Painful Shoulder

Shoulder pain is very common and there are many different causes. Exercises and specifically weight training is one of the most frequent culprits. Sometimes the pain can begin suddenly or it can be more gradual in onset. If the pain is not too severe, many people wait and see if the problem goes away on it’s own. They back off on activity or just continue despite the pain and then sometimes several months have gone by and pain is still present or returns.

A discussion of various causes of shoulder pain is available in the other education documents. General comments on shoulder care will be addressed here. The activities that will typically aggravate shoulder pain are the following:

  1. Reaching
  2. Quick sudden movements
  3. Extremes of movement
  4. Repetitive movements
  5. Overhead activities
  6. Throwing
  7. Push ups
  8. Dips
  9. Weight training
    1. Military press
    2. Bench press
    3. Flies
    4. Pull downs behind the head

Once shoulder pain develops, one naturally will avoid painful movements. But even through the course of a normal day, many of these motions are inevitable. This repeated aggravation keeps the pain going. Essentially, you are “blowing on the coals” and therefore, the fire will never go out. It is important to allow the inflammation to settle down. This not only requires avoidance of painful movements and activities, but often a medication to reduce inflammation (such as ibuprofen or other similar medicines). If exercise or sports aggravate your pain, then an imposed period of time off is needed. Many times some other activities are OK. If work aggravates your shoulder pain, then some stated restrictions or time off might be warranted.

The restrictions or suggested forms of activity modification correspond to the usual activities that aggravate pain in the list above. For instance, if you play tennis and can’t serve, then just do some volleys rather than competitive tennis, ground strokes and do other aerobic activities. If you like to lift weights but it hurts your shoulder avoid overhead, push-ups, dips or chest work for a while. You can do some arm curls, triceps, lat work in front of body, modified bench press, and even some lighter deltoids work (up to but not above shoulder height). Try to keep your arms below shoulder height and in front of the plane of your body.

For everyday activities, try to avoid quick sudden movements, repetitive movements (vacuuming, yard work, etc.), and reaching. Proper body mechanics can help reduce the stress on your shoulder. Instead of reaching out for something, train yourself to get as close as possible to it, then lift it (keeping it close to your body), go over to where you want to place and put it down. This applies to grocery bags, trash bags, briefcases, small children, etc.

When you have a painful shoulder, it often gets weaker as well. These strategies to reduce pain are especially important to minimize the stresses on your shoulder if it is weaker. After all, you can’t expect a weak shoulder to function like a normal one. Rehabilitation exercises to improve strength and function are often necessary.

This information is intended as a guideline. You may find that some or all of it applies to you.

Highlights

  • Avoid pain and painful activities whether through work or sport
  • Use proper body mechanics to protect your injured shoulder
  • Modify activities and substitute exercises during your recovery
  • Take anti-inflammatory medication if needed (and if medically OK)
  • Strengthen weak shoulder muscles to restore function (usually rotator cuff)

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