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Weightlifter’s Shoulder / Osteolysis

Weightlifter’s Shoulder / Osteolysis

Is your shoulder painful when lifting weights at the gym?

You could have weightlifter’s shoulder (osteolysis of the clavicle).

Weightlifter’s shoulder is an injury of the AC Joint, where the clavicle (collar bone) joins the shoulder blade. While it’s most prevalent in the gym setting (hence the name), any activity involving repetitive or heavy use of the shoulder such as overhead work, swimming, surfing, throwing, and boxing can cause weightlifter’s shoulder.

It causes pain and weakness during pushing exercises like the bench press and shoulder press.

Book an appointment with Perth Shoulder Physio for an accurate diagnosis, treatment and more specific information about your shoulder injury.

Note: This page contains general advice on weightlifter’s shoulder, which is intended for general education. There are other potentially more serious injuries that can cause pain when weight lifting.

What is the AC (acromioclavicular) joint?

The AC joint or acromioclavicular joint is a small joint between the acromion of the shoulder blade and the collarbone. It forms an important link between the arm and the skeleton and plays an important role when elevating the arm.

The AC Joint has a capsule and small AC Joint ligament, which provide stability. Although the AC Joint ligaments are relatively weak, there are also two much stronger ligaments that attach the clavicle to a different point on the shoulder blade called the coracoid.

These ligaments are termed the conoid and trapezoid ligaments and are collectively known as the coracoclavicular ligaments. They hold the clavicle in place and prevent it from being displaced upward.

What causes Weightlifter’s Shoulder?

The human shoulder has evolved from a weight bearing joint, into a finely tuned series of joints enabling significant mobility and precise hand placement for skilful tasks.

Whilst we are still capable of lifting and carrying heavy loads, the large compressive force on the AC joint can lead to inflammation and pain in the joint and the end of the clavicle bone.

Weightlifters of all levels are prone to developing weightlifter’s shoulder, especially those performing pushing movements like bench press, push ups, dips, and overhead press. The joint is placed under particular stress when the elbow drops below or behind the body, for example as the bar approaches the chest during bench press.

Continued loading of a symptomatic AC joint and clavicle may result in micro-trauma to the joint surfaces and in some cases, erosion of the bone.

Weightlifters shoulder (osteolysis of the clavicle) can be considered like a stress fracture, requiring significant offloading to allow the bone to heal.

What are the symptoms of Weightlifter’s Shoulder?

  • Pain on top and/or the front of the shoulder
  • Pain on palpation of the AC joint
  • Pain and weakness with weight lifting, especially push-ups, bench press, dips, shoulder press and chin ups
  • Potential clicking
  • Potential pain with end range elevation of the arm over head
  • Potential pain with reaching across the body and behind the body
  • Potential muscle soreness/tightness into the neck
  • Potential pain lying on the affected shoulder, especially at night

How is Weightlifter’s Shoulder treated?

Effective treatment of weightlifter’s shoulder relies on an accurate diagnosis and classification of the severity of the condition.

Physiotherapy Treatment for Weightlifter’s Shoulder includes:

  • Dry needling or massage to ease muscle tension and pain
  • Correction of muscle imbalances
  • Technique correction

Rest / Modification of Aggravating Activities can help too:

Severe cases - may require 6-12 weeks of rest to allow the bone to heal.

Moderate cases - may be possible to avoid the aggravating activities such as bench press, push-ups, dips and shoulder press but continue with other weight lifting exercises that do not cause pain.

Mild cases - may be possible to simply modify the technique of aggravating activities in order to reduce stress on the AC joint.

Your shoulder physio will instruct you how to modify your weight lifting exercises to reduce stress on the AC Joint.

Medical Treatment for Weightlifter’s Shoulder:

  • Anti-inflammatory medication
  • Cortisone injection into the AC Joint if inflammation persists
  • Surgical Management of Persistent Weightlifter’s Shoulder or Osteolysis.

If AC joint pain or osteolysis fails to resolve, a minimally invasive surgical technique may be performed. This involves the removal of less than one centimetre of bone at the end of the clavicle. Thus, preventing the bones of the AC joint grinding together, reducing pain and restoring range of movement.

Recovery time for this procedure is much shorter compared to open surgery, with most patients returning home the next day and resuming full activities within three months.

Get back to weight training with ease

Remember when weight lifting was easy and didn’t cause you pain?

Want to get back to that again? What are you weighting (waiting) for?

Book an appointment with Perth’s only Shoulder Physio to have your shoulder assessed and treated, so you can get back to lifting the weights you desire – without the pain or discomfort.


Ready to recover and get pain free?

Your Perth Shoulder Physio is ready to help.