Question
QUESTION: Dear Dr. G:

I have been lifting weights for more than 3 years.

Recently I was diagnosed with an acromioclavicular injury on my right shoulder.

The doctor (physical rehabilitation physician) started phyisical therapy along with some NSAID's 2 months ago on the injuried shoulder but I only noticed minimal improvement.

I'm almost sure that the exercise that caused this injury was the parallel bar dips as the exercises that I do for chest and back (which as you know also target the shoulder at some extent) have been the same for the last 3 years.

The only new compund exercise that I added was the parallel bar dips.

Maybe I did not warm up my shoulders properly or I went too deep when doing the exercise.

The next step suggested by my doctor is a cortisone injection on the inflammed site as nothing else seems to work.

I quit all upper body exercises but the discomfort (not severe pain by the way) does not go away.

This is very frustrating as I have been only doing lower body  exercises for almost 6 months.

Do you know if these injections are effective and safe?

Thanks for your help,
Robert

ANSWER: Robert,

There is a chance you have been straining the AC joint for a while and the dips were the "last straw..."   The cortisone can make your shoulder feel good again, and I've had patients over the years tolerate them well.   But if there are any structural problems with the AC joint, like bone spurs, that can a barrier to getting better.  If there are any functional problems such as adhesions in and around the shoulder, that needs to be addressed with manual therapy.   See some of the little video clips on my web site (www.drgillman.com/drgillman/pages/services.htm) to give you an idea of what I'm talking about.

'Hope this helps.

Dr G

---------- FOLLOW-UP ----------

QUESTION: Dear Dr. G:

Thanks for the valuable information and suggestions.

Do you think I should quit parallel bar dips? Or maybe you can recommend me some tips to avoid straining my AC joint?

What do you think about the deepness of the flat bench press?

Should you do it until the bar touches your chest or just when your arms are parallel to the floor?

Thanks for your help in advance,
Robert

Answer
Robert,

If you have an AC Joint problem, then dips may cause further irritation, especially if you go all the way down.   I would suggest doing 1/2 dips and seeing if that doesn't hurt your shoulder.   Chest press is the same.   If you go too far down, you strain the shoulders.  Technically, bringing the bar to the chest is fine.  If you have a big barrel chest, then that's not much of an excursion for the bar or strain on the shoulder.  But if you have a small chest, or worse: small chest and long arms, then you will strain your shoulders if you bring the bar all the way down to the chest.   With shoulder injury, do half-reps and cut the weight, testing what you can and cannot tolerate.  If you can't do any exercise without causing pain, then you may have to abandon it and rest the shoulder.   Find other exercises, like a wide-grip chest row, 3/4-range reps of lat pull-downs, core exercises, etc. to keep the surrounding regions in condition, and also to occupy your mind...

'Best,

Dr. G