Shoulder pain when lifting weights is one of the most frustrating problems an active person can face. Many people spend months stretching, foam rolling and doing mobility drills, only to feel the same pain again the moment they load up the bar.
That was the situation for Mr. R, who came to our Downtown Vancouver clinic with persistent pain at the back of his right shoulder. He trained regularly but spent his workdays at a desk, a combination that can put the shoulder under repeated postural and training stress.
Here is how we assessed his shoulder, why more mobility work wasn't the answer, and how a plan combining shockwave therapy, HeIT and progressive strength training got him back to lifting.
Mr. R described a pattern that is common in people who lift:
During the physiotherapy assessment, his active range of motion was completely normal. Flexibility wasn't the problem. Instead, his pain appeared during resisted testing of the lats and rotator cuff, and the teres major and right external rotator cuff tendons were tender to touch.
These findings pointed to a strain of the external rotator cuff and the teres major and minor muscles. Because his range of motion was already excellent, more stretching was unlikely to help and could keep irritating the tissue. What his shoulder needed was help settling the pain and a plan to rebuild its capacity to handle load.
Mr. R's plan combined in-clinic treatment to help settle his pain with a structured home exercise program to rebuild strength.
Shockwave therapy. We delivered 2,000 pulses of shockwave therapy to the back of the joint capsule and the teres major. Shockwave uses acoustic waves and is commonly used for persistent tendon and soft tissue pain.
HeIT (High-Energy Inductive Therapy). He also received a 20-minute session on the HeIT machine using a chronic shoulder setting. HeIT uses a strong electromagnetic field to stimulate the nerves and muscles beneath the skin, and it is used to help reduce pain and activate deeper muscles. Research on HeIT is still emerging, so we use it alongside exercise rather than as a stand-alone treatment.
Progressive strength training. In-clinic treatment can help calm pain, but exercise is what builds a shoulder that can handle heavy training. Mr. R followed a daily four-week program through the PhysiApp exercise app, focusing on:
Treatment settings and exercise choices are always tailored to the individual, based on their assessment.
By combining in-clinic treatment with targeted strength work, Mr. R was able to return to the training he enjoys. He shared his experience in a Google review:
Every shoulder is different, and the number of sessions people need varies. Results depend on the cause of the pain, how long it has been there, and how consistently the exercise program is followed.
If your shoulder hurts during pull-ups, rows or lat pulldowns but your range of motion feels fine, more stretching may not be what it needs. Strained muscles and tendons usually respond best to a plan that settles pain first and then gradually rebuilds strength.
Consider booking an assessment if your shoulder pain:
Seek prompt medical care if shoulder pain follows a fall or heavy impact, if you suddenly can't lift your arm, or if you notice significant swelling, numbness or weakness down the arm.
Why does my shoulder hurt when lifting weights?
Common causes include strains of the rotator cuff or surrounding muscles, tendon irritation and training load increasing faster than the shoulder can adapt. If your range of motion is normal but pulling or pressing hurts, a muscle or tendon strain is a common culprit.
Should I stop lifting if my shoulder hurts?
Not always. Many people can keep training with changes to weight, volume or exercise selection while their shoulder recovers. A physiotherapist can help you decide what to modify.
What is HeIT therapy?
High-Energy Inductive Therapy (HeIT) uses a strong electromagnetic field to stimulate nerves and muscles. It is used to help manage pain and activate deeper muscles, usually as part of a broader treatment plan.
How much do HeIT and shockwave therapy cost at VanCity Physio?
According to our published price list, a 30-minute HeIT session costs $145 and a 30-minute shockwave session costs $125.
Do I need a referral to see a physiotherapist in Vancouver?
No referral is required in British Columbia. VanCity Physio also offers direct billing to most extended health plans, including ICBC and WorkSafeBC.
Don't let shoulder pain keep holding your training back. A thorough assessment can find what is driving your pain and give you a clear plan to rebuild strength.
Book a HeIT session at our Downtown clinic, or contact us if you're not sure which treatment is right for you.
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