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How to Modify Weight Training Due to Shoulder Pain

This is an excerpt from Rock Solid Resilience by Dean Somerset,Dan Pope.

Bench Press and Shoulder Pain

Before listing the principles to remember when bench pressing is painful, I want to explain my use of the word stress in this section. It’s important to understand that stressing a structure is not a bad thing; quite the opposite. You have to stress your biceps with curls to stretch out those medium-sized T-shirts, right? With an injury, we’re attempting to modify the stress to produce a positive adaptation to the area while respecting the injury.

When bench pressing is painful, remember these principles:

• Greater loads increase stress to the shoulder. More weight on the bar generally equates to more stress on the shoulder. Faster lifting speeds also increase stress on the shoulder.
• The shoulder is very prone to overuse issues. Unlike the hip and knee, the shoulder was not designed to bear weight. For this reason, the shoulder may be more prone to overuse issues if bench-press frequency is too high.
• Specific bar paths, ranges, and positions can become overused. Overusing specific grips, angles of press, and specific ranges of motion can create overuse problems within the shoulder.
• Wider grips and deeper pressing increases stress to the shoulder (AC joint).¹⁰ The farther away the elbow gets from the body and the farther it travels toward the floor, the more stress on the shoulder.

Here are some tips for reducing shoulder pain during bench press.

First, decrease the total load or slow down the speed of movement. Lowering total load decreases the stress on the shoulder. To achieve this, you can increase the number of reps (decreasing the total load you can use for the set), slow down the speed of the lift, or add pauses at the bottom of the bench press.

Second, press less frequently and for fewer reps throughout the course of the week. Often, decreasing total pressing volume will be enough to end shoulder pain. Reduce the total sets of bench press in a given session or substitute one or two rowing exercises for pressing exercises in your program.

Third, vary the pressing exercise. Changing the angle, grip, or implement is often enough to remove or reduce pain while pressing. You can try changing to an incline or decline press, changing your grip width or switching to a neutral-grip bar, or using dumbbells.

Fourth, narrow the grip and limit the range of motion. A narrower grip and less depth will decrease stress on the AC joint. Switch to a closer grip or try a floor press, board press, or Spoto press.

Finally, if all else fails, try substituting a rowing variation for a pressing variation. Consider the seal row, chest-supported row, or single-arm dumbbell row.

If you are unable to eliminate pain by slowing down reps or attempting a higher rep range, use the bench press modification ladder for shoulder pain (figure 8.1) to find a pain-free bench press variation.

Overhead Press and Shoulder Pain

The overhead press is generally one of the toughest things to perform when the shoulder is painful. It often has to be taken out of the program temporarily to allow the shoulder to heal before being included again. Here are five things to keep in mind when overhead press is painful:

• Greater loads increase stress to the shoulder. More weight on the bar generally equates to more stress on the shoulder. Faster lifting speeds also increase stress on the shoulder.
• The shoulder is very prone to overuse issues. Unlike the hip and knee, the shoulder was not designed to bear weight. For this reason, the shoulder is more prone to overuse issues if too much overhead pressing is done.
• Different grip widths and pressing implements can help with pain. Often, switching grip widths or pressing implements (barbell versus dumbbell versus kettlebell) is enough to eliminate pain during overhead press.
• When overhead pressing is painful, sometimes horizontal pressing is well tolerated. For this reason, different angles of pressing can substitute for overhead pressing to get your training in for the day.
• Substituting a row variation for pressing is often helpful. When you can’t find a pressing variation that can be accomplished without pain, often substituting a rowing variation is well tolerated.

Here are some tips for reducing shoulder pain during overhead press.

First, decrease the total load or slow down the speed of movement. Less total load decreases stress on the shoulder. Achieve this by increasing the number of reps (decreasing the total load you can use for the set) or slow down the speed of the lift.

Second, press less frequently throughout the course of the week for fewer reps. Often decreasing total pressing volume will be enough to lessen shoulder pain. You can reduce the total sets of overhead press in a given session or substitute one or two rowing exercises for pressing exercises in your program.

Third, vary the grip. A narrower grip may help with shoulder pain.

Fourth, vary the pressing implement. Switching from a barbell to dumbbells, kettlebells, or a landmine is often enough to eliminate pain.

Fifth, vary the plane of pressing. Switching from an overhead press to a more horizontal press such as an incline press can be effective for reducing pain and continuing to train for the day.

Finally, if all else fails, substitute rowing for pressing. Try a seal row, chest-supported row, or single-arm dumbbell row.

If you are unable to eliminate pain by slowing down reps or attempting a higher rep range, use the overhead press modification ladder for shoulder pain (figure 8.2) to find a painless overhead press variation.

Pull-Up and Shoulder Pain

Fortunately for us, pull-ups are generally not as difficult for the injured shoulder than are other shoulder-dominant exercises, such as bench press and overhead press. However, when pull-ups are painful, we need to know how to work around it. Here are few things to keep in mind:

• Greater loads increase stress to the shoulder. More weight simply increases stress to the shoulder joint (think of performing a weighted pull-up). Faster lifting speeds also increase stress on the shoulder.
• Different grips can help with pain. Often, changing to an underhand or neutral grip is enough to make the movement painless.
• When pull-ups are painful, sometimes more horizontal pulling is well tolerated. Try a horizontal rowing motion.

Here are some tips for reducing shoulder pain during pull-ups.

First, decrease the total load or slow down the speed of movement. Less total load decreases stress on the shoulder. You can achieve this by increasing the number of reps (decreasing the total load you can use for the set via dropping any additional weight you were planning to use). Add band assistance or use the lat pull-down. You can also slow down the speed of the lift.

Second, vary the grip. A neutral or chin-up grip may help with shoulder pain.

Third, vary the plane of pulling. Switching from a pull-up to a more horizontal pull can be effective in reducing pain and continuing to train for the day. Try a half-kneeling overhead pull-down or other horizontal rowing variation.

If you are unable to eliminate pain by slowing down reps or attempting a higher rep range (dropping any additional weight added), use the pull-up modification ladder for shoulder pain (figure 8.3) to find a painless pull-up variation.

More Excerpts From Rock Solid Resilience

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