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Upper Extremity Weight-Training Modifications for the Injured Athlete

A Clinical Perspective

Martin Fees, MPT, ATC, CSCS^*, Tony Decker, ATC, CSCS, Lynn Snyder-Mackler, ScD, PT, ATC and Michael J. Axe, MD^,

^* Joyner Sportsmedicine Institute, Inc., Gettysburg, Pennsylvania, Departments of Athletics, University of Delaware, Newark, Delaware, Departments of Physical Therapy, University of Delaware, Newark, Delaware

Address correspondence and reprint requests to Michael J. Axe, MD, First State Orthopaedics, 4745 Ogletown-Stanton Road, Suite 225, Newark, DE 19713

The ability of the health care professional to make correct decisions about the progression of weight-training is critical to the rehabilitation process. The purpose of this article is to describe our approach to modification of weight-lifting techniques using the injured shoulder as a model. Additionally, the impact of various upper extremity weight-training techniques on healthy athletes is discussed. The effects of grip, hand spacing, bar trajectory, and start and finishing positions on microtraumatic injury and return to weight-training activities after injury are considered. Several weight-training functional progressions for common multijoint exercises (such as bench press, shoulder press, power clean) are presented. Adaptations for periodization are also presented for implementation in the rehabilitation sequence. The weight-training modifications described in this paper will assist the health professional to safely return athletes to the weight room after shoulder injury.

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