Helpful Tips in Avoiding Shoulder Impingement Injuries with Weight Training:
As a physical therapist and active recreational weight lifter, I feel that understanding the shoulder is vital to a healthy workout. Weight training is an exceptional form of exercise when practiced sensibly. In following certain stretches and strengthening exercises, shoulder injuries such as rotator cuff tears, impingement syndromes and bursitis could be avoided.
Below is an example of an external impingement syndrome. Over time, this injury can lead to rotator cuff tears, tendonitis and bursitis.
Shoulder Impingement (External):
Rotator Cuff Anatomy – The Shoulder Stabilizers:
These are examples of special tests that would indicate an impingement syndrome. These positions would cause pain.
Positive Shoulder Tests:
1. Hawkin’s Sign
2. Neer’s Test
Many times, someone with an impingement syndrome will have a tight inferior capsule (arm pit area) or posterior shoulder capsule (back of shoulder) which drives the humerus upward, causing the rotator cuff tendon to be pinched between the humerus and acromion (as shown in the picture above). These are good stretches to restore flexibility and to avoid this problem. Remember, stretches should not be performed to the point of pain.
1. Inferior Capsule Stretch
2. Posterior Capsule Stretch
3. Sleeper Stretch
Common Reasons For Injuries:
1. Overtraining: Many injuries occur from repeatedly training to failure or from too much resistance. Not enough recovery time is also a factor. Muscles need about 24 hrs of recovery time. Do not train the same muscle group daily.
2. Not warming up sufficiently. By increasing your body temperature through the use of an Upper Body Ergometer or other cardio equipment, you are increasing the circulation into the muscles and increasing their elasticity.
3. Not stretching sufficiently. It is safest to stretch before and after a workout. Make sure to stretch the areas mentioned above, not just the chest muscles. Hold your stretch for 20-30 seconds minimum.
4. Hyperextension of the shoulder when weight training. For example, allowing your elbow to drop too far below the chest with a bench press or too far back when doing an upright row. This motion may be overstretching the anterior shoulder and encouraging a shoulder impingement over time.
5. Performing shoulder press or lat pull downs behind the head.
6. Poor rotator cuff strength. Poor serratus anterior strength. The serratus anterior is a muscle that moves the shoulder blade upward and outward on your rib cage and is very commonly left out when weight training. Do not forget these small but very important muscles. They will allow your larger muscles to work more effectively and you will be less likely to have an injury.
7. Winging of Scapula. This means, the inside border of your shoulder blade wings outward. This is an indication that your lower trapezius and mid trapezius muscles are weak. Your shoulder blade must be stable on your rib cage in order to lift heavy weights.
See below for examples of shoulder exercises:
Gabriel Manzon, MPT
Paspa Physical Therapy