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As a sports physiotherapist that has worked with athletes and clients of all sorts, Karen Nichol, founder of Royal City Physio, has definitely seen her fair share of shoulder injuries. Many of these were preventable injuries, but the warning signs were ignored until something much more serious occurred.
Of course, we cannot always stop the traumatic events that occur in our lives that bring on serious injuries, but we can often prevent other injuries from creeping in which can lead to extremely painful shoulder injuries, which can prevent us from doing many physical activities. and can often affect our sleep.
The Culprit of Most Shoulder Injuries
Now, as much as we love to see our patients maintaining a healthy lifestyle, unfortunately the gym is most often the origination of many of the shoulder injuries that we see in the clinic. Too often we see pathology of the supraspinatus (one of the four rotator cuff tendons) and surrounding area, or injury to the long head of the bicep tendon. These injuries are usually caused by clients putting their shoulder joints into compromised positions with repetitive load on them. This has the potential of leading to an impingement of the supraspinatus tendon and the bursa above it or aggravating the bicep tendon.
How to Prevent Shoulder Injuries
As a specialist in shoulder rehabilitation, we thought we would impart some words of wisdom to help our readers avoid potential shoulder injuries. Here are some ideas on positions to AVOID, saving these tendons from potential damage!
AVOID allowing your elbows to drop back behind your shoulder joint in any pressing type motion (eg. bench press/ push ups etc.). Try to make sure you can always SEE your elbows slightly ahead of your body.
AVOID the military press machine! This machine has the potential to really compromise the structures surrounding the shoulder and neck. Instead opt for inclined dumbbell presses on an angled bench where you keep your hands ahead of your body and keep an eye on your elbows not going too far behind you.
AVOID lateral raises above 90 degrees and keep elbows in line with your shoulder blade, not your body! Draw a line that continues off the middle of the outside edge of your shoulder and keep your elbow in line with that. Generally, it’s 30-45 degrees ahead of your body, depending on how forward your shoulder blade sits around your rib cage. Keeping your shoulder below 90 degrees will avoid pinching your rotator cuff tendon.
And hopefully everyone knows this by now, but NEVER do lat pull-downs BEHIND THE HEAD! This is a lead up for huge injury to both shoulder and neck because of the position this machine forces those joints into.
Recovering From Shoulder Injuries
And for those of you that are already experiencing shoulder pain, we thought we would include some helpful hints to help you in your recovery. Obviously, every shoulder injury can differ but these are some general tips to alleviate pain to the rotator cuff or bicep tendon.
AVOID sleeping sleeping on that side! This can really compound the injury by putting a ton of pressure on the affected structures and worsen the injury and your pain!
AVOID those irritating positions AT ALL COSTS! This means all painful positions at the gym; lifting or carrying; overhead reaching; cross- body positions; sleeping on it etc. If it hurts, you are pinching or inflaming the painful structure and will worsen the injury!
ICE, ICE , ICE!! It’s the best natural anti-inflammatory and hugely reduces pain! These structures are also very close to the surface of the skin and can be easily contacted by ice laid congruently over the entire shoulder. Ensure ice hits the top, front and side of shoulder to cool all affected areas. I recommend a minimum of 4-6 times/day for 10-15 min.
See a physiotherapist to assess and treat this injury. The worst thing you can do is continue to insult these injuries and end up with a much worse injury in the long run.