Why are you having shoulder pain?
There are many reasons people get shoulder pain and most of them are modifiable or avoidable with the proper knowledge and programming. This is obviously not true for everyone or there would be no need for surgery. However, having knowledge of what factors you should look at and/or change might save you a trip to the doctors office. Below we will break down the 5 areas I see most often in the clinic.
Too much volume
This is often the case with people who are new to lifting or starting a new program. They jump into the new workout routine and want to go balls to the wall and make fast changes. When this happens their body does not have time to adapt to the new stressors put on it which can result in an overuse injury such as tendinopathies. Also, if your rotator cuff, pecs or lats are not used to the load being placed on it, they will find ways to compensate during the movement which can lead to injury.
Lifting too heavy
Lifting too heavy is something that is often a result of ego. Most injuries I see from group classes or CrossFit are not a result of programming but the patient’s ego. If you are working out next to Joe and he is lifting more than you, natural competitive nature would tell you to try and keep up. Motivation from group classes is great for keeping people on their training routine but can sometimes work as a negative. Just be sure to stay within your limits and don’t compare yourself to Joe.
Lack of mobility
Let’s face it, some people are just tight. If you have tight lats and you are trying to snatch or overhead squat you wont be able to maintain the weight in the proper position without compensating in another area. This will result in extra stress on muscles or joints that are not adequately prepared.
Lack of stability
Stability is another big issue with the shoulder. The shape of the glenohumeral joint allows for a lot of mobility but it also requires a lot of coordination between your muscles to prevent a subluxation or dislocation. When I talk to most people they are aware that the glenohumeral joint is a ball and socket joint, however they do not realize the size difference between the ball and the socket. The relationship between the two is equivalent to a golf ball sitting on a tee. This orientation allows for overhead reaching, throwing a football, reaching in the backseat of your car, and reaching up your back to put on a bra. However, with increased mobility you also need to be able to stabilize the joint. If the shoulder does not feel stable with any of the above movements, then adding in some extra stability work could go a long way.
Structural issues
This is everyone’s first thought when they start to experience pain, however I wanted to talk about it last. Do I have a rotator cuff tear? Did I tear my labrum? Most of the time if the pain is non-traumatic, it is a result of one of the above items. Which means, even if it is structural, it can improve through modifying your movement. A lot of people will show structural issues on MRI’s but present with no pain. And most people with structural issues can get out of pain and regain mobility/stability without any sort of surgical interventions. Obviously, this is not always the case but attempting conservative care first can prevent unnecessary surgeries or and also improve post surgical outcomes if surgery is ultimately needed.
I hope this helps break down a few places to look if you are having shoulder pain. If you need guidance or assistance in setting up a plan to get out of pain please reach out!
Mick Janusko, PT, DPT, MTC, CSCS
📞 (904) 534-0805
📧 m11janusko@gmail.com
5150 Palm Valley Road, #103
Ponte Vedra Beach, FL 32082
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