Shoulder injuries 101: The what, why and how

Shoulder injuries are more common than you think - occurring even as you perform daily tasks.

Shoulder injuries are more common than you think, but if not addressed properly, may turn chronic.

If you have been lifting weights for a while now, you would have experienced some sort of shoulder problem or injury at least once. Shoulder injuries are usually minor - and can occur even during daily tasks - but can turn chronic if not addressed properly. This is largely due to the shoulder being a very complex joint that relies on various tendons and ligaments to work.


Understanding the anatomy of your shoulder and the type of injuries that can occur will help in preventing and addressing those injuries. This can get quite technical, but stick with us!



How does the shoulder work?

Like all joints, the anatomy of the shoulder is complex. It is the most flexible joint in the entire body as it can rotate fully. Connected to a closely fitted ball-and-socket joint, is the humerus (arm bone), the scapula (shoulder blade) and the clavicle (collarbone), which collectively form the shoulder.


The complexity of the shoulder joint makes it the most flexible joint in the human body.

The cup-like depression of the scapula (glenoid fossa), forms a shallow socket that houses the humerus that is mainly reinforced by the rotator cuff muscles. The cuff muscles are made of four muscles, each with a different and important role but we won't go into those details. The main point is that these muscles connect your arm to your body and help raise and rotate your arm.



What are the common injuries?

A tear in the rotator cuff muscles is very common. Even in daily tasks like lifting boxes or reaching up the shelf, can cause tears in these muscles. There are two levels to this injury:


Tendinitis

Tendinitis is usually the first occurrence before the actual tear. A tendon that attaches to the bone is inflamed or irritated, causing pain just outside the joint. This usually occurs when the arm is raised and the tendons are pinched too hard.


Shoulder tendinitis and bursitis are usually overlapping injuries.

Bursitis

There is a small fluid-filled sac that protects your rotator cuff. Repetition of certain motions can cause an irritation of the sac.


These two injuries usually occur together and the pain is usually at the tip of the shoulder and muscle weakness that runs down the arm can be felt. There are various contributing factors:

  • Repetitive overhead motions resulting in overuse of the shoulders.

  • Muscle weakness whereby your surrounding muscles are not strong enough, causing more force is exerted on the tendons and bursa.

  • Improper lifting or training techniques which result in wrong force distributions on the joint.

  • Strenuous trainings again resulting in overuse of the shoulders.

  • Loose shoulder joint causing more stress on the tendons.



What can you do?

Rest. Seems like a no-brainer answer, but many of us are afraid to lose progress whether in the gym or in sports. The key is to be patient because chronic injuries are highly unpleasant and in the long term, cause more pain and injury risk.


Avoid irritating the injury even in menial daily tasks like lifting heavy boxes or reaching to grab something off the shelf. Try to immobilize the shoulder as much as possible. Of course, another no-brainer is to avoid the activity that started the problem.


Application of ice to reduce the inflammation will be useful. Apply it twice a day for 30 minutes or 15 minutes after any activity. In more serious cases, your doctor may prescribe anti-inflammatory medications to relieve the swelling.


Physical therapy is important as strengthening the shoulder will help prevent a recurrence of the problem. When returning to sports or weightlifting, make sure you warm-up and start from the bottom again.


For example, in weight training, warm-up with stretches and avoid any exercises that cause pain. Ease back into training with light weights for about 2-6 weeks, depending on the severity of your injury. Same goes for shoulder-heavy sports, gradually increase the intensity of your movements.


Patience is key!


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