The End of Shoulder Pain

If you’ve reached this article, it’s likely due to one of two reasons.

1. You have shoulder pain and want to do something about it. 
2. Your shoulders don’t hurt, and you want to keep it that way.

Either way, you’ve come to the right place if you want to end your shoulder discomfort and be able to move freely and perform exercises without pain.

I’ve spent my life working with a mix of rehab patients and strength athletes, which means my job requires me to become an expert in pain management and prevention.

Because let’s be honest: no one likes shoulder pain, and — even worse — no one likes doing a bunch of exercises that don’t seem to solve the problem. 

Shoulder pain has two different variations: you might experience acute pain (“Ouch! I did something and now my shoulder hurts.”), which makes it feel like your shoulder is only an issue when you perform certain moves. Or, you could have chronic pain, which is a constant discomfort or an achy soreness. 

Many people who perform a bunch of rotator cuff exercises to protect their shoulders are misusing their time.

In either situation, there are many commonalities that lead to both types of shoulder pain. There are many shoulder movements that can have a massive impact on whether you’re able to perform an exercise without causing damage or irritation.

The mechanics of your shoulder are complex, which means exercise technique matters a lot. But as you’ll soon see, there’s one factor that’s most important to healing and keeping your shoulders healthy. 

Exercise or Execution: Why Your Shoulders Really Hurt

Let’s begin with a simple disclaimer. I’ve spent my life helping people rehab and live pain-free, and no matter who I work with, it’s clear that no Internet article can diagnose and fix your problems.

If you’re here for a little achiness or prevention, then this will help. But, if you’re experiencing severe pain that hurts all day — or you’re recovering from a major injury or surgery — then you should get checked by a medical professional to see what’s going on and first consult with your doctor or physical therapist. 

With that out of the way, let’s make sense of your shoulder pain.

Shoulder pain is common among people who lift weights. It’s not just amateurs or weekend warriors getting hurt. It also applies to Powerlifters, CrossFitters, Bodybuilders, and even the Highland Games guys. And studies of highly-trained Olympic lifters show that they also struggle with shoulder pain.

The exercises that tend to cause the most trouble are pressing movements like the bench press or standing overhead press (also known as the military press).

Here’s the thing about those exercises: the movement itself usually isn’t the problem. In fact, the movement is quite simple—you just push the weight in a straight line. It’s pretty hard to mess that up.

So, if the movement isn’t the issue, then what is? It’s the position you’re in when you go to perform the exercise. Let’s take the overhead press and start with a simple example of why this causes problems.

The Shoulder Question You Didn’t Consider

An easy way to understand your shoulder pain is to think about running. If you rarely (or never) run and then are asked to sprint multiple times, what is likely to happen? Maybe you pull a muscle, feel a strain, or suffer some other injury that occurs from going from one extreme (no use) to another (high-intensity reps).

The same is true for overhead movements. Most people go through their days without bringing their arms over their heads at all. Instead, they spend the day in various hunched positions: looking at phones, staring at laptops, slouching in desk chairs.  

Over time, you lose the ability to extend your mid and upper back (this is known as your thoracic spine). To “extend” your upper back here would look like a “head up, shoulders back” position. Its opposite is the shoulders-rounded-forward hunchback that is your existence.

The thoracic spine directly impacts what your shoulders can (and can’t) do. If you’re unable to extend your thoracic spine, that in turn limits how your shoulder blades can move. The more your upper back starts to look like Quasimodo, the more difficult it is to get your shoulders into the proper position to press a weight overhead.

In other words: you struggle with the movement because your shoulder blades don’t know how to move correctly. I’m going to get technical for a moment to explain exactly why this is such a pain in the ass…or in your case, your shoulders.

Just know this: if you can’t move your shoulder overhead correctly, all the other small structures around your shoulder blade are working overtime, and like most things in life that get overworked, they quickly become pissed off and that’s why you have shoulder pain or get injured.

Why Your Shoulders Lack Mobility

Nerd alert: If you want to skip the detailed reason why your shoulders are not moving correctly, simply skip the next 4 paragraphs.

In order to lift your arm 180 degrees overhead, the scapula, or the triangular bone on the backside of your shoulder that kinda looks like a wing, must rotate about 60 degrees.

You get into trouble when you can’t get this movement to occur. If your thoracic spine is rolled forward, it limits your ability to move your scapula (AKA the shoulder blade).

As a result, in order to get your arm overhead, you’d have to move the entire shoulder joint—which requires a lot of its structures to move through a bigger range of motion than they can manage properly.

This also limits the ability of the upper arm bone (humerus) to make solid contact with the socket of the shoulder (glenoid fossa) to help bear the load of the weight being moved. As a result, the soft tissues of your rotator cuff and joint capsule have to pull double duty.

[Nerd alert over]

Think of your shoulder blade rotation like hip mobility on a deadlift. If you can’t move your hips back far enough so you can grab the weight, something else has to move in order for you to get down and grab the bar. This is why so many people hurt their back on deadlifts.

That “something else” usually winds up being your lower back. And, if your back is doing the work of your hips, you’re going to get hurt.

The same goes for shoulder movement. If soft tissues and joint capsules are doing the work that the bigger muscles like your deltoids were intended to do, you may get away with it for a while. But, you’re eventually going to have a problem.

Why Rotator Cuff Exercises Are Misused (The Fire Hydrant Rule)

Using the explanation above, this is why many people who perform rotator cuff exercises to protect their shoulders are misusing their time.

No amount of band rotations (those exercises where you bend your elbow 90 degrees, grab a resistance tube, and then rotate the forearm to pull the tube away from the body) will improve your thoracic spine mobility.

Sure, doing those moves will help your rotator cuff be strong and powerful. But, it’s the equivalent of grabbing a bigger bucket to catch water from a fire hydrant instead of just turning off the hydrant itself.

If you address the things that are really causing poor shoulder mechanics, you can stop the problems at their source.

Why Bench Press Causes Shoulder Pain

The bench press can cause similar issues for the shoulder, but for a slightly different reason.

In order to set up properly for the bench press, you have to pull your shoulder blades together and down in order to create a strong and stable base of support.

Here’s what you should do before every bench press set. (The first 15 seconds of this video are the most important):

There are just two problems:

1. Not everyone realizes that pulling the shoulders together and back is part of the setup. (And if that’s you, now you know. Go forth and conquer.)
2. Some do know this but don’t have enough thoracic mobility to pull their shoulder blades back and tight.

In either case, without the proper setup, the front of your shoulders wind up paying the price.

If your shoulders aren’t pulled back and locked in, when you lower the weight toward your chest, your upper arm bone has to move around within the shoulder capsule to allow the bar to get down.

This can result in the arm moving forward—a motion called anterior glide. And anterior glide puts a lot of pressure on the tissues meant to keep the joint together, like the biceps tendon and rotator cuff muscles, causing them to be irritated or even damaged.

How to Fix Your Shoulder Pain 

Here’s the good news: Many of the problems with the overhead press and the bench press are rooted in issues with your thoracic mobility and shoulder blade movement. This means fixing those issues will help you feel better during both of those exercises (and plenty of others, too).

Instead of loading up on 15 different variations of rotator cuff exercises, let’s address both of these common movement problems—thoracic and scapula issues—at their source. Then, you can set the stage for more appropriate shoulder pressing movements with less discomfort.

Shoulder Pain Solution #1: Breathe (But, do it correctly)

The first thing you should do to correct your thoracic positioning is to spend just a few minutes doing a little breathing drill, which my friend Tony Gentilcore is going to demonstrate for you here:

https://youtu.be/EtpB8dM4cEM

You’re probably thinking, “Breathing? What?” But stay with me.

Your breathing holds a big influence over the position of your torso. Not breathing correctly tends to limit thoracic motion, which as we discussed earlier has a direct effect on shoulder motion. So, when you perform these drills:

• Breathe deep, with long slow inhales and forceful exhales.
• Go slow and focus on getting more movement versus just doing the reps. Quality should always come before quantity.

Shoulder Pain Solution #2: Foam Roll Like a Pro

Next up you’re going to bring in the foam roller to work on the tissues in your thoracic spine directly. Pay close attention to how we’re going to use it.

Those are called T-Spine Extensions. Let’s talk about what the movement is not:

• It is not you rolling around a whole bunch. In fact, watch that video again. Notice that the roller doesn’t move at all.
• It is not you trying to get a bunch of movement by flaring your ribcage out. You want to keep your abs engaged throughout this drill so that the movement is coming entirely from your upper back.
• It is not your goal to touch the ground with the back of your head. You’re not trying to be Gumby here.

What you are trying to do is get a little more up-and-back movement out of your thoracic spine. That’s all. The motion will be subtle and may be difficult to feel at first.

But work at it, and you’ll soon feel a little more freedom in your upper back and shoulders. That’s what you’re going for here.

Advanced Exercises To Relieve Shoulder Pain

You’d go a long way toward having better shoulder mechanics just by adding the moves shown in those two videos to your warm-up. But, if you want to go further, you can jump into the deep end of the pool with this clip from The Complete Shoulder & Hip Blueprint:

In this video, you’ll find more awesomely impactful breathing drills—including one that works the smaller muscles in the thoracic spine, so much that a guy actually starts shaking.

The clip starts out with those. And, if you’re the type of person who secretly loves band rotator cuff exercises, be pumped: Later in the clip, you will find band exercises, except these will have a lot more impact on improving your shoulder movement and position overall:

• Beginning at 7:08, you’ll find the “Band W,” which activates the muscles around your shoulder blade and the lower part of your trapezius.
• At 8:56 you’ll see Tony demonstrate two more band exercises—the Windshield Wiper and the Wall Walk—that will light up the muscles in and around your back, especially your serratus, or the muscles on the sides of your ribs up by your armpits. Bonus: A strong serratus helps give you a “V” shaped torso.
• Lastly, when you reach the 12:12 mark you’ll get a move that lets you correct some of these issues in one shoulder at a time—a helpful way to correct imbalances.

These movements can act as a warm-up for your workout, fillers between sets of presses to help keep the motion gliding along nicely, or as the workout itself if you’ve been experiencing pain and want to improve your mechanics.

But again, if your shoulders always hurt, you should speak with a qualified therapist. There may be something more specific you could be doing, and you’ll want to make sure these aren’t going to do any harm. (The moves are very safe, but it’s worth checking.)

Here’s one more thing to keep in mind whenever you perform a shoulder exercise: Use your abs.

If you have limited movement from your thoracic spine, a common mistake is to just lean back with your lower back and avoid doing anything with your upper back.

This is both risky and counterproductive since you’re simultaneously putting extra pressure on your lumbar spine while also decreasing tension on the muscles you’re trying to work in the first place. By bracing your abs, you can help limit this and be sure that you’re getting movement in the places you actually want to move.

READ MORE: 

How to Fix Your Posture

6 Exercise Upgrades for Better Results

Foods That Fight Inflammation

Dean Somerset is a kinesiologist, strength coach, author and public speaker who specializes in injury and medical dysfunction management through exercise program design. The seriously in-depth “The Complete Shoulder & Hip Blueprint,” which Somerset and Gentilcore teamed up to create, is available online. Born Fitness is not an affiliate and has no financial stake or interest in the product, other than our general want for Dean and Tony to succeed in life since they’re good guys who offer great info.