If you do develop weightlifters shoulder then certain activities such as bench press, dips, and push-ups should be avoided for a while to allow healing. Don't rack the bar (lift the bar and let it rest on the clavicles or deltoids.) Start with the elbows even with, or above your shoulders and lift. The power clean or power jerk can also be modified. Some lifters place a two-inch folded towel on the chest as a reminder of when to stop. Stopping your bench press two inches above the chest also decreases the stress on the distal clavicle. For example, if you narrow your hand spacing on the barbells this takes the stress off the distal clavicle. One of our Physical Therapists at Humpal Physical Therapy & Sports Medicine Centers can help you with advice for activity modification and specific strength training tips for this problem. If you do develop weightlifters shoulder, take quick steps to modify your weightlifting techniques and avoid over-training. Smoking decreases the amount of oxygen available to the bones and tissues and thus creates a less resilient tissue. Over-training adds too much stress to the bone, which can contribute to rapid bone breakdown. Avoiding over-training and smoking are two very effective ways to prevent this condition. This may include rest and/or changes in weight-training activities and techniques. Treatment begins with conservative (non-operative) care. Degenerative joint disease occurs as an end-result of the pathologic process. Part of the breakdown process of the joint is from the fact that the synovial lining, which lines most joints, starts to overproduce itself during this injury and invasion of the underlying bone begins. Chronic inflammation with scar tissue called fibrosis is commonly found when tissue from the area is examined under a microscope. A network of blood vessels forms in the area during the attempted healing process. In studying this injury, there is evidence that the body tries to heal the fractured bone but the bone dissolves or is resorbed by the body instead. As mentioned above, weight training, intensive lifting, and operating an air hammer are examples activities that can lead to acute distal clavicular osteolysis.
In most cases, there is repetitive stress to the affected upper extremity. Some people affected by weightlifters shoulder may have a history of an acute injury of the AC joint but the condition can occur without any known previous trauma. As the bone does not have a chance to heal before the next training session begins, the bone actually starts to dissolve. This places the shoulders in a position of excess extension. Excessive traction on the AC joint from bench presses or chest fly exercises occurs when the elbows drop below or behind the body. Repetitive trauma or stress from training and lifting causes tiny fractures of the distal end of the clavicle bone.