Weightlifter’s Shoulder (Distal Clavicular Osteolysis)

Weightlifter’s shoulder is an overuse injury where tiny fractures occur along the end of the clavicle, or collarbone. This leads to a deterioration of the bone.

Despite its name, weightlifters are not the only ones affected. Soldiers, handball players, air-hammer operators, and others can develop this problem.

Weightlifter’s Shoulder Anatomy

The joint that is most often affected by weightlifter’s shoulder is the AC (acromioclavicular) joint, or the place where the collarbone attaches to the curved part of the shoulder blade, also known as the acromion. There are many soft tissues, including various ligaments, tendons, and cartilaginous discs that hold the clavicle in place inside the AC joint. 

The end of the clavicle which forms the AC joint is also known as the “distal” end. For this reason, weightlifter’s shoulder is also called distal clavicular osteolysis. Osteolysis is another word for the breakdown of bone.

Weightlifter’s Shoulder Causes

The most common causes of weightlifter’s shoulder are repeated trauma and stress while lifting heavy objects. When doing bench presses, for instance, excessive pressure is placed on the AC joint whenever the elbows drop below or behind the body. Tiny fractures will be created in the bone. Because these fractures will not have time to heal before the next training session, the bone will begin to dissolve.

If left untreated, this could potentially lead to degenerative joint disease.

Weightlifter’s Shoulder Symptoms

Some of the most common symptoms of weightlifter’s shoulder are:

  • Aching pain in the front of the shoulder
  • Pain and tenderness over the AC joint, at the shoulder end of the collarbone
  • Weakness in the arm and shoulder
  • If you are a weightlifter, pain and tenderness will worsen after participating in a weightlifting competition or training night
  • Pain when moving the arm across the body
  • Pain when engaging in activities like push-ups, bench presses, or any throwing motions.

Weightlifter’s Shoulder Diagnosis

The most common way your doctor will diagnose weightlifter’s shoulder is by discussing your signs and symptoms. They will ask you questions about your medical history and when you believe your symptoms began. During a physical examination,your doctor may manipulate the AC joint in order to assess exactly where the injury has occurred. 

The diagnosis can be confirmed with X-rays, and also with steroid injections. If there is relief from pain after an injection of steroids into the shoulder, this confirms the diagnosis of weightlifter’s shoulder.

Weightlifter’s Shoulder Treatment

There are potential nonsurgical and surgical treatments for weightlifter’s shoulder.

Nonsurgical Treatments for Weightlifter’s Shoulder

Nonsurgical treatments will likely comprise wholly of changes to your lifestyle. If you are a weightlifter or any other type of athlete, your doctor will likely work with a physical therapist to determine a training plan for you that will not aggravate your symptoms. 

A physical therapist will be able to give you specific advice on activity modification for your specific injury. For example, narrowing your hand spacing on barbells can take the stress off the distal clavicle. Ending your bench presses at least two inches above the chest can also help.

Ice can be applied to the affected area after a workout session to help manage pain and stimulate healing. Anti-inflammatory medications like ibuprofen can also be used to help manage pain. 

Surgery for Weightlifter’s Shoulder

For those who do not improve with nonsurgical treatment, or for those who are unwilling or unable to change their training routine, there is a procedure called a distal clavicle resection, in which the affected end of the clavicle will be removed. This can be done arthroscopically, with tiny cameras and surgical instruments, or through a larger open incision.

It is also possible, once the end of the bone has been cut, to transfer a nearby ligament over the cut end. This helps protect the joint and makes weightlifting significantly more comfortable for many athletes.

Weightlifter’s Shoulder Recovery

Recovery from nonsurgical treatment is different for everyone. It is generally okay to return to normal activities once you are pain-free. A physical therapist can help you gradually resume normal activity without aggravating your symptoms.

After undergoing surgery, training can be tentatively resumed in as little as three days, and most return to normal preoperative activities within one week. 

At SPORT, we will identify the source of your pain and then utilize state-of-the-art therapeutic techniques that focus on restoring your range of motion.

Depending on the specific condition and its severity, these treatment options may include physical therapy, over-the-counter anti-inflammatory medication, slings and supports, cortisone shots, or shoulder or elbow surgery.

If you have an acute or chronic shoulder or elbow injury that needs medical attention, call SPORT at (469) 200-2832 to arrange a consultation or you can request one online. Hurt today? We can arrange a same-day urgent care visit to ensure you get fast, effective relief.

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