The shoulder press is a foundational movement in strength training for building upper body power and stability. This overhead lift often causes pain that forces many lifters to stop or modify their workouts. The ache felt during the upward or downward phase of the press is common across all levels of fitness. Understanding the biomechanical reasons behind this discomfort is the first step toward resolving the issue and continuing to train safely and effectively.
Primary Mechanical Causes of Shoulder Pain
The majority of shoulder pain during the overhead press stems from mechanical compression within the glenohumeral joint. This ball-and-socket joint requires precise coordination with the shoulder blade, known as scapular rhythm, to function correctly. If the shoulder blade fails to rotate upward smoothly as the arm elevates, the space beneath the acromion narrows, leading to impingement. This pinching action irritates the rotator cuff tendons, particularly the supraspinatus, and the fluid-filled bursa that cushions the joint.
Undue stress on the acromioclavicular (AC) joint, located where the collarbone meets the shoulder blade, is another factor. Errors like using an overly wide grip or pressing too far behind the head place excessive shear forces on this joint. Repetitive stress can contribute to degenerative changes in the AC joint, resulting in tenderness at the joint line during the press. Weakness or imbalance in rotator cuff muscles, such as the infraspinatus and teres minor, prevents the humeral head from centering properly in the socket. When these stabilizers are weak, the larger deltoid muscles pull the humerus upward and forward during the press, contributing to impingement and strain.
Immediate Technique Modifications for the Press
Immediate relief often comes from adjusting the angle and path of the bar or dumbbells to minimize joint compression. Instead of flaring the elbows straight out to the sides, you should tuck them slightly forward. Aim for an elbow angle of approximately 45 degrees relative to the torso. This aligns the movement with the scapular plane, the safest and most natural arc of the shoulder joint.
This slight forward positioning also dictates the bar path, which should travel in a vertical line directly over the shoulder joint and mid-foot. The grip width should be just outside shoulder-width; a narrower grip helps maintain the tucked elbow position and reduces strain on the AC joint. When lowering the weight, stop the descent at a point just above the shoulder line if pain is felt at the bottom of the movement. Limiting the range of motion to a pain-free zone allows the supporting muscles to be strengthened without repeatedly aggravating the irritated tissues. Focusing on a controlled tempo, especially on the eccentric (lowering) portion of the lift, can also improve motor control and reduce reliance on momentum that compromises form.
Strengthening Supporting Stabilizer Muscles
The long-term solution for overhead pressing pain involves strengthening the muscles that stabilize the shoulder joint. External rotation exercises are primary, specifically targeting the infraspinatus and teres minor muscles of the rotator cuff. These are best performed with a light resistance band, keeping the elbow bent 90 degrees and tucked against the side of the body. Rotate the forearm outward slowly against the band’s resistance.
Another foundational exercise is the Face Pull, which activates the posterior deltoids and mid-back musculature. Using a cable machine or resistance band set at head height, pull the rope toward your face while driving the elbows out and up, ensuring a strong squeeze of the shoulder blades. To improve overall scapular control, incorporate the prone Y-T-W raises. Lying face down, these exercises involve lifting the arms into positions that form the letters Y, T, and W, with the thumbs pointing toward the ceiling. The focus is on squeezing the shoulder blades together to engage the mid and lower trapezius muscles, which stabilize the shoulder blade during overhead movement.
When to Pause Lifting and Seek Professional Help
While minor aches can often be resolved through technique adjustments and accessory work, certain symptoms warrant pausing lifting and a consultation with a healthcare professional. Any sharp, shooting, or sudden pain is a warning sign, especially if it exceeds a moderate intensity level of 5 out of 10.
Pain that persists at rest, or pain that wakes you up at night, indicates inflammation or structural damage that will not resolve with simple modifications.
Symptoms Requiring Professional Evaluation
- An audible and painful clicking, grinding, or catching sensation during movement suggests a mechanical issue, such as a labral tear or significant tendon pathology.
- Neurological symptoms, including numbness, tingling, or weakness that radiates down the arm into the hand, may signal nerve compression.
- Visible swelling, bruising, or a noticeable change in the shoulder’s contour requires medical evaluation to rule out severe injuries like a fracture or a full rotator cuff tear.
- Sharp, shooting, or sudden pain that exceeds a moderate intensity level of 5 out of 10.