Shoulder pain.
The mysterious enemy of many men and women on a mission to build a leaner, stronger version of themselves.
It can seemingly appear out of nowhere, and has sabotaged countless people’s attempts to achieve better body composition and a more confident version of themselves.
While the gym used to be your sanctuary, now it’s a place of frustration. You get shooting shoulder pain any time you try to train your upper body.
Needless to say, you’re desperate for a solution to your shoulder woes.
Not to worry. There’s still hope.
I say this, because I’ve been there.
After a grade 3 AC joint separation (my left shoulder joint was detached from my clavicle), I was in your shoes – frantically searching through the T-Nation forums, looking for a solution for my shoulder pain and and rapidly declining body composition.
It was crazy frustrating. Pain shot through my shoulders every time I trained upper body, and any type of pressing was out of the question entirely.
But, through lots of trail-and-error, as well as reading hundreds of articles from the likes of Eric Cressey, Mike Robertson, and Mike Boyle, I was able to escape the shoulder troubles.
It’s really been a blessing in disguise – I’ve been able to use my knowledge to help dozens upon dozens of online clients work through similar issues and achieve their best body composition ever.
Before we dive in, be aware that the
information provided is not intended to be a substitute for professional
medical advice, diagnosis or treatment. Consult with a doctor before applying any of this information to your own training.
From my anecdotal experience with myself and tons of clients, improving your shoulder issues in our time working together so we can help you achieve your best body ever comesdown to establishing a clear list of priorities.
The single biggest reason most new online clients report having trashed shoulders since their mid-twenties?
They lack the ability to properly move and stabilize their shoulder blades (a.k.a scapulae).
Your shoulder blades/scapulae control the positioning of the glenohumeral joint (your shoulder joint). Your scapulae have six different movement patterns:
1. Retraction: Pulling the shoulder blades back and together – like when you’re rowing something towards yourself.
2. Protraction: Pulling your shoulder blades forward and apart – like at the front of a row when you let your back stretch.Elevation: Pulling your shoulder blades towards your head – like when you’re shrugging.
3. Depression: Pulling your shoulder blades towards your feet.
4. Anterior tilt: Your shoulder blades tilt forward – like when you’re hunched over in front of the computer.
5. Posterior tilt: Your shoulder blades tilt backwards – like when you’re reaching overhead.
Poor scapular stability OR movability means that your shoulder joint is often positioned incorrectly throughout your training and day-to-day life.
This typically results in movement dysfunction and pain.
The unique thing about the scapulae – unlike most joints, movement depends entirely on the muscles attached to the scapula. So weakness in any of the muscles attached to the shoulder blade will result in a lack of stability or proper movement in the scapula.
The largest muscles attached to the scapula (and therefore the most important stabilizers) are:
→ Traps – You traps can be divided into three subcategories:
1. Upper traps: Elevate the shoulder blade.
2. Middle traps: Retract the shoulder blade.
3. Lower traps: Depress the shoulder blade.
The upper and lower traps also work together with the serratus anterior to upwardly rotate the scapulae.
→ Rhomboids – Responsible for retracting and downwardly rotating your scapulae.
→ Serratus Anterior – Upwardly rotates and protracts the scapulae.
→ Levator Scapulae – Elevates and downwardly rotates the scapulae.
Strong scapular retractors and depressors are KEY to keeping the shoulders healthy. Lack of strength in these muscles can lead to worn or torn rotator cuffs, shoulder pain, and neck pain.
When you take all the different movements into consideration, you realize that creating truly stable shoulders doesn’t just mean being able to squeeze your shoulder blades together – but rather being able to position your shoulders in whatever position is most optimal for your current movement.
From years of anecdote coaching hundreds of people, it seems of all the major muscles attached to the scapula, most have the most trouble activating (and therefore strengthening) the lower traps.
Let’s start there.
Lower Trap Training
As mentioned, the lower trap is responsible for depressing the shoulder blades, as well as a contributor to upward rotation of the shoulder blades.
A few great movements to connect to and strengthen your lower traps:
→ Scapular Wall Slides
Cues:
1. Keep upper back and butt against wall. Avoid hyperextension in lower back.
2. Work to keep elbows and hands against wall throughout the movement.
3. Walk feet out from wall to regress movement.
→ Cable Scap Pulls
The focus here is depressing the shoulder blades – one of the primary functions of the lower traps. Start using the lat pulldown machine, before advancing to a pull-up bar as you strengthen your lower traps.
That said, to understand the movement, Lee Boyce does a GREAT job of explaining scap pulls in this video:
Cues:
1. Pull the shoulder blades down as much as possible, WITHOUT letting the elbows bend.
2. You’re pulling from the muscles of the lower traps. Imagine initiating the move by pulling down from the area directly beneath the shoulder blades.
3. To apply all of this to your pulling movements: Whenever you are pulling from overhead, focus on initiating the move by pulling your shoulder blades down (and keeping them in the down position as you follow through with your elbows to finish the pull.)
→ Prone 1-Arm Trap Raise
This is a great one for activating and strengthening the lower traps – but also often butchered.
Cues:
1. This is all about tilting your shoulder blades backwards (hard concept to visualize, I know). Don’t focus on movement at the shoulder socket, so much as pulling through the lower traps.
2. Avoid shrugging up
→ Use 1-2 of these movements as activation exercises during your warm up.
→ The idea here is to build a solid mind-muscle connection with the lower traps, so you can better activate the lower traps and control the scapulae during your compound lifts.
→ The goal here isn’t to create tons of fatigue. These movements are best implements with high frequency, low-volume (3-4x/week, 2-3 sets each).
Rhomboid Training
Like we discussed earlier, the rhomboids are responsible for pulling together and downwardly rotating the shoulder blades.
Your rhomboids are much more noticeable than your lower traps.
You probably try to train these, but they fall victim to sloppy form and failure to focus on retracting the shoulder blades properly.
If you’re already following a periodized, well-designed training program like my online clients, not much changes here. You should already be doing lots of rowing movements.
So what gives?
The shift I help online clients make?
Being intentional with your rowing movements.
You’ll likely need to drop the weight, and focus on fully protracting and retracting your shoulder blades… Every. Single. Rep. Your shoulders will thank you, and your back will get much stronger.
→ Batwing Rows
This is an underutilized movement I stumbled across in an article by the legend himself, Dan John.
Cues:
1. Row the weight towards your ribs, squeeze your shoulder blades HARD at the top of the rep. I love John’s cue of “sticking your thumbs in your armpits”.
2. The range of motion here is relatively short (~6 inches).
3. Think of the top of the movement as an isometric, focusing on the squeeze for 3-5 seconds. This will absolutely light up your rhomboid
→ Rear Delt Rows
These are another little known row variation that will light up your rhomboids (and rear delts, obviously).
Cues:
1. Allow your shoulder blades to roll forward at the front of the movement – you should feel an upper back stretch.
2. Initiate the pull by pulling the shoulder blades back.
3. Complete the move by driving the elbows back and out. Squeeze your shoulder blades hard at the back of the move.
→ Your training should feature a lot of rowing work – all of your rows will build your rhomboids to an extent. These two moves are simply a few of my favorites for actually allowing you to feel the rhomboids at work. Apply the same concept to all of your rows to build a strong back and stable shoulders.
→ Intersperse these movements in your upper back work until you get a good “feel” for how to activate your rhomboids, and then carryover your new mind-muscle connection to the rest of your rowing movements.
Serratus Anterior Training
You don’t need to spend hours focusing on your Serratus, but making sure you can activate it properly will go a long ways in positioning your shoulder blades properly when pressing.
I like this drill from Eric Cressey:
Upper Trap and Levator Scapulae Training
The most common issue here isn’t that you’re weak and disconnected from these muscles – it’s that they’re overactive and too tight.
This is especially common with the upper traps, as most dudes tend to shrug as they row – thus the movements that should be building all the muscles responsible for stabilizing your shoulders are for naught – your upper traps are doing all the work.
By implementing the above and training your upper back correctly, you’ll balance out your over-dominant traps. Upper trap specific training is very rarely needed for those with shoulder issues.
Now that you have scapular movement mastered, it’s time to build your upper back in a major way.
This will pay huge dividends in allowing you to stabilize your shoulders, and improve your chest and shoulders pain-free in the near future.
The Pull:Push Ratio
A good rule of thumb for most everyone to follow – but especially those with beat up shoulders…
→ Pull 2-3 times more than you push.
More specifically, pull horizontally (row) twice as much as you pull vertically. Your total upper body pulling volume (in number of hard sets) should be somewhere between 2-3x more than your upper body pushing volume.
DON’T let your reps get sloppy. It’s easy to bang out meaningless reps that do absolutely nothing to improve your back. Don’t make this mistake.
To build stable, pain-free shoulders, the meat and potatoes of your upper back volume should come from movements like:
→ Train these 2-4x per week. Your upper back can handle a lot of volume and frequency – take advantage of this.
Not as important to build stable shoulders, but still great upper back builders are your vertical pulls. Movements like:
→ Train these 1-2x/week. The most common mistake here is NOT initiating the movement by pulling the shoulder blades down first. This creates a lot of wear and tear on the shoulders. Again, you HAVE TO drop the ego here, a prioritize proper scapular movement first.
For a complete guide of the proper ratios to train every movement pattern with for pain-free lean muscle, check out The Movement Hierarchy.
The horizontal press is typically easier to perform pain-free than the vertical press. Although chest dominant, training this movement pattern will also build your delts, so it makes sense to start here to get the most bang for your buck.
Prime Your Upper Back Before Pressing
Don’t just hop under the bar and start pressing.
As you now know, the muscles of your upper back are KEY to keeping your shoulders stable and healthy – but only if you can activate the properly.
Take some time pre-pressing to activate the muscles of the upper back. GREAT movements here include:
Pack Your Shoulders
All those muscles of your upper back we just spent so much time connecting to and strengthening?
You’re going to use ‘em to keep your shoulders locked in a stable, strong position as you press.
Focus on retracing and depressing your shoulder blades into the bench – maintain this position through the entire movement. This will create some arch in your lower back, which is fine.
Failure to do this creates lots of shoulder instability – and in-turn, pain.
This is the most common mistake new online clients were previously making on their horizontal presses that is creating pain.
Do You REALLY Need To Keep Flat Benching?
The bench press IS a great movement – but it also seems to be the one that most commonly causes shoulder aches and pains to flare up.
Now, this is more common in the men I coach online than the women – most guys are very emotionally attached to the amount they can bench press.
Here’s the problem – stubbornly insisting on fighting through the pain of flat bench is a great way to NEVER get stronger, or build your shoulders and delts pain-free.
From my experience, most women and men that can’t flat bench without pain, CAN get away with pressing from inclines and declines pain-free.
You can still focus on pushing the weight and setting PR’s.
Does it matter that you achieved all of this on a Dumbbell Low Incline Bench instead of a Barbell Flat Bench?
You still got the result you wanted, WITHOUT the pain.
Use Dumbbells More Frequently Than Barbells
Sure, you can push more weight with a barbell. But you can also easily push much harder with one side of your body than the other, leading to even worse imbalances and overuse injuries than you already have.
This, paired with ability to find a grip that feels most natural and pain-free when pressing makes dumbbells superior to barbells for online clients with banged up shoulders.
Low Incline Presses, Floor Presses, And Decline Presses
Most online clients will find pressing from a low incline (around 15°) allows them to push very similar weight to the flat bench – without the pain. For most clients I’ve worked with experience shoulder issues, the low incline bench becomes their new bread and butter.
Other great shoulder friendly options to overload the horizontal press without irritating your shoulders include:
Remember not to get overzealous with the presses, and maintain the proper pulling:pushing ratios. Train the horizontal press 1-2x/week.
Finally, we have vertical (overhead) presses.
These are a great way to add lean muscle to your shoulders… but also a shoulder pain trigger for most… which is why you’re focusing on this after pain-free mastery of the first three steps.
Priming For Vertical Pressing
Just like with horizontal presses, your upper back plays a key role in stabilizing your shoulders and allowing you to press pain-free here.
Facepulls and band pull-aparts work great as priming movements here.
That said, my all time favorite primer to program for online clients before pressing is the Forearm Banded Wall Slide:
These recruit your rear delts, rotator cuffs, and lower traps – basically, these help you keep your shoulders stable and in a better position for pain free pressing.
Actively avoid shrugging, and keep constant outward tension on the band.
Vertical Pressing
Now, it’s pretty likely that pressing overhead is the current hardest thing for you to do pain-free. We want to ease into your overhead presses, starting with pain-free variations that will increase stability and shoulder health.
→ 1/2 Kneeling KB Bottoms Up Press
This movement is GREAT for increasing shoulder stability. It also allows you to effectively train the overhead pressing pattern, but makes your shoulder stabilizers the limiting factor in the movement. These allows you to press overhead and build stronger, more stable shoulders without unsafely loading up the weight.
→ ½ Kneeling Landmine Press
One of my favorite “workaround” movements to allow online clients with shoulder issues to keep building their delts is the 1/2 Kneeling Landmine Press.
The kneeling + unilateral aspects of the press make it a great core stability/anti-movement exercise. The arc of the bar path makes it easier for those who have poor shoulder mobility/stability.
→ Z-Presses
This is very “self-limiting”. You can’t let form break down and use sloppy technique (another common cause of shoulder pain).
To quote Dr. Joel Seedman: “Many lifters have tendency to over-arch their lumbar spine when performing overhead presses simply because they lack the ability to extend their t-spine and engage their core. With the Z press it literally forces the lifter to do both of these (t-spine extension and anterior core activation) as anything less will result in repeated failed attempts.” (1)
→ Trap bar Overhead Presses
A great substitute for barbell overhead work – the neutral grip and more natural range of motion allowed by the trap bar makes this movement a winner for the men and women I coach with beat up shoulders.
→ Now, definitely ease your way into overhead work. Start with once per week. You can eventually ease your way into twice a week as your shoulders get healthier – but BE CAREFUL. Too much overhead work can beat your shoulders up quickly.
→ I would recommend training no more than 6-8 sets overhead per week. From there, I help online clients ramp up the volume and build better shoulders by adding volume and frequency through delt fly variations. These are much more joint-friendly, and can be done up to 4-5x/week for most without pain or recovery issues.
If your shoulders are beat up, know that hope isn’t lost.
You can still achieve the lean, strong body you want.
Change your approach, and you (and your shoulders) will thank me later.
Jeremiah Bair is a certified nutrition coach, strength coach, and owner of the Online Coaching Business Bairfit. His Instagram is noticeably missing any calf pictures.