that all need to work together to move your shoulder, especially when weight-training.
That’s why it’s really important to address injuries as they occur, because when left alone, they will cause issues down the road, especially when you’re starting to become more active or doing weight-training. At our clinic, one of our guiding principles is addressing all the contributing factors of an acute injury that may lead to further issues down the road.
We often get asked for advice when it comes to shoulder pain prevention. These questions typically range from best practices in the gym (such as proper techniques and activities to avoid), to exercises for when you have a sore shoulder or when you experience shoulder pain while lifting.
In terms of prevention, it comes down to understanding all the contributing factors that cause shoulder pain, as outlined above. Our team of experts at Endeavour will work with you to address the different factors contributing to your specific pain and work with you to develop exercises you can do to prevent shoulder pain in the future.
As we’ve mentioned, it’s key to address injuries as they crop up and not rush back to activities before your body is recovered. Another strategy for prevention is addressing your scapular (shoulder blade) control and the balance between your different shoulder blade muscles. You can work on movements such as pressing and pushing, stability, or weight-bearing movements to find balance by working all your different muscles.
Movements like planks or push-ups are a great way to work on proper shoulder blade mechanics.When you are weight-bearing with your hands or forearms placed firmly on the ground, there are less opportunities for your shoulders to move, creating greater stability throughout your body.
You can also work on your rotator cuff muscles, which are the stabilizers of the ball and socket (glenohumeral) shoulder joint. They may be small muscles, but they have high demands, so it is imperative that they are working well. One way to strengthen your rotator cuff muscles is by choosing exercises with internal and external rotation. Resistance bands work great here, and dumbbells can be used as well. It’s a good idea to do these activities not just for maintenance, but as a warm-up activity before heavy lifting.
When designing an exercise program for you, we’ll make sure there’s a balance between pushing and pulling type exercises, as we’ve mentioned. It is also important to build proper progression into your program—oftentimes we see people adding more weight before fully understanding the different effects of their movements.
When it comes to treatment for shoulder pain as a result of weight training, the first step is to identify the types of movements being done and where imbalances may have occurred. This helps the team at our clinic put together a great, multi-faceted treatment plan. We’ll go over a lot of what’s been discussed in this blog post, but with applications personalized to your lifestyle and injury history. We’ll give you exercises to both address the acute issue and develop a robust warmup and strengthening program.
In terms of the treatments themselves, we often use electro-acupuncture and other hands-on techniques to target the specific nerves that come off your neck, the rotator cuff muscles, the joints of your shoulder, your shoulder blade and collarbone attachments, as well as bigger muscles such as your pecs and lats.
It’s pretty common to experience shoulder pain when sleeping. Often, this happens when lying on an injured shoulder, we recommend laying on your back or opposite side for a period of time as a quick fix. If you find that you end up rolling back over throughout the night, you can try placing a pillow between your knees, in front of you, or behind you to limit your ability to roll. If you are experiencing pain in the arm you do not sleep on, you can put a pillow in front of you and rest your arm there to stop it from stretching forward and causing pain.
When dealing with acute shoulder issues, there will be some discomfort as you try to find a comfortable position. We can work with you to navigate you through this period. Our main is to increase your body’s resilience so the injury is more comfortable during the day, which in turn will reduce irritability at night.
The things you do to prevent shoulder pain are the same as those you can do to manage shoulder pain: activities like rotator cuff exercises, scapular exercises, movements up against a wall, and pushing and pulling exercises—all movements which take into consideration the different factors impacting your shoulder blade, while ensuring stability. Oftentimes, we’ll recommend easier progressions in activities to avoid putting too much load on the body too soon. This might look like reducing the load and increasing rest time in the short term, or focusing on lower weight and longer duration exercises: for example, holding a movement for longer rather than increasing the weight.
The shoulder is an incredible part of the body consisting of one bone-to-bone joint connecting the entire arm to the torso, with a multitude of different muscles. There are many complex components of the shoulder that allow us to do a variety of things: for example, throwing, swimming, and putting weight over our head or in front of our chest.
The biggest thing to understand about shoulder pain, is that there is no one size fits all answer or fix for everyone. Many different factors contribute to the onset of shoulder pain, and there isn’t one magical exercise or technique that will help—but rather a complete program to address all the individual components contributing to your pain. Come see us at Endeavour to get started on building a personalized treatment program!
The medical information on this blog is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-therapist relationship and should not be used as a substitute for professional diagnosis and treatment.
Please consult your health care provider before making any health care decisions or for guidance about a specific medical condition. Endeavour Sports Performance and Rehabilitation and its practitioners expressly disclaim responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this article.