In the gym, pain can be a difficult thing to assess especially for those whose workouts focus heavily on weightlifting.  In some instances, a mild amount of pain is the result of the muscles being stretched and strengthened and is normal.  In other instances, pain is the body signaling an injury.  Many patients often cite pain in the shoulder while bench pressing or overhead exercises, as well as a feeling of the shoulder “clicking”, “catching”, or “locking”.  The cause of this is most often an injury to the AC (acromioclavicular) joint of the shoulder.

The AC joint is the area of the shoulder where the collarbone attaches to a curved bone, known as the acromion, and collectively form the top portion of the shoulder.  Weightlifting injuries to this joint tend to relate to the age of the athlete but both can result in severe pain in the top of the shoulder that may radiate into the trap muscle.

ac joint

Below are two of the most common causes of AC joint injury.

Younger athletes – Distal Clavicle Osteolysis
Commonly referred to as “weightlifters shoulder”, this injury not only effects weightlifters but also those engaged in any repetitive overhand motion.  This injury is not the result of a single incident, but a repetitive wearing of the joint.  Exercises that allow the elbows to be lowered below the body such as bench press, chest fly or military press, cause stress to the joint and can result in tiny fractures of the bones. 

benchpress shoulder pain

Overtime, these small fractures cause a breakdown of the bone (osteolysis) and result in pain and inflammation of the joint.  The osteolysis can be seen on an X-ray as small cysts in the end of the collarbone.

Symptoms of Distal Clavicle Osteolysis can include:

·      Pain at the top of the shoulder

·      Pain when pressure is applied to the AC joint

·      Pain when reaching the affected arm across the body

·      Pain that is most severe several hours after lifting


Older athletes – Shoulder Osteoarthritis
In older athletes, the primary cause of AC joint injuries is preexisting arthritis in the acromioclavicular joint due to degeneration of the bone and cartilage or as a result of a prior injury.  There are several forms of arthritis, however osteoarthritis accounts for almost 80% of all arthritic conditions.  Osteoarthritis in the shoulder causes a breakdown of the cartilage in the AC joint and causes inflammation and limited mobility in the joint.

Certain shoulder exercises and stretches can help strengthen the shoulder and counteract much of the pain as a result of osteoarthritis.  However, it is best to first consult a specialist to determine the best weight training regimen as many exercises can cause increased degeneration of the joint.

Symptoms of Shoulder Osteoarthritis can include:

·      Pain at the top of the shoulder

·      Pain toward the side of the neck

·      Pain while moving the shoulder especially reaching across the body

·      Pain lying on the affected side

·      Limited range of motion in the shoulder

·      A “popping” or “clicking” sound on the top of the shoulder

At Total Ortho Express in Massapequa, we offer walk in orthopedic care with no appointment needed.  We offer extended evening and weekend hours so you can visit us before or after your gym session.

Our team of orthopedic specialists are experts in the diagnosis and treatment of sports and orthopedic injuries and utilize on-site imaging to treat you quickly and effectively.  If advanced care is needed, our team can schedule an appointment with one of our Orthopedic Surgeons – right on site.  So next time, save yourself the time and hassle of the ER or General Urgent Care and come to Total Ortho Express in Massapequa.