Weight Training For The Older Shoulder

An Increase In Older Weight Lifters

In recent years I have noticed a trend of more and more of my older patients becoming seriously invested in weight training as a form of exercise. Lifting weights was previously an activity favored by guys in their 20’s, is now common for both men and women in their 40’s and 50’s even beyond to regularly work out at the gym. Not surprisingly associated with this increase in the average age of gym goers, I am seeing an increase in older individuals coming to my Sydney physio practice complaining of shoulder issues. Some such issues are significant enough to require surgery, others respond nicely to some treatment and a few training changes. However I am definitely dealing with a rise in injuries from weight training for the older shoulder when compared to only ten years ago.

Benefits Of Weight Training

Don’t get me wrong I don’t see this increase in weight training by those longer in the tooth like me as a bad thing, resistance training has many benefits for the general public,

• improved fat metabolism aiding with fat loss,
• improved metal health,
• improved sleep quality
• maintenance of bone density
• prevention of age related muscle atrophy
• and general well being to name a few…

Many benefits associated with weight lifting fall across all ages, but specifically in the elderly, weight training can aid in reducing the risk of falls and help reduce any perceived joint pain. However I do feel resistance training should be approached in an age specific way, if one is to remain injury free.

An At Risk Shoulder

Some structures in the shoulder are specifically subject to wear and damage, weights may further accelerate and heighten this process, particularity when the athlete chooses exercises that add excessive load to the shoulder joint in vulnerable positions. At risk tissues include the rotator cuff, specifically the tendon part of the rotator cuff which does not have great blood flow and thins with increasing age making injury more likely and slower to recover from. Other tissues which commonly wear with age include the biceps tendon and the labrum which is a “ring” of fibrocartilage attached to the rim of the shoulder socket, helping provide stability and cushioning to the ball and socket joint. Both the biceps tendon and labrum commonly demonstrate age related changes and may be further damaged with poorly guided weight training.

Exercises That May Risk Damaging The Shoulder In The Older Athlete?

Your labrum, biceps tendon and the tendon portion of the rotator cuff are vulnerable to damage when lifting weights, particularly when doing exercises where your arm is raised away from your side and your hand rotated upwards/outwards (adopting a position similar to the queens wave, similar to as if you were going to place your hand behind your head). Anatomically this position is referred to as a combination of abduction and external rotation this combined movement is used in a few weight lifting movements.
At risk activities for the shoulder in this position are:

• Shoulder press (or overhead press, specifically when performed behind the head).
• Wide grip pull ups / wide grip lat pull downs.

Activities where the elbow positioned at, or around shoulder height moves behind the body can also place significant strain on the structures listed above.

At risk activities commonly performed at the gym for this shoulder position are:

• Push ups or bench press (including incline press, as well as wide flys and cable flys).

A Balanced Training Regime Is Crucial When Weight Training For The Older Shoulder

Training for cosmetic purposes can have a negative impact on your shoulder biomechanics and how your shoulder functions. The shoulder and shoulder blade is supported by many muscles and an imbalance in the shoulder via over training particular muscles can lead to poor scapula positioning and function, putting the shoulder joint at more risk of being injured as a result. One of the most common training mistakes is focusing efforts on growing the “mirror muscles” like your pecs, muscles that look good when the are large but don’t necessarily have a positive impact on shoulder function when big and strong.

Safely Approaching Weight Training For The Older Shoulder

Firstly what do I define as the older shoulder? For the purpose of this blog, any individual over 40 would be considered “old” when it comes to weight training for the older shoulder. Individuals of this vintage and beyond lifting and training at the gym should seriously consider adjusting their training accordingly to enable safe longevity with their training, remembering life is a marathon, not a sprint and the goal is to continue training long into your golden years.
As an older individual, either new to training, or looking to adjust their resistance training to something a little more age appropriate, it is important to make sure you partner up with a trainer experienced in dealing with the older athlete. A trainer who appreciates the need for a balanced training program, where the focus is more on staying healthy and injury free more than “bulking up”. Bulking up can add excessive loads and this is where things will go wrong, often very quickly if you are not careful.

Generally exercises to avoid, or perform with caution when weight training beyond your 30’s and well into middle age include:

• Push ups
• Shoulder press (overhead press)
• Bench press where your elbows go below the level of your shoulder
• Dips
• Chin ups and wide grip pull downs
• Lateral raises with a heavy weight

Tips for the older athlete to help avoid injury to their shoulder when weight training:

• Avoid the above exercises and generally avoid or take care with wide grip activities (it is safer and less stressful on your shoulder to choose activities that keep your elbows in towards your side).
• Listen to your body. If you feel pain then stop and seek advice (early intervention is likely to give you a better outcome. Early treatment with a physiotherapist combined with exercise modification can help reduce damage and avoid the need for surgical intervention).
• Consider training with a personal trainer, or at least having a program built for you by an experienced trainer.
• Avoid training the same body area on consecutive days, unless conditioned that way as overload through a lack of rest is a common cause of injury.
• Toning training is much safer than training for bulking up in individuals around or above 40 yrs old.
• and finally prevention is better than cure.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Weight Training For The Older Shoulder should consult his or her general practitioner, physiotherapist or otherwise appropriately skilled practitioner.