No pain no gain. It's a common phrase that most lifters live by. But when it comes to lifting and shoulder pain, it could be a signal of something more serious than the regular muscle soreness you experience after a hard workout.
A big? An injury to your rotator cuff, a group of four muscles and tendons that keep the ball and socket joint of your shoulder centered on the socket joint. Its primary function is to help move larger muscles, such as your deltoids, says Christopher Camp, M.D., an orthopedic surgeon at the Mayo Clinic. It helps you rotate and lift your arm.
You don't have to be a world-class athlete—think major league pitcher—to develop serious rotator cuff problems. Even casual lifters can fall victim to rotator cuff injuries.
So here's everything you need to know about it – and how you can quickly stop your shoulder from hurting.
Related: The best exercises for your shoulders
Rotator Cuff Injury Symptoms
If you experienceeveryoneshoulder pain, it's a sign that something is wrong.
“It is critical for weightlifting enthusiasts to know that shoulder pain is not normal, especially acute pain that occurs after a single lift,” says Dr. Camp. It means any pain that arises after something specific - e.g. Anlateral elevationofshoulder pressure- could be a sign of injury to your rotator cuff.
The pain you would feel would be like a toothache, according to the Cleveland Clinic. This means that the discomfort radiates, usually from your outer arm to slightly below the top of your shoulder. It usually gets worse if you hold your arms above your head or reach behind your body, as if you were putting a belt through your belt loops. You may even hear a clicking sound when you raise your arms.
Related: 12 sounds you don't want your body to make
Unlock your shoulder mobility with this simple stretch:
How do you know if you have torn your rotator cuff?
But don't be too quick to assume that this is necessarily the caseresumeyour rotator cuff, a serious injury that occurs when your tendon is actually torn from your bone.
In fact, the most common type of rotator cuff injury among casual lifters is something called rotator cuff tendinitis, an inflammation or swelling of the tendons that connect your muscles and bones in your shoulder, says Lawrence V. Gulotta, M.D., an orthopedic surgeon at Hospital for Special Surgery in New York City. It often occurs as a result of overworking your delts in the gym, such as doing too much or too heavy rear hang gliding or shoulder presses.
If you have had an actual rotator cuff tear, your pain will be more severe.
"Symptoms that indicate a tear include severe pain and weakness. The pain is usually on the outside of the shoulder," says Dr. Gulotta. In addition, it is usually worse at night and you may not be able to lift your arms above your head or lift things away from your body.
Related: 5 surprising body parts that are extremely sensitive to pain
How to prevent rotator cuff injuries
You can prevent rotator cuff tendonitis by balancing your training.
“The rotator cuff and deltoids are antagonists and should always be trained in combination with each other,” says Dr. Gulotta. “Failure to do so can lead to imbalances around the shoulder that cause tendonitis due to overuse of the rotator cuff.”
This means that for any set of exercises that target your rotator cuff, for examplean external rotation of the barbell- you should make one that targets your delts, e.ga barbell lift at the front.
When it comes to preventing rotator cuff injuries when lifting, it's all about using the right weight and form.
“Although rotator cuff injuries can occur in a variety of ways, they are most common when lifting heavy weights overhead,” says Dr. Camp. “For weightlifters, the bench press and overhead (military) press are probably the most common culprits.”
Of course, that doesn't mean you shouldn't do these lifts. Make sure your form is correct, such as keeping your elbows at an angle in front of your body rather than straight out to the sides when you press. Going wide allows you to push more weight, but puts extra strain on your rotator cuff.
InStayAlso on form during your set: "In my practice, the most common way people tear their rotator cuff while training is when they don't pay attention to their form while trying to do one last rep," says Dr. Gulotta. “The one thing they all have in common is that the main muscles lose control due to fatigue, which puts a lot of pressure on the rotator cuff, causing it to tear.”
It's not just about the shape either; you need to make sure you are lifting a safe amount of weight. Plus, because your shoulders are endurance muscles, you don't need a lot of weight to grow them, says Dr. Kamp. Lower weight and higher reps may do the trick, while keeping your rotator cuff safe.
Additionally, you need to make sure that you don't overload them either. Stick to shoulder training twice a week, says Dr. Camp. (You'll still work your shoulder muscles if you also do other lifts, such as arm and back exercises like seated cable rows).
Related: 21 Day Metashred - Men's Health's home workout plan that burns fat and builds muscle
How rotator cuff injuries are treated
When shoulder pain develops, it is best to stop lifting for a while.
Avoid lifting the upper body and apply ice for about 20 minutes two to three times a day. Take anti-inflammatory medications such as ibuprofen or naproxen to ease the pain, especially if your injury is related to tendinitis, says Dr. Kamp. Most milder shoulder injuries will resolve with this type of treatment.
Related: Why every man should take a day of rest
If the pain doesn't improve after a few weeks, something more sinister may be going on, especially if you have weakness in your arm or can't lift it. This could be a sign of a completely torn rotator cuff, says Dr. Kamp.
So see your doctor if you develop these symptoms or if the pain persists after a few weeks, he says.
Your doctor can help you identify the problem and give you a specific diagnosis based on your symptoms, physical exam, x-rays, and/or MRI. He or she can work with you and a physical therapist or trainer to develop a comprehensive treatment plan tailored to your specific problem, says Dr. Kamp.
“Although most patients with rotator cuff tendonitis can be treated without surgery, patients with true tendon tears often require surgery,” says Dr. Camp. six to nine months.
Bottom line: “With the rotator cuff, an ounce of prevention is worth a pound of cure,” says Dr. Camp. To avoid long lifting, you need to lift smarter—with better form, safer weights, and less excessive volume—to prevent a rotator cuff injury from developing in the first place.
