AC Joint Problems in Weight Lifters Share By Mr Harry Brownlow, July 2018 Over the last 10 years an increasing number of people are attending the gym on a regular basis. For most people this is part of a general fitness programme which involves mostly cardio workouts and light weights. For others the aim is heavy lifting or muscle bulking. In 1982 an American surgeon described a series of heavy weight lifters who had pain in the AC (acromioclavicular) joint. Xrays revealed that the end of the clavicle (collarbone) was partially resorbed and abnormal. This was described as distal clavicle osteolysis. It’s odd to think of bone as a living structure which is constantly being turned over and changing in response to the biomechanical stresses being applied. We expect a bone to heal when it has been fractured but we might not expect a bone to start to absorb itself if it sustains excessive load. However that does seem to be what happens to the end of the collarbone when exposed to repeated heavy loading in the gym. In particular it would seem that bench pressing and shoulder pressing cause the most trouble. Treatments involve adjusting technique or reducing weights, physiotherapy, injections, and sometimes an operation to remove the abnormal end of the collarbone. DISTAL CLAVICLE OSTEOLYSIS Osteoarthritis of the AC joint is also very common and is evident on xrays of most middle aged men. For most people this arthritis is asymptomatic but any keen gym attender, who happens to have this arthritis, will probably notice pain when heavily loading the shoulder. Typically this pain is felt either directly over the top of the AC joint or radiating down the line of biceps. It is also often associated with popping, clicking, crunching or grinding symptoms. The same treatments are available and include adjusting technique or reducing weights, physiotherapy, injections, and sometimes an operation to remove the abnormal end of the collarbone. NORMAL ACROMIOCLAVICULAR JOINT ACROMIOCLAVICULAR JOINT ARTHRITIS However not all shoulder pain in weight lifters relates to the AC joint. Other problems we encounter include posterior ligament tears, shoulder arthritis and articular cartilage damage. Perhaps the most common problem is muscle imbalance with strong outside muscles and relatively weak deep rotator cuff muscles. If you suffer with shoulder pain in the gym then talk to a trainer to review your technique and style. Failing that see what happens when you rest the shoulder for a few weeks and try returning in incremental steps. If the pain immediately returns consider seeing a shoulder specialist to fully understand the nature of your problems. You can read more about AC Joint problems here.