Acromioclavicular Joint Osteolysis (Weightlifter’s Shoulder)

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What is Weightlifter’s Shoulder?

Weightlifter’s shoulder is a painful overuse injury that involves microtrauma and tiny fractures along the clavicle (collar bone), slowly leading to a painful osteolysis (boney deterioration) of the distal end of the clavicle.

Who does Weightlifter’s Shoulder affect?

This condition affects weightlifters who endure tremendous compressive forces across the acromioclavicular (AC) joint with activities like bench press or overhead press.

AC joint osteolysis does not merely affect weightlifters, but anyone who performs movements that chronically compress or stress the AC joint such as manual laborers, handball players, racquetball players, etc.

What are the symptoms of Weightlifter’s Shoulder?

The most common symptoms of AC joint osteolysis are pain and tenderness upon palpation of the AC joint and the end of the clavicle. The athlete will complain of pain with upper extremity exercise overhead activities that aggravate it. There may also be some swelling and deformity (shoulder bump) of the joint space and surrounding soft tissue.

How is Weightlifter’s Shoulder diagnosed?

A clinical assessment can be made with a focused history and physical exam findings. A crossover adduction test may illicit pain on the AC joint.

A shoulder x-ray is typically obtained to assist in the diagnosis. The x-ray will show broken down bone (osteolysis), bone spurs (osteoarthritis), areas of poor bone density or bone lacking appropriate mineralization (osteoporosis).

How is Weightlifter’s Shoulder treated?

Initial treatment involves:

  • Activity modification (avoiding overhead work, bench press, throwing motions, clean and jerking, snatching)
  • Rest
  • Ice
  • Heat
  • Anti-inflammatories
  • Physical Therapy with focus on shoulder strengthening and scapular stabilization
  • For patients who do not find symptom relieve with simple treatments, surgery is an option to consider.

Scapular Stability Exercises
Advanced Scapular Stability Exercises

By Viet Truong & Mo Mortazavi, MD