Small Steps to Health

Good vs. Bad Pain and Rotator Cuff Injury

April 28th, 2008 by asithi · 1 Comment

Tagged Exercise Injuries, exercise injury

Strength training does not have to be painful to be effective. This will be a series of post talking about the three most common strength training injuries (rotator cuffs, the kneecap, and the lower back). This post will focus on the rotator cuffs in our shoulders.

We should replace ‘no pain, no gain’ with ‘no strain, no gain’ as our motto when lifting weights. If we are lifting, most likely we will experience some muscle soreness. The important thing is to know the difference between good pain and bad pain.

Good pain:

• happens in the muscles, not the joints or connective tissues.
• is localized to the body part you are working.

Bad pain:

• lingers when you stop the exercise.
• happens when you are working both limbs, but only one of them hurts.
• might happen suddenly or with warning.
• can be dull, radiating, throbbing, or chronic.

Rotator cuff
The rotator cuff in our shoulders has four small muscles to stabilize the joint. There are only two ball and socket joints in your body — the shoulders and the hips. This allows for a myriad of movement: forward and back, away from and across the center of the body, in circles, and in and out rotation. This freedom of movement and the fact that the shoulders have less sturdy bones than the hips is the reason why they are the most vulnerable to injury.

The rotator cuffs are most vulnerable when the shoulders are externally rotated such as in a tennis serve or bench press. When these muscles get injured and swell, the rotators and bursas (little sacs of fluid that cushion joints) get compressed by the shoulder bones making it difficult to lift your arms out to the sides. Most often when weight training, the rotator cuff gets injured because of a sudden increase in the intensity (including an increase in weight), frequency, or duration of the exercises.

After getting an okay from your doctor, you might want try these modifications to your workout:

Bench press

• Avoid heavy weights.
• Avoid bringing weights to the chest.
• Shorten the range of motion and bring weights approximately 4 inches in front of the chest bone. If this caused pain, avoid this exercise altogether until you recover from your injury.

Military press (overhead press)

• Avoid bringing weights behind the neck (this externally rotate the rotator cuff).
• When pressing, bring the weight slightly in front of your ears.

Lat pull down

• Avoid pulling the bar behind the head. This movement also externally rotates the rotator cuff.
• Pull the bar to your chest instead.

Lateral raises

• Avoid raising the arms above the shoulders.
• Avoid rotating the weights at the top of the lift (thumbs pointing down, as if you are about to pour out a glass of water). This movement adds to the internal rotation.
• Keep shoulders down as you lift.
• End with arms parallel to the floor.

Upright rows

• Avoid rowing to the chin. This is another uncomfortable internal rotation.
• Lift weights to the chest or avoid altogether.

Besides limiting your range of motion and using light weights, try changing your grip when working your shoulders when a rotator cuff injury. A very wide grip causes your shoulder to rotate externally into it most vulnerable position.

Until next time and thanks for stopping by.

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