Attention all gym fanatics! Share by Harry Brownlow, September 2017 There are many reasons that might get you going to the gym: you might wish to improve your fitness or to lose weight or to bulk up or to gain the perfect body shape or to maximise power. Whichever is your principle aim you need to be aware of potential shoulder injuries, how to avoid them and how to treat them if they happen. I see many patients, mostly men, who suffer with shoulder problems relating to working out in the gym. The commonest source of pain is from the acromioclavicular joint (ACJ) which is where the clavicle (collarbone) meets the shoulder blade on top of the shoulder. It causes pain on top of the shoulder typically when pressing heavy weights. It can happen during bench pressing or shoulder pressing and is typically really sore during incline presses. The pain often seems to radiate down the line of the biceps tendon. However biceps tendon pain is actually quite uncommon. I see many patients, mostly men, who suffer with shoulder problems relating to working out in the gym The best treatment is to avoid heavy shoulder work for some weeks and consider taking a regular course of anti-inflammatory tablets. If these actions fail to help then seek medical attention for an xray, perhaps an MRI scan and possibly a cortisone injection into the AC joint. Older patients sometimes complain of pain deep in the back of the shoulder again when pressing. This tends to be due to labral (ligamentous) injury and degeneration in the posterior glenohumeral joint. This can only be diagnosed by MRI scan and treatment may require arthroscopic surgery. The best treatment for tendon rupture is surgery, but this has to be done quickly Less common problems include rupture of tendons including long head of biceps, triceps and pectoralis major. These ruptures are most often encountered in people who use anabolic steroids. The best treatment for tendon ruptures is surgery but this has to be done quickly: within 4 weeks of rupture. I have also treated patients with severe arthritis of the shoulder due to years of heavy lifting. This can be difficult to cure. The best ways to avoid injury are to ensure that you maintain careful shape and use the correct technique, you do not over-train, and that if you are already carrying an injury that you are very careful not to aggravate it further or cause injury elsewhere by compromising your position and style. If are having shoulder trouble start by talking to a personal trainer or physiotherapist. For persistent problems see a shoulder specialist who has direct access to xray, ultrasound and MRI scanning facilities.