Training Camp Woes: Navigating Shoulder Injuries in August
As the calendar turns to August, the intensity on the football field shifts. After the initial period of heat acclimation in helmets, players transition into pads—first shells (helmets and shoulder pads), and then full contact. While this transition is essential for season preparation, the sudden increase in physical pounding, overhead reaching, tackling, and repetitive movements like up/downs creates a perfect storm for a specific type of injury: rotator cuff tendinitis.
Understanding the Injury
The rotator cuff is a group of four muscles that surround the shoulder joint. Their primary role is to provide stability, keeping the ball of the humerus centered within the socket of the scapula. This stability is critical for everything from lifting weights overhead to driving a 250-pound defensive lineman off the line of scrimmage. When these tendons become irritated or suffer micro-tears due to repetitive stress, pain and dysfunction quickly follow.
There are some key warning signs that will tell you that you could be on the path to injury.
Pain when lifting the arm out to the side, overhead, or behind the back.
Pain with reaching forward, or holding something outstretched.
Tenderness felt along the outside aspect of the shoulder.
Weakness or pain during movements where the arm rotates outward or when carrying something heavy by your side.
Recent screening data suggests that many athletes enter camp with underlying deficits that increase their risk of shoulder injury. In a screen of 34 high school football players, several significant concerns were identified:
Assessment Area / Finding
Glenohumeral Mobility: 50% (17/34) showed deficits in at least one shoulder.
Thoracic Mobility: Significant limitations in mid-back extension.
Upper Extremity Stability: 35% (12/34) scored below normal for dynamic stability.
(Data collected by Ignite Physical Therapy - Preseason Testing 2025)
These deficits can be caused by previous injuries, current pain leading to "guarding" movements, or muscle imbalances that restrict the natural movement of the shoulder blade or function of the shoulder joint.
Treatment and Recovery Path
If caught early, the recovery time for acute rotator cuff tendinitis can range from a few days to four weeks. However, if the injury becomes chronic, limitations can persist for up to three months. To get back on the field quickly, a multi-faceted treatment approach is recommended:
Manual Therapy: Instrument-assisted soft tissue mobilization (IASTM) and joint mobilizations to improve pain and restore normal mobility of the shoulder joint.
Corrective Exercise: Strengthening the rotator cuff and improving periscapular stability are common exercises. Correcting abnormal movement patterns is important through exercise and will also assist with pain and function.
Stretching: Implementing specific stretches like the Sleeper Stretch or Cross Body Stretch to address posterior capsule tightness.
When dealing with shoulder pain due to rotator cuff tendinitis in our football athletes the time to deal with the pain isn’t when it gets worse, it is right now! Allowing tendinitis to get worse creates more dysfunction, pain, and even worse, less time on the field.
For athletes looking to stay healthy this season, addressing these mobility and stability gaps before they lead to time on the sidelines is paramount. If you are experiencing shoulder pain during camp, seeking professional screening by a physical therapist and treatment early is the best way to ensure a fast return to the field. At Ignite Physical Therapy we know the game of football and what it takes to be successful because we have lived it. If you want professional, experienced treatment AND someone who knows the game, we got you covered.
by: Dr. Jared Bonacquisti, PT, DPT Co-Owner and Co-Founder of Ignite Physical Therapy