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Shoulder Pain

Posted Apr 09 2009 5:23pm

Next to lower back pain (and followed by knee pain), shoulder pain is the most common complaint I hear from new clients who hire me to help them reach their fitness goals. Luckily, most chronic shoulder pain can be alleviated by making some changes to your exercise programming and lifestyle habits. Here are my top tips for preventing and alleviating shoulder pain:

1. Ditch the Barbell Bench Press

One exercise I’ve eliminated from 95% of my clients strength training routines is the barbell bench press. Although it is without question the most commonly performed exercise (particularly by males) in any gym world wide, it is also without question the exercise which ends up screwing up peoples shoulders the most. There are several reasons for this (many of which are beyond the scope of this article), but, the primary reason is most people simply have no clue how to perform the exercise in a manner which is the least bit safe (ironically, bench pressing correctly will also allow you to use the more weight).

Most bench press with the elbows flared out to the sides (abducted) and lower the bar way too high onto their chest. Most also have no concept how to stabilize their scapula while bench pressing (shoulder blades pulled down and back). Both of these mistakes place a great deal of stress on the shoulder joints. Without getting into the other half dozen reasons why the barbell bench press is a bad idea, just take my advice and minimize the use of the exercise…or just completely eliminate it altogether. If there is no way in hell you’ll stop performing the exercise, at least learn how to perform the exercise correctly (and even this won’t completely eliminate the dangers of the exercise).

2. Replace the Bench Press with Push-ups

The good old fashioned push-up exercise is a terrific replacement for the barbell bench press. The push-up is a closed chain exercise (the hands stay in contact with the ground) which works all the same muscles as the bench press, as well as the core muscles of the midsection and hips. It also activates a muscle called the serratus anterior, which is responsible for rotating the scapula upwards, an anatomical movement most people are very, very deficient in. If you have adequate scapula upward rotation range of motion, the rotator cuff tendons will not become impinged when you raise your arm up or out.

Push-up variations are simply terrific, and there are variations which are appropriate and challenging for people of any fitness level. For those who feel the push-up is a “beginner exercise”, I can assure you that you haven’t experienced some of the advanced push-up variations performed at my facility. When performing the push-up, it is important not to let the elbows flare out to a 90 degree angle. You want to keep the elbows tucked into your torso, closer to 45 degrees, when performing the exercise. Your shoulders will thank you for it.

3. Row, Row, Row Yourself to Better Shoulder Health

Rowing exercises (and there are literally dozens of variations), where a resistance is pulled into your body, are great for keeping the shoulders healthy. Most people are horribly imbalanced between the muscles of the front of the body and the back of the body. People who perform too many pushing exercises (such as the bench press discussed above), and not enough pulling exercises (like rows and chin-ups), end up with poor posture, tight pectoral muscles, and rounded shoulders. These imbalances put your shoulder health at risk.

I usually prescribe a 2-3:1 ratio of pulling (rows fall into this category) to pushing exercises for the vast majority of my private clients. Doing so typically reduces shoulder pain in those clients who have it, and prevents future shoulder pain in those who don’t.

4. Keep Your Thoracic Spine Mobile

Most people-largely due to sitting at a computer in a hunched over position all day long-have terrible thoracic spine (think mid to upper back) mobility and exhibit a kyphotic or “hunch back” posture. Most people simply lack the ability to extend and rotate at the thoracic spine. The hunch bank posture most find themselves in (consciously or unconsciously) throughout the day eventually leads to their scapula becoming misaligned…and shoulder pain will result.

While rowing exercises (discussed above) can certainly help reset the scapula into a healthy position, you also need to included drills and exercise which help you gain extension and rotation range of motion in the thoracic spine. Many of these exercises may feel uncomfortable and awkward at first, but, over time, range of motion will improve, and, again, your shoulders will thank you for it.

5. Perform Strength Exercises for the Rotator Cuff Muscles

While a lack of strength in the rotator cuff muscles are rarely the root cause of shoulder pain (it’s usually poor scapula stability and positioning), it still needs to be addressed. These muscles, particularly those which externally rotate the arm, need to be activated and strengthened. There are numerous exercises which can be performed with common resistance training equipment which will do the trick. Make sure to include these exercises in your workouts.

So, there are some tips for keeping-or getting- your shoulders healthy. Truth be told, I could have listed 15 or 20 more tips, but these should point most people in the right direction and benefit them. If you have ANY questions about this article, specific exercises or techniques, etc., please don’t hesitate to email me at or visit my website at Now, go implement some of this information!
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