Assessing Shoulder Weight-Training Readiness: Identification of Muscle Dysfunction To Prevent Weight Training Injuries

By Ken Kinakin, DC

 

Weight-training dysfunctions can develop from a variety of sources, such as poor lifting technique, lifting beyond one’s capabilities, training too often, and insufficient rest or recuperation. An often-overlooked cause is a previously injured area that does not heal correctly and becomes dysfunctional when an excessive load is put on it.

Weight-training dysfunctions can be caused by a lack of recuperation that causes microtrauma (small amounts of muscle damage important for growth and strength) to develop into macrotrauma (a large amount of damage that does not contribute to muscle growth or strength but instead actually prevents training due to pain).

Shoulder problems are among the most difficult injuries from which to recover since the shoulder is involved with so many ranges of motion and exercises.

The main focus of any weight-training routine is to optimize the potential for strength and development.

Many factors can create what is known as a weight-training dysfunction, which can limit lifting potential. A weight-training dysfunction is an abnormality in a structure or system that causes an alteration in how the body performs during weight training. Weight-training dysfunctions can develop from a variety of sources, such as poor lifting technique, lifting beyond one’s capabilities, training too often, and insufficient rest or recuperation. An often-overlooked cause is a previously injured area that does not heal correctly and becomes dysfunctional when an excessive load is put on it.

To prevent weight-training dysfunctions most effectively, three different approaches should be taken. The first approach is to use excellent lifting technique. The second is to make sure that the exercises performed are not contraindicated for biomechanical reasons. The third is to test to make sure that muscles, joints, nerves, and biochemistry are all working optimally and have no dysfunction.

Microtrauma/Macrotrauma

A weight-training dysfunction is much different from an injury in a contact sport such as hockey or football and from an overuse injury in an activity such as running. Weight-training dysfunctions can be caused by a lack of recuperation that causes microtrauma (small amounts of muscle damage important for growth and strength) to develop into macrotrauma (a large amount of damage that does not contribute to muscle growth or strength but instead actually prevents training due to pain). Macrotrauma can affect muscle, joint, or nerve or create a biochemical problem and is the usual cause of weight-training injuries. One or more of these types of injury can be present at the same time, causing pain, weakness, and altered joint motion during an exercise. The more complex and chronic the problem, the more likely that multiple types of dysfunction are going on at the same time.

Four types of weight-training dysfunctions can occur:

  1. Muscle dysfunction occurs when muscle has been damaged and bears scar tissue, a muscle imbalance exists, the muscle is shortened or the muscle is deconditioned.
  2. Joint dysfunction occurs when there is abnormal motion of a joint or a joint has become separated.
  3. Nerve dysfunction occurs when tension on or compression of the nerve has decreased or altered the action potentials of the nerve. Altered proprioception at the joint can also inhibit the potential strength of the muscle.
  4. Biochemical dysfunction occurs when overtraining or deficiency in specific nutrients causes a global lack of strength and recovery that can contribute to the chronicity of the injury.

Shoulder Weight-Training Readiness Tests

These tests are examples that can be incorporated into your existing assessment of the client before they start a weight-training program. The way to check if they can do shoulder exercises is to do a shoulder assessment on various ranges of motion. Here are the exercises and ranges you can check with your clients to see if they experience pain or a decreased range of motion, and to determine if they need treatment or rehabilitation before they start the program.

Lateral Deltoid Raise Test – This motion will check the ability to perform lateral dumbbell raises for the lateral deltoid. With the arm resting beside the body and the palm facing the thigh, have the patient raise their arm until it is straight up and touches the head. (Figure 1)

  

Figure 1 – Functional Lateral Deltoid Raise Test

A dysfunctional shoulder muscle or joint will reduce arm abduction and the hand will be below shoulder height. A shortened pectoralis muscle will pull the arm forward when raising it up overhead. (Figure 2)

  

Figure 2 – Dysfunctional Lateral Deltoid Raise Test

Dumbbell Fly Test – This motion will ascertain whether dumbbell flys for the chest can be done. Instruct the client to position the extended arm in front of the chest with the thumb up, then bring the arm back while keeping it shoulder height until the hand is behind the shoulder. (Figure 3)

  

Figure 3 – Functional Dumbbell Fly Test

If the pectoralis muscle is shortened, the hand will be in front of the chest. (Figure 4)

  

Figure 4 – Dysfunctional Dumbbell Fly Test

Bench Press Subscapularis Rotator Cuff Test – One of the muscles that can be frequently damaged in weight training is the subscapularis rotator cuff muscle. As an internal rotator cuff muscle, it is commonly too tight or shortened and therefore becomes dysfunctional when a load is put on the shoulder. The subscapularis muscle prevents the humeral head from going forward when the bar is in the bottom position on the chest in the bench press. If the subscapularis muscle has scar tissue formation and adhesions due to years of training, it will allow the humeral head to translate forward when the weight-trainer is in the bottom position of the bench press, and there will be resulting pain in the anterior shoulder. This is the most common cause of shoulder pain due to bench pressing and usually necessitates treatment of the subscapularis muscle along with other areas.

A simple test to see if the subscapularis is working correctly is to have the client put their hand behind their back palm facing backwards. Then ask them to try and raise the hand away from the low back. This may reveal limitations in range of motion and whether the subscapularis muscle is firing properly. (Figure 5)

  

Figure 5 – Functional Bench Press Subscapularis Rotator Cuff Test

A shortened subscapularis muscle or thickened shoulder capsule will restrict the hand from going behind the back. (Figure 6)

Figure 6 – Dysfunctional Bench Press Subscapularis Rotator Cuff Test

Shoulder problems are among the most difficult injuries from which to recover since the shoulder is involved with so many ranges of motion and exercises.

The tests described above will allow greater depth of client assessment to uncover any hidden problems that may be exposed during training. Adding the tests to your assessment program will aid in further analysis of the type of exercises clients need. More importantly, they will help show which exercises should be avoided until dysfunctions have been remedied through treatment involving various soft tissue or myofascial techniques, chiropractic adjustments and rehabilitative exercises.

 

  Dr. Ken Kinakin is a chiropractor, and a certified strength and conditioning specialist. He has also competed in bodybuilding and powerlifting for over 30 years and regularly lectures across Canada and United States and Europe to doctors and personal trainers on the areas of weight-training, rehabilitation and nutrition. Dr. Kinakin is the author of “Optimal Muscle Training” and is the founder of the Society of Weight-Training Injury Specialists – SWIS that educates and certifies doctors, therapists and personal trainers in the prevention, treatment and rehabilitation of weight training injuries, www.swis.ca  

 

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