woman pressing barbell overhead

How To Prevent Shoulder Pain When Pressing

As a physiotherapist, shoulder pain when pressing is one of the most common complaints I hear from regular gym-goers and athletes alike. More often than not their pain isn’t caused by a true rotator cuff injury, such as a rotator cuff tear or tendinopathy, but is in fact quite easy to change with some simple technique corrections or other exercises.

Below there are some simple and easy technique changes and exercises that will help you with your shoulder pain. Most of these exercises and tweaks will help you if you have a rotator cuff tear or just general shoulder pain.

Elbow Position

One common mistake is pressing with our elbows too flared out. This can place a lot of stress and load on the rotator cuff. This is not inherently a bad issue: if you have a nice strong rotator cuff to be able to handle it. Therefore we want to change this position to having our elbows closer to our body to reduce this risk on our shoulder joint. Check out the cues below that I use with patients during barbell and/or dumbbell pressing to make these positional changes and help take the stress off of our rotator cuff muscles.

Barbell Shoulder Press – Grip 

Try adjusting your grip to just slightly outside your shoulders. This will allow you to keep your shoulder joint in the most comfortable position to keep your elbows in close to your body.

Shoulder Press Elbow Position With Barbell

Barbell Bench Press – Bend the Bar in Half

Keeping your elbows in while bringing the bar down to your chest when bench pressing can be quite hard to teach. As you bring the bar down to your chest, try to bend the bar in half by retracting and squeezing your shoulder blades together. That will facilitate optimal elbow positioning and get your rotator cuff muscles working hard.

Barbell Bench Press Elbow Position

Dumbbell Shoulder Press and Bench Press – Wrists at 45 degrees (pinky finger facing in front)

As seen in the second photo, the wrists are turned in at a 45 degree angle. This makes it easier to keep your elbows closer to your side.

Seated Shoulder Press Dumbell Press Movement
Elbow Position For Dumbell Bench Press

Shoulder Positioning

Keep your shoulder blades ‘back and down’. Almost imagine that you are trying to tuck your shoulder blades into the opposite back pocket of a pair of pants. It is so common to see people at the end of their barbell bench press or dumbbell bench press roll their shoulders forwards. Keeping your shoulder blades back and down is going to result in your shoulder joint remaining in a more stable position, and in the long term is going to translate to you lifting heavier weights, pain free. What’s not to love?

Keeping Shoulders “Back and Down” on the Bench:

Barbell Bench Press

Bench Press Barbell Shoulder Position

Dumbbell Chest Press 

Dumbbell Bench Press Shoulder Positioning

Making these simple adjustments to your pressing technique is not only going to allow you to lift heavier in a more stable position, it’s going to place less stress on your rotator cuff muscles and allow you to lift pain free for longer!  

Can I continue to press?

Let’s assume any modifications necessary to your bench press have been made, but you are still getting a niggle in your shoulder joint; especially at the bottom of the movement as you try to press up. Never fear, we can still work with this! There are some variations we can use to help you keep pressing whilst we work on the underlying issues.

More often than not we find that it is the bottom part of the movement that causes the most shoulder pain, so there is a simple solution. For a couple of weeks, we get rid of the bottom part of the movement, and implement a floor press instead.

As you can see below, I find it particularly easy to set it up on the squat rack. Although it limits shoulder joint range of motion, you can usually go quite heavy with this movement and it is particularly effective in working on your lockout while you are helping to calm your shoulder pain down.

Give it a go!

Barbell Press From Floor In Gym

For overhead press, this can be achieved by a pin press or a landmine press. Set the safety pins up in a squat rack so the bar rests at a height that stops short of the range you get shoulder pain during a pin press.

Pre-Activation/ Warm Up

If you have read our previous blog on tips for keeping your shoulders healthy, you would have seen that we recommend warming your shoulder joint up properly before you lift. Before pressing, try some activation work of your rotator cuff muscles and shoulder blade stabilisers. Having a strong, active base to press from can help keep your shoulder muscles in a good position and stop certain structures getting overloaded and sore.

1. Band pull-apart 3 x 15

Band Pull Apart Shoulder Exercise Start
Band Pull Apart Shoulder Exercise Finish

2. Band shoulder external rotation 3 x 15

Band Shoulder External Rotation Exercise Start
Band Shoulder External Rotation Exercise Finish

We hope this article has given you some insight into your shoulder pain, as well as some tangible action points that you can begin implementing from today to become pain free whilst staying active & doing the things that you love!

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