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Shoulder pain: should we do pressing movements?

Updated: May 26, 2023

Hey fellow trainers! Let's chat about a common issue many of our clients face: shoulder pain, especially rotator cuff related, which can be a real roadblock when it comes to pressing exercises. These movements, while hugely popular, can be tricky for clients with shoulder troubles to handle. So, how do we get them back to pressing without causing a flare-up? Let's dive in, shall we?

Before we start, let's set some ground rules. Before your client even thinks about pressing, they should have:

  1. Pain-free shoulder movement (flexion and abduction) up to 90 degrees, along with full, pain-free shoulder horizontal adduction and abduction.

  2. No major issues or only mild pain when doing basic scapular exercises like rows, and fundamental rotator cuff strengthening drills.

Now, onto the main course. I've had success with the following progression ideas for clients with rotator cuff related shoulder pain. Please note that while this approach works for me, you might want to use your own discretion.

For any shoulder work where the client is upright I like to have them stationed in front of a mirror and watch both their own unaffected side as well as the affected side and get the visual feedback from the mirror.

  1. Kneeling cable single arm chest press static hold. Get the cable into position for the client and start light.

  2. Dumbbell Floor Press, then smith machine bench press, DB bench press, then BB Bench press: Create an arched back, and press through the feet firmly to reduce instability at the shoulder. Encourage a slight elbow tuck to lessen shoulder stress..

  3. Push-up Progression: Start with wall push-ups, then gradually move to push-ups with hands on a bench, and finally to full floor push-ups, keeping elbows tucked in and not flaring to perpendicular to the body. This depends on client's body weight and relative strength - for heavier clients, you might want to progress to dumbbell presses before push-ups.

  4. Smith seated machine overhead press, then landmine before seated DB. Press scapula into the bench to reduce instability.

Remember, it's all about individual progression. Make sure your clients are comfortable and pain-free at each stage before moving onto the next. If they're experiencing mild pain that doesn't worsen with each rep, that's generally okay. But in most cases, you want them to be able to perform the exercises pain-free before progressing.

That's it! I hope this guide gives you some ideas on how to safely reintroduce pressing exercises for your clients dealing with this kind of shoulder pain. As always, keep learning and stay strong!

If you want to know more, I have a few courses to help you to help your clients with shoulder pain. Just send me a message to determine the best choice for you and your clients!

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