Weightlifters shoulder is basically a wearing away of the bones that comprise the shoulder joint. The bones of the shoulder consitis of the scapula, clavicle and the humerus. The acromion portion of the scapula meets the distal clavicle and forms what is known as the acromioclavicular (AC) joint. An injury to this joint can result in osteolysis of the distal clavicle. Osteolysis refers to dissolving of bone in the injured area. Osteolysis can develop as a result of:
1. A minor injury to the joint such as a sprain;
2. A severe injury to the joint such as a blunt trauma; and/or
3. Repeated minor trauma.
Weightlifters shoulder is related to repeated minor trauma. This trauma occurs as a result of pushups, dips, flies, and various shoulder presses. This repetitive stress to the AC joint sets up an inflammatory reaction which may eventually lead to osteolysis of the distal clavicle.
Weightlifters will complain of pain with shoulder workouts, especially those exercises that stress the AC joint. They can go on to develop pain with activities of daily living. They may also complain of pain while sleeping on the affected shoulder. A physical exam will reveal pain over the AC joint with direct evaluation as well as pain with maneuvers that stress the joint. X-rays will show degeneration of the distal clavicle that may even reveal a moth-eaten appearance of the distal clavicle.
Treatment includes rest from those exercises that stress the AC joint, physical therapy, anti-inflammatory medications, steroid injection, and surgery if conservative management fails.
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