Shoulder Pain When Pressing: Should You Stop Shoulder Pressing?
Shoulder pain during a shoulder press can be frustrating, particularly when an exercise that was previously comfortable suddenly starts to hurt.
A common reaction is to stop the exercise completely.
But is that always necessary?
Not necessarily.
When we assess people with shoulder pain at Body Fit Physiotherapy, one of the things we consider is whether we can modify an exercise rather than simply remove it. Changing the position, range of movement, resistance or type of press may significantly change how the shoulder responds.
The important point is that there isn't one universally "safe" shoulder pressing position. The best option depends on the individual, their symptoms and what their shoulder currently has the capacity to tolerate.
Why does my shoulder hurt when shoulder pressing?
The shoulder is a highly mobile joint. Performing a shoulder press requires coordinated movement between the shoulder joint, shoulder blade, upper back and surrounding muscles.
Pain during pressing can therefore have a number of contributing factors.
These may include:
A recent increase in training load
Increasing weight too quickly
Changes to training volume or frequency
Reduced shoulder or thoracic mobility
Rotator cuff-related shoulder pain
Reduced strength or capacity of the shoulder muscles
Previous shoulder injuries
The position or range in which you are pressing
Performing more load than the shoulder currently tolerates
This is why simply saying that one particular shoulder exercise is "bad" is usually an oversimplification.
The exercise may not necessarily be the problem. It may be the current relationship between the exercise and the capacity of your shoulder.
Should I stop shoulder pressing if it hurts?
If a particular shoulder press causes pain, stopping that exact exercise temporarily may sometimes be appropriate.
However, that doesn't automatically mean you need to stop all pressing or shoulder strengthening.
Instead, we can ask:
Can we find another way to perform the movement that is better tolerated?
For example, someone may experience pain with a traditional barbell overhead press but tolerate a dumbbell press differently.
Another person might find exactly the opposite.
Some people may tolerate pressing on an incline better than directly overhead. Others may respond to changing their grip, reducing their range of movement or simply decreasing the resistance.
There is no single modification that works for everyone.
The goal is to find an appropriate starting point for your shoulder.
Changing your pressing position may change your
symptoms
One of the simplest things we can trial when assessing a painful exercise is changing the position.
Small changes can alter how load is distributed across the shoulder and how much movement is required from different structures.
Depending on the person, this might involve:
Changing from a barbell to dumbbells
Altering your grip
Changing the angle of the press
Reducing how far you lower the weight
Performing an incline press rather than pressing vertically overhead
Reducing the resistance
Changing the speed of the movement
Importantly, a modification shouldn't automatically be labelled the "better" exercise.
It is simply another option to test.
If it reduces symptoms while allowing you to continue strengthening, it may provide a useful starting point for your rehabilitation.
Watch: Shoulder pain when pressing
In our video, we demonstrate this concept using shoulder pressing as an example.
Rather than assuming that pain means you must stop strengthening your shoulder, we look at whether changing the pressing position can provide an exercise that is better tolerated.
The important message isn't that one pressing variation is superior to another.
It's that exercise should be individualised.
What works well for one person's shoulder may aggravate another person's symptoms.
Should you exercise through shoulder pain?
This is where things become more individual.
Pain during exercise doesn't always mean you are damaging your shoulder. At the same time, repeatedly forcing your way through significant or progressively worsening pain isn't necessarily a sensible rehabilitation strategy.
We generally want to consider several factors:
How painful is the exercise?Mild discomfort may sometimes be acceptable depending on the condition and rehabilitation stage, whereas significant pain may indicate that the exercise needs to be modified.
What happens afterwards?An exercise may feel reasonable while you're performing it but produce a significant increase in symptoms later that day or the following morning.
Are your symptoms improving over time?A rehabilitation program should generally be progressing towards greater function and capacity rather than continually aggravating the shoulder.
What are we trying to achieve?The appropriate exercise for someone returning to competitive sport may be very different from someone wanting to comfortably perform everyday activities.
These decisions are one reason individual assessment can be useful.
Why completely avoiding the shoulder isn't always the answer
When something hurts, avoiding it makes intuitive sense.
In the short term, modifying activity can certainly be appropriate.
The problem is when short-term modification becomes long-term avoidance.
If you completely stop loading your shoulder for an extended period, you aren't necessarily addressing the underlying capacity required to return to the activities you want to perform.
For many shoulder conditions, progressive exercise is an important component of rehabilitation.
The goal is therefore often not:
"How do we avoid using this shoulder?"
Instead, we want to ask:
"What can this shoulder tolerate now, and how can we progressively build from there?"
That is an important difference.
Strengthening your shoulder is a progression
Imagine your normal shoulder press is currently painful at 20 kg.
Your rehabilitation doesn't necessarily need to start with trying to repeatedly press 20 kg until it stops hurting.
Your starting point might instead involve:
A lighter weight
A different pressing angle
A different range of movement
A different exercise entirely
Specific rotator cuff strengthening
Shoulder blade strengthening
Improving movement elsewhere in the shoulder complex
Once you find an appropriate starting point, resistance and movement can be progressively increased.
Eventually, the aim may be to return to the original exercise that was painful.
This is the difference between simply avoiding pain and actually building physical capacity.
When should shoulder pain be assessed?
If you've experienced minor shoulder discomfort after an unusual workout, it may settle relatively quickly.
However, consider having your shoulder assessed if pain is:
Persisting rather than improving
Regularly stopping you from exercising
Becoming progressively worse
Affecting your sleep
Restricting normal shoulder movement
Associated with noticeable weakness
Affecting work or everyday activities
Returning every time you increase your training
Sudden severe pain following trauma, obvious deformity, significant loss of strength, or other
concerning symptoms should also be appropriately medically assessed.
Physiotherapy for shoulder pain in North Adelaide
At Body Fit Physiotherapy in North Adelaide, our approach isn't simply to give everyone with shoulder pain the same list of exercises.
We first want to understand what you are trying to get back to.
For one person, that may be comfortably reaching into an overhead cupboard. For another, it might be returning to heavy shoulder pressing at the gym.
We can assess your shoulder movement, strength, current symptoms and exercise tolerance before developing an individualised rehabilitation program.
Where appropriate, this may involve finding alternative exercises that allow you to continue training before progressively rebuilding towards the movements that currently cause pain.
The takeaway
If shoulder pressing hurts, you don't necessarily need to stop strengthening your shoulder altogether.
Your current pressing position, resistance, range or training load may simply be more than your shoulder currently tolerates.
Changing the exercise may provide a better starting point.
But there isn't one "best" shoulder press for everyone.
The aim is to find a position and load that works for you, progressively build your shoulder's capacity and, where appropriate, work back towards the activities you want to perform.
If shoulder pain is limiting your training or everyday activities, the physiotherapists at Body Fit Physiotherapy in North Adelaide can assess your shoulder and help determine an appropriate way forward.
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