Why your shoulders, elbows and everything else hurts (and 5 Tips to stop it)

Andrew Jansen

Powerlifting and strength sports have a close relationship with injuries and pain management. If you have been lifting for some time, you have had a sore joint, and a fear that pain will never go away.


So why do your joints hurt? Here are some obvious things:


  1. Muscles grow faster than tendons
  2. What is optimal for muscular growth is not optimal for tendon regeneration
  3. What is optimal for tendon regeneration, is not optimal for muscular growth


If you have a program that is based around strength, it will largely cater to increased muscular growth and increase neural recruitment. It would be doubtful you have a program based around tendon strength.



Why go straight to tendons? How do we know that’s the issue?

Because it’s the most common overuse or repetitive use injury. The nature of powerlifting is three lift specific, so your movements are repetitive (leaning toward overuse).


ALL force goes through our tendons. Tendons connect muscles to bone. All force goes into tendons as well. So if you jump, when you hit the stretch at the bottom of the loading phase, you stretch the tendon, then muscular force goes through the tendon (you land, and your poor tendon gets smashed again).


Tendons are built to be robust, but we are not programming to optimise tendon regeneration.

 Why your shoulders, elbows and everything else hurts (and 5

Anatomy and Tendon Basics

  1. Tendons are mostly collagen (similar to ligaments and fascia)
  2. Ligaments connect bone to bone
  3. Fascia connect muscle to muscle
  4. Tendons connect muscle to bone
  5. All force goes through tendons (muscular force)
  6. Tendons have elastic properties

 Why your shoulders, elbows and everything else hurts (and 5


Happy and Sad Tendons

Happy tendons are a series of parallel collagen fibrils. They are all chilling, together, and able to take muscular force. The opposite to happy tendons is ‘tendinopathy’, which means a bunch of micro-tears in the formerly happy collagen fibrils. Sad tendons.


A sad tendon is when ‘degradation exceeds regeneration’. Basically, you are messing up your tendon with repeated efforts before it can heal. Once that area is inflamed, its generally called tendonitis.


Tendonitis is part of the process. Tendon degradation, repair, and at times, inflammation is all part of the circle of life. The issue is when this becomes chronic, or when the repair is sub-optimal.



Sad Tendons are complex beasts

If left alone without stress, collagen fibrils don’t heal all nice a parallel as they started. They may take longer to heal without any stress at all.


If you overtrain the tendon, then you get MORE degradation that further outweighs the regeneration.


So, the key is enough input, but less than the regeneration process. Complex and needy those tendons.


The Top 5 Tips to Avoid Pain (thanks to Tom at Switch)

  1. Load management – adjust down until your pain subsides. (This includes lower volume, or lower weight or lower frequency)
  2. Movement management – overuse injuries are caused by specific sequences. Move to high bar, widen your grip on deads, close your hands slightly on bench, minor incline or decline
  3. Strengthen the problem area (more below)
  4. Avoid rubbing the tendon. Tendons can get sore when they get overly compressed against bony prominences around the joint. Rubbing the tendon can cause further inflammation
  5. Use over the counter pain medication if needed (there is no science that says this slow anything down)



But I don’t want to get weak (or injured in the first place)

Tendons rely on adaption. More of less. More frequency, less overloading. Large acute spikes of load are what creates chronic issues.

Just because you decide you should bump you bench volume by 30%, doesn’t mean your elbows agree. This is especially true if you dump all the volume in one or two days.

Tendons (especially in rehab) respond to eccentric loading (the negative), which we love to ignore in powerlifting.


Here are 5 tips to reduce your future tendonitis

  1. Slow negatives on accessories, like 5 seconds (you will notice your joints thank you in days)
  2. Stress your tendons from multiple angles. This does mean you should do curls and some tricep work. Do some lunges. Do a leg press. Multiple angels, slow negatives.
  3. The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. You need to load you rotator cuff from all angles, with slow negatives. Ignore this at your peril.
  4. Do some form of deadlift with a negative (even if you comp deads drop fast, put in RDLs as an accessory)
  5. Consider some level of kettlebell or club work, just because it will add stress/load but from multiple angels



Program out of Pain

For example (thanks again to Tom), if you had a rotator cuff issue that was expressed as tennis elbow or golf elbow (common for us benchers and low bar squatters)

If you this rotator cuff issue, you could

Stage 1

  1. Load up your rotator cuffs in isometrics
  2. Load with light load - I.e single arm kettlebell upright row into a overhead press
  3. Do wrist extension isometrics with a dumbbell to load areas in pain

Stage 2 (no pain)

  1. Ab roller to strengthen lats while rotator cuff under stress
  2. Upright rows into an overhead press with a kettlebell



Wrapping Up

Lets put them in this into perspective. You can tell an acute injury – you messed up, something has snapped or stretched wrong. You feel in straight away. Tendonitis – literally means inflammation of a tendon, its what you feel the next day or dull pain into the night after training.

Tendon regeneration does not match muscular growth, and newbies and intermediates will become painfully aware of this if they don’t plan. Micro tears and trauma have ended a lot of PL careers before they even started.

Tendons adapt but require load. Those strands of collagen fibrils need weights or stress for adaption. Eccentric loading is an excellent tool to consider if you want long term gains.

Lastly, the more advanced you are, you need to differentiate between degeneration and inflammation. It's not likely you will get to a comp without some level of inflammation, but anything chronic, you may not get to the comp at all.


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