The condition that I'm referring to is otherwise known as shoulder bursitis and tendonitis. Shoulder bursitis and tendonitis is a common overuse injury in sports where the arm is used in an overhead motion such as swimming and baseball. The pain, which is usually felt at the tip of the shoulder and referred down the deltoid muscle into the upper arm, occurs when the arm is lifted overhead or twisted. In extreme cases, the pain will be present at all times.
The shoulder is a closely fitted joint. The humerus (upper arm bone), certain tendons of the muscles that lift the arm, and associated bursa (fluid filled sac that cushions to prevent friction) move back and forth through a very tight archway of bone and ligament called the coracoacromia arch. When the arm is raised, the archway becomes smaller, pinches the tendons, and makes the tissue prone to inflammation. The condition known as bursitis occurs when the bursa becomes inflamed and painful as surrounding muscles move over it. The condition known as tendonitis occurs when the tendons or surrounding tissue becomes inflamed, swollen, and tender. Symptoms of these two conditions can last for only a few days but they may recur or become chronic, such as in my case.
There are many contributing factors to these two conditions. The first is overuse. Repetitive overhead motions are the most common cause of the problem. The second is muscle weakness. When the muscles are weak, more force is exerted on the tendons and bursa, causing inflammation and pain. The third is improper technique in lifting, throwing, swimming, etc. The fourth is strenuous training which I'm sure many of you are quite familiar with. If you train hard, you're risking injury. It's all part of the game though. The next contributing factor is a loose shoulder joint, which I have in my left shoulder. The doctor that I visited said that a loose shoulder joint causes more stress on my tendons and could be the reason why I've been having chronic shoulder problems.
If you've ever suffered from shoulder bursitis or tendonitis, there a few treatment options that you can choose from. The first is rest. Avoid doing things that can hurt or make the pain worse the next day. Avoid the activity that started the problem. Your doctor may even recommend a sling to immobilize the shoulder to hasten recovery. The second treatment method is the application of ice. Apply an ice bag over a towel to your shoulder at least twice a day for 30 to 60 minutes. You should always apply ice for 15 minutes after any activity using your arm. The next is physical therapy. Your doctor may send you to a physical therapist for exercises or other therapy. Exercises that strengthen the shoulder may help to prevent a recurrence of the problem. The next treatment option is medication. Your doctor may prescribe an anti-inflammatory/analgesic medication to relieve pain and inflammation while your body's natural healing process goes on. An injection of cortisone into the shoulder may be recommended although it is usually a secondary treatment to supplement other therapy. The final option for correction of the problem is surgery. Although this is the most extreme option, it is usually required to treat chronic shoulder bursitis and tendonitis.
If you've recovered from your shoulder injury, you should return to your sport slowly. Warm up well and do range of motion exercises. Avoid the overhead throwing position and do not play for a long time and slowly increase your intensity. This is common sense but I'm still amazed at how gung-ho people can be especially in sports. I say this because I haven't always followed the rule of returning to the gym with ease. I usually jump right back into the fire because after a long lay off, I feel like Pee-Wee Herman coming out of a ten year coma. Here are some examples in other sports.
In throwing sports, one should initially start with an underhand or sidearm throw which will be easier than an overhand throw. One should warm up well and throw easily while gradually increasing the intensity of the throws. Try to maintain a smooth throwing motion that will make use of the overall strength of your body.
In swimming, the breast stroke or side stroke will be easier than the front crawl or butterfly strokes. Sometimes, the back stroke is all right. If you choose to do any hard swimming, do so early in your workout after you are warmed up but before you are fatigued. You can also try to change your swimming style by rolling your body to the side.
In weight training, one should warm up slowly with lighter weights and stretch the shoulder thoroughly. Avoid any exercises that cause any pain at all. This eliminates most overhead pressing and pulling movements. Be patient and ease back into these exercises with light weight. Depending on the severity of the injury, it will take an individual anywhere from 2-6 weeks, generally speaking, to be able to go full throttle again.
Fortunately for use, there are range-of-motion exercises that can be done daily to help keep the joint loose. These exercises consist of moving the joint, carefully, as far as it can go in all directions. After pain has subsided, shoulder muscles must be strengthened to prevent bursitis/tendonitis from recurring. One should repeat these exercises two times a day or as often as a doctor recommends.
The first exercise requires you to start with the "pendulum swing." (see figure #1) Support yourself with your good arm on a stool as if you were doing a one arm dumbbell row. Keeping your knees slightly bent, bend forward at the waist and let your bad arm hang down (or dangle off the bed). Then make circles with your arm three to five times in one direction, then the other. Start with small circles and gradually make them larger.
The second exercise requires you to start with palm out, place the hand of your injured arm behind your back and reach up as high as possible as though you were going to scratch your back with your thumb.
The third exercise requires you to stretch the back portion of the shoulder joint by gently pulling your arm across your body.
The fourth exercise requires you to stand with your arms close to your body and elbows bent to 90 degrees, hands pointing straight ahead. Now slowly move arms so that hands point out to the side. Lean into a corner in this position with shoulder muscles relaxed. Lower your arms to your sides, then raise the injured arm overhead as shown, helping with your other hand.
There are also strengthening exercises done with weights or resistance which aid in the prevention of further shoulder injuries. The first exercise requires you to start with elbows straight and thumbs turned toward the floor and arms about 30 degrees forward. Now slowly raise the arms to just below shoulder level and slowly lower arms to starting position and repeat. This is very similar to standing or seated dumbbell side laterals.
The second exercise requires you to lie on your side with the injured shoulder up. In this position, you should hold the elbow close against your ribs while slowly raising the weight until it points to the ceiling. Then lower to starting position and repeat.
If all of these exercises are performed on a daily basis, it is possible for you to prevent shoulder bursitis/tendonitis. However, not to discourage anyone but if you choose to train heavy, you will get an injury or two somewhere down the road. Our bodies aren't made to handle the poundage's that we hoist. So the question is not "will I get injured?" but rather "how well will I handle these injures and how well will I bounce back?"
Phano Paul Som
Phano Paul Som is an experienced bodybuilder, athlete, freelance writer and currently a medical student.