You couldn't tell it from her smile, but Dara Torres was dealing with some serious pain during the Olympics. She had surgery on her shoulder this week to shave down the end of her collarbone and relieve some of the pain from the degenerative arthritis she's developed in her acromioclavicular, or AC, joint. That joint is formed where the clavicle meets the top of the shoulder blade, and injuries to it aren't uncommon, especially among athletes who use overhead motions, like swimmers or tennis players, says Rebecca Demorest, a sports medicine physician at the Hospital for Special Surgery in New York. Those athletes can get arthritis from repeatedly stressing the joint, which erodes the cushioning cartilage and may cause the bones to painfully pinch the surrounding tissue. That's apparently what has happened to Torres. (Demorest isn't familiar with the details of her case.)
Serious bodybuilders who lift heavy weights over their heads are also at risk of AC joint injury, she says. In their case, the bone can actually start to die a bit at the end of the clavicle. "But the most common way to injure the joint is if you fall on the side or front of the shoulder," she says. People who get such a separated shoulder may be at some small risk of future arthritis in the joint, she says. As far as fixing any AC joint problems, physical therapy and more conservative measures such as rest and icing are always the first steps, but especially among high-level athletes like Torres, surgery to remove excess bone is sometimes required.
More common shoulder injuries are tendon problems like rotator cuff tendinitis, which can also strike swimmers or other athletes who use repetitive motions. And kids can get "Little League shoulder," an overuse injury that comes from too much fast pitching. Again, the remedies are usually rest, ice, and physical therapy rather than surgery. To help prevent shoulder injuries, see this list of recommended exercises from the American Academy of Family Physicians. And when overuse is a cause, prevention, of course, includes listening to your body and taking a day or so off when heavy training starts to cause pain or discomfort.