Shoulder Injuries in Powerlifting

A Sports Physio's

Perspective 

Even whilst we’re away from competition, we all need to do our best to keep in shape. Cumbrian physiotherapist, Mary McCance takes a dive into one of the most common injury/lack of mobility areas, the shoulder!
 

I’m a Physiotherapist and powerlifter from the North West division. I run my own clinic Ullswater Physiotherapy & Sports Injuries Clinic in Penrith, Cumbria. I’m currently in the early stages of my PhD, researching shoulder injuries in competitive powerlifters. So I thought I’d get involved with the British Powerlifting Magazine and write a short piece on shoulder injuries in the sport.

As powerlifters, we are all too familiar with aches and pains associated with training and competition; but did you know the most commonly injured body part is the shoulder complex?

The shoulder complex consists of four main joints, including the main ball and socket joint (glenohumeral joint); the end of the collar bone as it joins to the shoulder blade (acromioclavicular joint); the joint between the sternum and the collar bone (sternoclavicular joint); and the joint between the shoulder blade and the chest wall (scapulothoracic joint).

Within the shoulder, problems with the rotator cuff, biceps and chest (pec major & pec minor) muscles, and collar bone injuries have been described as complications of weight lifting in general. Shoulder injuries have been shown to be prevalent specifically in powerlifters, and in some circumstances they can be career ending injuries. Stomback ​et al​ (2018) in their research on Swedish sub-elite powerlifters reported 39.5% of females studied sustained a shoulder injury over a 12 month period and in males this was 32.5%. These injuries were associated with the bench press in particular, with pec major ruptures being most common.

Deepak ​et al​ (2007) use the term ‘bench-pressers shoulder’ to describe pain and injury to the pec minor muscle (the smaller chest muscle) due to bench pressing as the mechanism of injury, and as the main aggravating factor.

Shoulder injuries during the squat have also been reported with a gradual onset over time, particularly during ‘low bar’ squats when the bar is placed low across the shoulders. In my clinical experience of working with a number of powerlifters, the end of range position of the shoulder for hand position on the bar during the squat can predispose the athlete to shoulder pain, particularly in those with limited shoulder mobility.

The deadlift has been reported to predispose athletes to bicep injuries and in severe cases complete rupture can occur. Anecdotal evidence suggests this is associated with a mixed grip where one arm is pronated (palm down) and the other supinated (palm up) placing an uneven force through the supinated arm.

So what can we do to improve our overall shoulder health? Well there’s quite a lot we can do. 

ONE Ensure that programming includes appropriate shoulder and upper back mobility exercises to help maintain joint health and range of movement, such as the easy roller exercise illustrated below; this is one we can easily do at home.

TWO Strengthen the rotator cuff muscles to promote optimal joint biomechanic. The illustration below shows this done with a band, from something as common as a doorknob.

THREE Include pulling exercises as well as pressing exercises to maintain muscle balance around the shoulders, such as a bent over row shown here. You should ensure to squeeze your scapula together at the top of the movement.

FOUR Proprioception (bodily awareness) and balance exercises can assist with managing bar position and bar path in the bench press. A good example here below is doing pressups on an upside down bosu ball, which you can find in most gyms.

Include the above or similar in your regular routine of exercises.

These exercises are to be used as a guide only and not to replace the treatment advice you receive from another qualified professional.

If you’re already doing some or all of these things then you’re on the right path to maintain your shoulder health. If you’re not, then give them a go. If you have a shoulder injury then please see a qualified Chartered Physiotherapist in your local area.

Mary the Physio

REFERENCES Deepak, N. B. de Beer, J.F. Karin, SR. Francis, L. Donald, FdT. (2006) The “Bench Presser’s Shoulder”: An Overuse Insertional Tendinopathy of the Pectoralis Minor Muscle. ​British Journal of Sports Medicine. ​41​. E11. DOI: 10.1136/bjsm.2006.032383
Stromback, E. Gilenstam,K. Berglund, L. (2018)​ ​Prevalence and Consequences of Injuries in Powerlifting. ​The Orthopaedic Journal of Sports Medicine​. ​6​. (5). DOI: 10.1177/2325967118771016

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