Shoulder pain is a common complaint when training in the gym. I have often seen shoulder pain occur when someone is doing a deep bench press or a very low shoulder press. This pain could be associated with a clicking noise or a sharp pain at the point of deepest position. Often the person tries to train harder to resolve the problem, because they believe that strengthening the shoulder will be the solution to the problem.
The other time shoulder problems can occur is when someone is given a new exercise which is very functional in many degrees of motion, using small weights quickly or pushing very heavy weights. Today exercises are often more functional which means that they do not function in single planes of motion. These movements can be very complex and require coordination and skill. When a person does this for the first time, and then they try to do this too fast with a heavy weight, they lose control of their shoulder joint and the shoulder joint is put under unnecessary stress. This stresses the shoulder over time and breaks down the tissues leading to injury.
When the total movement of an exercise is videoed it can be seen that the shoulder can also be put under stress because other parts of the body are not moving as well. When someone rotates their body and pulls weight up and out above their head, if their hips, pelvis or knee are not moving in a coordinated fashion the shoulder gets unnecessary stress and this can also lead to tissue breakdown and injury. An injury can occur from one explosive movement or from repetitive movements done badly over time. Sudden movements are often associated with a one off severe pain; however the repetitive movements done badly over time tend to creep up on a person. Pain develops insidiously and starts at a low level, gradually building to a point at which they must seek physiotherapy.
Rehabilitation protocol for shoulder pain can be very complex as the shoulder is the most mobile joint in the body. The shoulder can be prone to increased movement in some areas but stiffness in others. The spine, hips and knees – even the big toe – joints can all be causes leading to shoulder pain. The assessment protocol for assessing the shoulder will be a global one and treatment may involve working on areas other than the shoulder.
To prevent shoulder problems it is very important for a physiotherapist to work closely with a personal trainer. The trainer communicates clearly with the physiotherapist what they intend to do with their client, and then the physiotherapist can guide the trainer as to what potential risks there are. If this close relationship functions correctly between the physiotherapist and trainer than injuries can be prevented, goals can be achieved and long term damage to the body can be avoided.