Overhead lifting is a fundamental movement in strength training, many athletic activities, and everyday tasks. However, it can lead to shoulder pain and is also one of the most common complaints we see in the orthopedic clinic. Understanding why overhead lifting can hurt requires a closer look at shoulder anatomy, how it moves, and common injury patterns seen in sports medicine.

The shoulder has the greatest range of motion of all our joints. It consists primarily of the glenohumeral joint, where the head of the humerus (arm bone) sits in the shallow glenoid socket. This allows for flexibility, but places heavy reliance on surrounding soft tissues — such as the rotator cuff muscles, labrum, and scapular stabilizers — to maintain alignment during movement. When lifting overhead, these structures must work together to keep the joint in its proper place.

Pain during overhead lifting or activity often is caused by subacromial impingement. As the arm is raised, the space between the acromion (part of the shoulder blade) and the humeral head naturally narrows. If the shoulder moves abnormally, due to poor posture, muscle imbalance, or fatigue, the rotator cuff tendons and bursa can become pinched. This repetitive compression can lead to inflammation and pain, particularly during the mid-range of lifting (often referred to as a “painful arc”). Shoulder impingement/bursitis is probably the most common shoulder “injury” I see and treat in my clinic.

Another culprit is scapular dyskinesis, or abnormal movement of the shoulder blade. The scapula is essential in overhead movement, maintaining space for the rotator cuff. Weakness in the muscles around the shoulder blade and chest can disrupt this motion. When the scapula fails to move properly, the shoulder joint has to compensate, increasing stress on soft tissues and increasing the risk of pain.

Rotator cuff tendinopathy is also another cause of discomfort. These muscles stabilize the shoulder joint, keeping the humeral head in the socket during overhead activity. High stress on the tendons during training sessions and poor recovery can lead to microtrauma and degeneration within these tendons. Oftentimes, people describe a deep, aching pain or weakness, especially with repeated lifting.

From a sports medicine standpoint, addressing overhead lifting pain involves identifying and correcting the root cause. This may include strengthening the rotator cuff and scapular stabilizers, optimizing lifting technique, and modifying training load. Early recognition and intervention are key, as persistent pain can progress to more significant injuries such as rotator cuff tears, chronic tendon disease, or labral issues. With proper assessment and targeted rehabilitation, most people can return to pain-free lifting and even improve their performance. When conservative treatment alone doesn’t lead to improvement, however, your local sports medicine physician has many options to get you back to your activities!

Dr. Joshua Brandon is a board-certified, fellowship-trained primary care sports medicine physician specializing in the evaluation and management of non-surgical musculoskeletal issues and sports medicine. Visit Campbellclinic.com or call 901.759.3111 for more information.

 

By Joshua Brandon, MD, CAQSM