Most people will have some type of shoulder pain. Whether it be a one time shoulder “twinge” that has come and gone or something that we are continuing to try and improve and help feel better, most of us have had something like this.
Shoulder pain can limit many things from day to day activities to activities in the gym such as bench pressing, overhead pressing, squatting, etc.
Even though you may have pain with certain movements at the gym, you are injured, but you are not dead!
Now, I am not telling you to push through shoulder pain or other types of joint pain. But, you need to find ways when you are hurt or injured, to be able to continue to train pain-free so that you can continue to make improvements as a whole. Not only will this improve issues elsewhere, but it will make you feel that you are still able to do something at the gym.
*Disclaimer*: If you are trying these options and still dealing with shoulder pain, seek out a licensed medical practitioner for a full evaluation.
1. Adjust Your Pull/Push Ratio
Anytime an athlete or client is dealing with shoulder pain, we typically like to adjust their push-pull ratio. Ideally, 2:1 Pull/Push ratio is a good place to start. If someone is dealing with shoulder pain, I recommend going to a 3:1 ratio.
Pushing movements are usually emphasized more in the gym setting vs pulling. This can affect the shoulder as well as other joints. By adjusting the pull/push ratio, this can help alleviate some symptoms.
Here is an example:
If you do 3 sets x 6 reps of push-ups (pushing), you would want to do 3 different exercises of some other pulling variation such as:
Horizontal Rows (1 or 2-arm variations)
Vertical Pulling (Pull-ups, 1-arm pull-downs), etc.
By adjusting the pull/push ratio, this can help to decrease pain at the shoulder as well as improve muscular imbalances throughout the upper body.
2. Incorporate Limited Ranges of Motion
A way to train “around” shoulder pain is by shortening the ranges of motion in which you are lifting. Instead of performing a full-range barbell or dumbbell bench press, shorten the range of motion.
Variations can include:
Barbell Floor Press
Dumbbell Floor Press
Most injuries occur at end range or the end position of a joint’s range of motion. By limiting the range of motion of an exercise, you can decrease the strain on the joint, etc. and still get a training effect.
3. Closed Chain vs Open Chain
When we think of pushing movements, we think of bench press, etc. Push-ups, etc. are also considered a pushing movement. The only difference between the two is that one is closed chain (push-up) and the other is open chain (bench press).
I’m sure there is research out there, but anecdotally, I have found that people have improvement in shoulder symptoms when they perform closed chain movements as compared to open chain movements.
One potential reason behind this is the increased recruitment of the upward scapular rotator muscles (serratus anterior, lower trapezius, etc.). Also, in an closed chain exercise, the scapula is allowed to move. Allowing the scapula to move allows for fluid movement and can minimize the chance that the humerus and the scapula run into each other.
Push-ups are often seen as “too easy.” For those who have trouble doing them from the floor, try performing them elevated.
For those who do find them too easy, there are a multitude of ways to load them such as:
Band Resisted Push-Ups
The benefit of Band Resisted and Chains for push-ups is that it provides accommodating resistance. What that means is that the resistance is not constant throughout the motion. As you progress into the hardest portion of the movement, the resistance becomes the least challenging. Then as you progress through easier parts of the movement, the resistance increases.
4. Switch Out the Barbell
Instead of trying to push through shoulder pain and continuing to press with a barbell, try using dumbbells or kettlebells.
Using different implements can change the shoulder position. Dumbbells and kettlebells allow for more degrees of freedom unlike the barbell which locks you into an internally rotated position at the shoulder. With dumbbells and kettlebells, the shoulder is allowed to move and in turn can decrease stress/strain at the shoulder.
Variations can include:
Kettlebell Bottoms Up Incline Press
Dumbbell Bench Press
Or use kettlebells in place of dumbbells during the bench press.
5. Incorporate Slow Eccentrics/Pauses
Another option you can try is incorporating slow eccentrics or pauses into your training. When there is pain in the body, it doesn’t always mean there is structural damage or inflammation. If the Central Nervous System (CNS) perceives that there is a threat to the body, it can create pain to force the body to stop/mitigate that threat.
In the case of the shoulder and bench pressing, if someone can’t control the bench press properly, the body can create pain due to the threat of not being able to control the movement.
With that being said, incorporating slow eccentrics or pauses into training can potentially help.
Slow Eccentric Push-Ups
Slow Eccentric 1-Arm DB Bench
Bench Press with Pause
By incorporating slow eccentrics and/or pauses, it can help train you and your body to control the movement to not only decrease pain aspects of the movement, but also to increase strength as well.
If you are dealing with shoulder pain, you are injured, not dead. There are ways to continue to train when dealing with aches and pains. Try:
-Adjusting your Pull/Push Ratio
-Limiting Ranges of Motion
-Closed Chain Movements
-Using dumbbells or kettlebells
Here I will be writing and posting about topics ranging from physical therapy, injury prevention/reduction, and strength and conditioning.