Category Archives: Muscle sprains and injuries

Weight Lifting Injuries

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Statistically, more and more people are working out using weights and weight bearing exercise than ever before.  Whether it’s to achieve those major biceps for men or to tone and stave off the ravages of osteoporosis for women,  fitness with weights is at all an all time high.  So, unfortunately, are serious shoulder injuries, most of which occur with upper arm strengthening.

One common problem  is an injury to the A-C joint  The A-C Joint is the small accessory joint at the top of the shoulder. You can feel it — it is the small bump at the end of your collarbone. A-C stands for Acromio-Clavicular. The acromion is a flat bone at the top end of the shoulder blade. It is nature’s shoulder-pad — a square shaped bone that you can feel at the top of your shoulder.  The clavicle is the collarbone. Between the end of the clavicle and the acromion is the A-C joint which plays a major supporting role in the function of the shoulder.”

Both those who work out and their fitness trainers can stress the A-C joint when they do bench-presses and overheads because any exercise that uses a substantial amount weight to move the arm also involves stress to the shoulder.  Both of these lifts strengthen the powerful deltoid muscle which lies along the acromion and the clavicle and thus, the stress of heavy lifting can be transmitted to the small A-C joint. People who lift weights for years may injure the A-C joint and develop arthritic degeneration in the area. My patients frequently complain of pain and popping  at this joint.   I can even hear the pop on examination before x-ray or MRI confirms the injury or arthritic condition.”

The bad news on A-C  joint degeneration is that  once the damage occurs, it cannot be reversed. There is no cure for arthritis. One solution might be to curtail or give up overhead lifting, but this is usually not an option for dedicated weight lifters.  They may abstain from or limit weight lifting, but usually only for short periods of time and rarely long enough to stabilize a serious joint condition. Anti-inflammatory medicines like Aleve, Celebrex and Advil  may relieve pain but their effects may only be temporary.  A cortisone injection into the A-C  joint may also help, albeit temporarily. And neither will relieve the ‘popping’ of the joint.  That said, both therapies  should be tried prior to surgical intervention.

When A-C joint surgery is indicated, both the pain of the injury and the ‘popping’ sound can be cured with comparatively minor surgery. Quite simply, the end of the collarbone is removed. The painful arthritis and the pressure at the joint are relieved. This often ends both the pain and the popping.  The surgery can be done either arthroscopically or through a very small incision at the top of the shoulder. Recuperation is relatively quick – usually two to three weeksto return to normal activity .  The good news for the gym set is that there is usually little or no postoperative impairment to the shoulder and patients can happily resume weight lifting and other sports. Some lifters may note slight loss of maximum bench press strength, but this will be offset by relief of painful popping.

Weight lifters can also develop muscular injuries from overuse or overdoing it! One common condition is bicepital tendinitis.  “The biceps muscle bends the elbow and it’s long tendon lies in a groove in the front of the shoulder. Tendinitis or inflammation of the tendon can occur with bench presses and ‘dips’.  Treatment consists of pain and/or anti-inflammatory medication ; Physical therapy can be useful.  Sometimes, a cortisone injection. is necessary. 

Older lifters may even rupture the tendon. Sharp pain and a popping sensation may be felt in the front of the shoulder. The pain will eventually subside and usually there will be little or no lasting disability so surgery is rarely necessary.

Another muscle that can tear with excessive stress during bench presses is a tear to the so-called “pecs” – the pectoralis major muscles. A partial tear can be treated with rest and therapy and should heal on it’s own. A complete tear may require surgical repair.

Working out with weights is an important part of many people’s lifestyles. It is, for the most part, an excellent way to help stay fit and an anti-aging boost.  That  said, it must be approached with care in order for people to gain the maximum benefit from work-outs.”  In short, take care of your arms and shoulders and they will help take care of you.  If not, your upper body fitness is at serious and potentially permanent risk due to injury.

 Please note: these articles are for general information. They are not intended to serve as medical advice or treatment for a specific problem. Diagnosis and treatment of a problem can only be accomplished in person by a qualified physician.

Muscle Strains / RICE

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Hamstring Pain:  R.I.C.E.

Pulls or strains of the hamstring muscles are one of the most common sports ailments.  They occur often in running sports and are frequently caused by quick starts and stops—as in sprinting, baseball, basketball, tennis, etc.

The hamstring consists of three large muscles in the back of the thigh.  They begin at the pelvis and end just below the knee.  If you straighten and tense your knee, the fleshy part of the muscle can be felt behind the thigh.  If you run your hand behind the knee, you will feel the lower hamstring tendons on each side.  The hamstrings bend the knee.  The opposite muscle in front of the thigh is the powerful quadriceps which straightens the knee.  This muscle is approximately one-and-one-half time stronger than the hamstrings.  People with weak hamstrings are more prone to injury.

Muscles tear as a result of sudden changes in tension.  For example, a sudden start or stop can stress the muscle.  This is why sprinters are more susceptible.

When a hamstring tears, the runner feels a sudden pain in the back of his thigh.  The sensation of a “rip” or “tear” is also common.  Pain will increase over the following hours and swelling and/or a large black and blue spot (ecchymosis) may also occur from the bleeding of the injured muscle.

There are three grades of muscle tears:

Grade I:  (mild strain)  Less than 10% of the muscle is torn.

Grade II:  (moderate tear)  Up to 50% of the width of the muscle is torn.

Grade III:  (severe)  Over half of the width of the muscle is torn.

If you think you have injured the hamstrings, it is best to stop playing or exercising.  Treatment can be summed up with the acronym RICE, which stands for:

  1. Rest—crutches may be necessary.
  2. Ice—to stop swelling and relieve pain.
  3. Compression—apply an Ace bandage to lessen swelling.
  4. Elevation—helps decrease the swelling.

Treatment

Several days later, a warm whirlpool is soothing and aids in the healing process by increasing the blood flow to the injured muscle.  Mild strains will heal in a couple of days, while Grade II injuries may take up to two weeks to heal.  Grade III injuries take even longer (three to four weeks).  You can return to sports when it is no longer painful to tense the muscles.  Before you start running, it is best to rehabilitate the knee.

Initially, gentle motion to the knee should be done to regain motion.  Next, when the pain subsides, work out with light weights to re-strengthen the hamstrings.  A simple exercise is to lie face down and bend the knee with an ankle weight attached to the lower leg.  Hold for a few seconds and then relax.  It is best to start with two to three pound weights and gradually increase the amount every week.

Before returning to full activity, you should first do slow, easy running or jogging.  Running speeds can later be increased.

Prevention:

Hamstring pulls can frequently be prevented by proper warm-ups and preliminary stretching exercises.  The warm-ups increase blood supply to the muscles, making them less likely to tear.  The following are good hamstring-stretch exercises.

  1. Lie on your back.  Bring one leg up to your chest with the hip and knee bent.  Cup your hands behind the knee and push knee against the hand, straightening the knee.  Hold the stretch for five seconds.  Repeat the exercise five times.  Then do the opposite leg.
  2. Kneel down with one knee and straighten the opposite leg in front of you.  Bring your upper torso over the outstretched leg, keeping your arms at your side and your back straight.  Hold the stretch for three to five seconds.  Repeat five times.  Next, stretch the opposite leg.

Please note: these articles are for general information. They are not intended to serve as medical advice or treatment for a specific problem. Diagnosis and treatment of a problem can only be accomplished in person by a qualified physician.