The shoulder is made up of 3 bones: the scapula (shoulder blade), humerus (upper arm bone) and collar bone. Repeated stress from sports such as weight lifting or weight training or using an air hammer frequently at work can cause small fractures at the end of the collar bone close to the shoulder joint. This type of injury is called distal clavicle osteolysis or weightlifter’s shoulder.
Due to repeated stress and trauma on these fractures, the bone does not have a chance to heal, leading to deterioration. It may also occur due to an acute injury in the past that was not given sufficient time to heal.
Symptoms of distal clavicle osteolysis may include pain over the top and front part of the shoulder, tenderness, swelling, pain with lifting weights and cross arm movement, and a feeling of weakness in the shoulder. Chronic inflammation may occur along with formation of scar tissue (fibrosis).
When you present to the clinic with these symptoms, your doctor will review your history and perform a thorough physical examination for tenderness and range of motion. X-rays, CT scans and bone scans may be ordered. Pain relief with a steroid injection into the AC joint confirms it as the site of origin of the pain.
Non-surgical treatment options include:
- Rest, as much as 6 weeks for a distal clavicle osteolysis injury to heal.
- Activity modification by using different hand positions while lifting weights, using lighter weights and avoiding certain exercises.
- Anti-inflammatory medications.
- Steroid injections into the joint.
- Physical therapy.
Surgical treatment is suggested when conservative methods fail to provide relief. The procedure is called distal clavicle excision, where the end of the clavicle that is degenerated is removed to allow for increased space within the joint, improved range of motion and to provide substantial pain relief. Post-operative recovery usually takes up to 3 months. Following the surgery, your surgeon will recommend physical therapy rehabilitation to maximize pain relief and range of motion of the shoulder.