Ask the trainer: Dealing with shoulder problems

Q: I have been working out faithfully for the last few months and making good progress with my weight-lifting program. Out of the blue my shoulder has started to hurt, so much that now I can barely lift my arm over my head. Whats going on?

A: The shoulder has the greatest range of motion of any joint in the body, making it vulnerable to a variety of problems. The shoulder is made up of three bones: the scapula (shoulder blade), humerus (upper arm bone) and clavicle (collarbone). A loose bag of tissue (capsule) completely surrounds and helps protect the shoulder joint. Inside this capsule is a small amount of fluid that lubricates the joint surfaces. Movements such as stretching the arms overhead, in front of you, or out to the sides should not cause pain.

A possibility for what you are experiencing is “frozen shoulder” (Adhesive Capsulitis), a condition named because of its association with loss of movement around the shoulder joint. For those suffering with this condition, normal movements such as lifting the arm over the head, brushing the hair, reaching into a back pocket or putting on a coat become extremely difficult. With frozen shoulder, abnormal bands of tissue can grow between the joint surfaces, restricting normal range of motion, along with a lack of synovial fluid, which normally lubricates the gap between the arm bone and socket. Usually only one shoulder is affected, although in about one-third of cases, motion may be limited in both arms. Surprisingly, the non-dominant shoulder is typically affected more than the dominant one.

Suspected contributing factors can include postural problems, injury, overuse, medical conditions such as diabetes, hyperthyroidism, clinical depression, Parkinson’s disease, and heart or lung conditions. Frozen shoulder is more common in women than men, five times more common in diabetics and usually occurs between the ages of 40 and 60. The pain associated with frozen shoulder can be quite severe and may last a year or longer. Night pain is not uncommon, especially when lying on the affected shoulder. Researchers believe that there may be a genetic component for frozen shoulder, however, the most convincing study to date has indicated shortening in one of the shoulder ligaments due to long-term poor posture could be responsible. While it is rare for this condition to last longer than a year, it may last as long as three years. Fortunately, it is very rare for frozen shoulder to recur.

Many other conditions can cause shoulder problems, including arthritis, rotator cuff injury, impingement, tendinitis, bursitis, sprains and strains. If you are experiencing shoulder pain, the worst thing to do is to try to work though it. Instead, hold off until you have seen your physician, who can give you proper diagnosis and decide the best course of treatment for you.

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Marjie Gilliam is an International Sports Sciences Master certified personal trainer and fitness consultant. She owns Custom Fitness Personal Training Services LLC. Send email to marjie@ohtrainer.com.

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