Dear Running Doc:
As a runner, I’ve finally been convinced I need to lift weights to keep my upper body strength, especially now that I’m in my 40’s. But I’ve been at the program for just a couple of weeks now, and I’m already getting a sharp pain in my right shoulder near the collarbone every time I lift. My doctor says it’s probably bursitis, which I should have expected starting with weights at my age, and that I’m lucky I didn’t get something more serious like a rotator cuff injury. He thinks I should stop. What do you think?
Richard A., Goshen, NY
Weight-lifting at any age can strain a ligament or rotator cuff muscle, or trigger bursitis. But a pain like yours that comes on gradually and is focused where the shoulder bone meets the collarbone has all the signs of something else: a harmless but painful syndrome of the collarbone from the constant chafe of the adjoining shoulder bone pressing against it. Any repetitive and forceful overhead motion can bring the problem on, like javelin throwing, putting the shot — or weight-lifting.
This is not a difficult injury to diagnose. Bone that’s chafed this way takes on a distinctive “cheesy” appearance in a simple X-ray, a bright white area on the film where the crumbly-looking bone has already “lysed” or lost calcium: Hence the medical term osteolysis.
Once a correct diagnosis is made, osteolysis can respond in as little as a week to the right medication and a brief break from just your overhead work. In fact, though it may take six months to a year for the bone to smooth itself over, you can be back on the bench as soon as you’re pain-free. The wait probably won’t be long. If oral anti-inflammatories don’t do the trick in a few days, a PRP injection will usually provide virtually instant relief. And in stubborn cases, the collarbone can be surgically filed down to eliminate excess chafe.
Meantime, put away your self-recriminations about whether or not you should have “known better.” Though the softening of the collarbone most commonly follows a direct blow — ask any quarterback — it can just as easily come out of nowhere. As any sports medicine physician will tell you, it probably has nothing to do with how much weight you’re working with, or whether you push up the load too soon, or use lousy form, or start training either at 47 or in high school. The mechanics are the same: Every time you push a weight above your head, it brings the two bones together. Some collarbones resent this, others don’t. And it’s not even an overuse injury: You can get it whether you do five reps or 25.
Pushing through the pain won’t do any additional harm to the bone, but why put yourself through it? With the right treatment, you could be just a week away from kissing the worry goodbye.
Enjoy the Ride!
Lewis G. Maharam, MD, FACSM is one of the world’s most extensively credentialed and well-known sports health experts. Better known as Running Doc™, Maharam is author of Running Doc’s Guide to Healthy Running and past medical director of the NYC Marathon and Rock ‘n’ Roll Marathon series. He is Medical Director of the Leukemia & Lymphoma Society’s Team in Training program. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
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