Shoulder and Spine Injuries in New Fitness Routines

Sports injuries, shoulder joint, and spine?

Hello, Doctor.
I used to have no exercise habits, but I started bodyweight training three months ago, doing push-ups, sit-ups, jogging, and pull-ups (about 5 days a week, focusing on major muscle groups each day).
I have two questions:
1.
When I move my left shoulder in a large circle backward, I hear a noticeable "crack" sound at a 45-degree angle, but there is no pain.
However, I feel that my left arm joint is quite strained during push-ups and pull-ups.

2.
One night, I suddenly woke up with a sharp pain near my spine, but I haven't experienced any pain since.
However, I feel more sensitivity in my lower back, from my buttocks to my waist, when lying down in a sit-up position.
Given these conditions, do I need to schedule an appointment for a consultation? Should I consider rehabilitation or maintenance exercises? Thank you, Doctor!

Yang, 20~29 year old female. Ask Date: 2016/03/23

Dr. Shi Guozheng reply Orthopedics

If the pain persists and does not improve, it is necessary to seek medical attention.

Reply Date: 2016/03/23

More Info

Understanding shoulder and spine injuries, especially in the context of starting a new fitness routine, is crucial for preventing further complications and ensuring a safe and effective workout regimen. Based on your description, it seems you are experiencing two primary issues: a clicking sound in your left shoulder during certain exercises and occasional sharp pain in your spine that disrupts your sleep. Let’s break down these concerns and explore the potential underlying causes, as well as recommendations for management and recovery.

1. Clicking Sound in the Left Shoulder
The "clicking" or "popping" sound you hear in your left shoulder when performing exercises like push-ups or pull-ups could be attributed to several factors. This phenomenon is often benign, especially if it is not accompanied by pain. Common causes include:
- Tendon Movement: The sound may result from tendons or ligaments moving over bony structures in the shoulder joint. This is often seen in individuals who are new to exercise, as their muscles and tendons may not be accustomed to the movements.

- Shoulder Impingement: In some cases, the clicking could indicate shoulder impingement, where the shoulder tendons become irritated or inflamed due to repetitive overhead activities.

- Rotator Cuff Issues: The rotator cuff muscles stabilize the shoulder joint, and any weakness or imbalance can lead to abnormal movement patterns, resulting in clicking sounds.

While the absence of pain is a positive sign, it is essential to monitor the situation. If the clicking persists or worsens, or if you begin to experience pain, it would be wise to consult a healthcare professional, such as a physical therapist or orthopedic specialist, for a thorough evaluation.

2. Sharp Pain in the Spine
The sudden sharp pain in your spine that awakens you from sleep could be indicative of several issues, including:
- Muscle Strain: A sudden movement or awkward sleeping position could lead to a muscle strain in the back, which may cause temporary discomfort.

- Nerve Compression: If the pain is associated with specific movements or positions, it could suggest nerve compression or irritation, potentially linked to spinal alignment or disc issues.

- Postural Issues: As a beginner in fitness, improper form during exercises can lead to postural imbalances, which may contribute to discomfort in the spine.

Given that this pain has not recurred frequently, it may not be a cause for immediate concern. However, if you notice that it becomes more frequent or is accompanied by other symptoms (such as numbness, tingling, or weakness in the arms or legs), it is advisable to seek medical attention.

Recommendations for Management and Recovery
1. Consult a Professional: If the clicking sound in your shoulder continues or if you experience recurrent back pain, it would be beneficial to schedule an appointment with a physical therapist or orthopedic specialist. They can provide a comprehensive assessment and tailored rehabilitation program.

2. Strengthening and Flexibility Exercises: Incorporate exercises that strengthen the rotator cuff and shoulder stabilizers. Additionally, focus on core strengthening exercises to support your spine and improve overall stability.

3. Proper Warm-Up and Cool Down: Always ensure you are adequately warming up before workouts and cooling down afterward. This practice can help prevent injuries and improve flexibility.

4. Monitor Your Form: Pay attention to your exercise form, especially during push-ups and pull-ups. Consider working with a trainer to ensure you are using proper techniques.

5. Rest and Recovery: Allow your body adequate time to recover between workouts. If you experience discomfort, consider taking a break from specific exercises that exacerbate your symptoms.

6. Posture Awareness: Be mindful of your posture throughout the day, especially if you spend long hours sitting. Ergonomic adjustments to your workspace can help reduce strain on your spine.

In conclusion, while your symptoms may not currently indicate a serious issue, it is essential to remain vigilant and proactive about your health. Engaging in a new fitness routine can lead to various adaptations in your body, and understanding how to manage these changes is key to long-term success and injury prevention.

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