Shoulder pain should not be the norm. Learn why your shoulders hurt and what you can do to remedy this issue. This feature includes a sample superset warmup workout

Why Healthy Shoulders Is A Foreign Concept

Shoulder pain during a workout is not normal, and should not be treated as such. We live in a society that thrives on piss poor posturing between our 12 hour a day desk work and pathological cell phone addiction. This obviously isn't doing any of us any favors, but sometimes it’s unavoidable. The fact of the matter is, when your lazy daily habits start hindering your ability to stay healthy in your training, it's time to take action.

The most notorious suspect for front-sided shoulder pain in the gym is the bench press, and its many variations. The usual gym bro who puts a heavy emphasis on chest and biceps training deals with shoulder pain in an eerily common fashion shown below:

  • Starts with barbell bench press, the most alpha of all chest exercises.
  • Shoulder starts to hurt, so the bench gets put aside for the dumbbell bench press.
  • After a week or so of hitting the chest 5+ times, the dumbbells get thrown away for push-ups, because it's only bodyweight bro!
  • Sometime in the near future, even the push-ups kill your shoulders, and the thought of getting a skin-tearing pump on the chesticles is the least of the bros problems.

Why Your Shoulders Hurt

Without diving too deep into anatomy and movement mechanics, here's why your shoulders hurt when you do chest, or any push heavy movements:

  • Your programming ratios are off. The formula to healthy shoulders lies within a 2:1 pull to press ratio. This is even more important for heavy upper body work, due to your daily routine of slouching and handheld technologies.
  • Your pressing frequency is too high, limiting your ability to recover between push emphasized upper body training days. This releases a cascade of acute inflammation and breaks down soft tissues quicker than you can shotgun your $8 gluten free smoothie. The tissues simply never get the chance to fully regenerate, and you are left in a world of hurt.
  • Your form sucks. Your idea of a tight core and stable pelvis during pushing movements is flailing around on the bench, hip thrusting your way to an illegitimate new PR.
  • Your scapulas have no rhythm. Depending on the position (either open or closed chain), your shoulder blades must have the ability to dynamically stabilize on the backside of your rib cage. Your scaps should at least be mobile enough to take just enough pressure off the gleno-humeral joint and keep you from teary eyes mid set.
  • The function of your shoulder stabilizers is non-existent. Just as you can't maintain proper biomechanics during the bench, your ability to activate stabilizers to keep your joints properly aligned have not been used since your cookie cutter physical therapist prescribed you thera-band shoulder external rotations pinning a tampon between your arm and body.

Bench Press Form

Your form sucks. Your idea of a tight core and stable pelvis during pushing movements is flailing around on the bench, hip thrusting your way to an illegitimate new PR.

Activating Shoulder Stabilizers

Programming, frequency and ability to maintain good form are highly manageable by putting aside your ego and intelligently going about your training in a controlled fashion. On the other hand, activating shoulder stabilizers is an uphill battle since you most likely have ingrained shitty movement patterns into your brain, and forgot what pain free motions are supposed to feel like. In these cases, some serious movement remediation is necessary to break down old habits one rep at a time.

My go to exercise for clients with years of wear and tear on their shoulder joints is cable loaded face pulls. This movement positions the gleno-humeral (true shoulder) joint in a neutral position inside the glenoid fossa (socket), allowing smooth and free joint translations. When properly executed, the face pull forces you to activate the posterior rotator cuff, posterior deltoid and rhomboid complex, while maintaining a stable thoracic spine.

Completing a single set of 15-20 repetitions in a dynamic warm-up can activate posterior chain shoulder stabilizers needed to safely press weight horizontally or overhead. But as always, this simple addition to a program does not work for everyone, especially the train wrecks that have been benching multiple times a week for decades. More times than not, these are the people who end up in my office praying for a miracle.

Prime the Movements and Stabilize the Core

Cheaters will cheat movements instinctively. Even corrective exercises and activation drills such as the face pull can be a wild ride. I have seen this happen more times than I would like to admit throughout my career, and every case is as frustrating as the last.

Some cheaters cheat to bring their numbers up, while others don't even realize they are cheating. For cheaters who lack the ability to properly execute a bilateral face pull, first make them own their spinal and pelvic position. This can be achieved through single arm face pulls:

Getting the posterior shoulder and cuff firing is only half the battle in most cases. After you have earned the right to incorporate pressing motions back into your routine by showing a glimpse of improvement in your shoulder stabilization patterns, it's time to work on those shoulder blades that were set in concrete back in 2004.

Free Your Shoulder Blades

This is going to be a hard concept for some deeply rooted bros to grasp, but not every chest exercise has to involve a bench and a piece of iron. This type of thinking is what got you hurting in the first place. It’s insanity to make the same mistakes over and over, but continuing to literally hurt yourself is just down right stupid.

When you approach the bench, ready to release your inner demons, your shoulder blades are essentially stuck between a rock and a hard place. Your thoracic spine most likely resembles a round atlas stone at this point, while the bench just adds to the dysfunction. This position allows minimal movement of the shoulder blades as the angle of your humerus (bone of the upper arm) changes during a pressing motion.

Not only are your shoulder blades cast in stone during the bench press, but unless you’ve been properly coached on how exactly to actively stabilize your scaps during the eccentric, amortization and concentric phases of the bench press, the smaller, more injury prone structures such as the rotator cuff can be overloaded. Don't be fooled, the proper bench press technique involves more than throwing a few wagon wheels on the bar and grunting your way to injury.

There is nothing inherently wrong with flipping your body over and hitting up some loaded push-up variations. Your training partner may call out your manhood, but hey, tough love is what mothers do best. Because you decided to swallow your pride and train properly, the shoulder blades are free to move as they were originally designed to move. Congratulations, you are on the right path.

Before you tell me you can't get any work done on your chest using only gravity, listen up. This isn’t Crossfit, and we haven’t flushed the idea of horizontal pressing down the shitter quite yet. The easiest way to keep pressing pain free while still getting a training effect is by incorporating a banded push-up variation into your training.

Banded push-up variations create an accommodating load that challenges the triceps at the top of the motion into elbow lockout, where there is the most tension in the band. The bands also deload the push up slightly at the bottom of the motion, the position in which most shoulder injuries and irritation occurs. Push-ups keep you honest with core positioning, while linking up entire kinetic chain in a single motion. Can the bench do that for you...and keep you healthy? Probably not, or you wouldn't be reading this article.

Use any variation of the banded push-up by altering the height of either your feet or your hands. The change in angulation can increase or decrease gravity-enforced loads, and emphasize different portions of the pecs and triceps. Check out the banded push up here:

Enhance Performance With Proper Ordering

If using the face pull or single arm face pull during the dynamic warm-up is not getting the job done, while training is continuing to tear your shoulders apart, a stronger emphasis should be placed on the face pull movement.

Programming supersets within a program can be advantageous in a few ways:

  • More volume placed on corrective/activation movement patterns.
  • Face pulls act as a primer for the bigger multi-joint movements that it’s paired with.
  • More active rest periods for primary power or strength movements.

The most advantageous program order for supersets containing corrective or activation exercises is always posterior chain before anterior chain. Use the activation movement to enhance the overall performance of the primary strength or power movement. This is called a synergistic movement pair. Anytime you can get more out of your primary strength movements by fine-tuning the neuromuscular system, use it.

Programming Considerations

We are using the face pull and single arm face pull as dynamic neuromuscular activators, so make sure to program them as such. Use these programming parameters below to seamlessly integrate the face pull variations into your current warm-up, or as a priming superset for any heavy push variation:

  • Sets - 1-4 (match your primary strength movement)
  • Reps - 6-8
  • Rhythm - 1-1-X-0 (X- maximal velocity)
  • Load - 50% 1RM
  • Rest - 30-45 seconds

Example primer superset using face pull:

Primer Superset Workout
Exercise Sets Reps Rest
Single Arm Face Pull 4 6 per arm 30 sec
Banded Push Up 4 8 60 sec

Here's to Healthy Shoulders

Using some face pulls in conjunction with deloading your heavy pushing movements can be a game changer for shoulder health. Though these movements are fundamental in nature, they take concentrated time and effort to nail down the proper biomechanics and activations that will keep you out of pain in the long run. Work these variations slowly into your training schedule, and reap the benefits.

Raine Virta
Posted on: Thu, 01/22/2015 - 04:42

> unless you’ve been properly coached on how exactly to actively stabilize your scaps during the eccentric, amortization and concentric phases of the bench press

Where might I learn more about this concept?

Steven Maier
Posted on: Mon, 12/29/2014 - 17:37

Well done Doc. I am just working on some ideas for a patient of mine (Chiropractic) and I was going to teach him face pulls. But now they will have you to thank for the single arm variation.
I'll keep you updated on their progress.

John Rusin
Posted on: Thu, 10/09/2014 - 18:18

Hey Ian, give my business manager Lindsay an email from this page and I'll try and point you in the right direction!

Posted on: Tue, 10/07/2014 - 14:41

Hey John,
Interesting read. I am a current student (2nd term) in progress to get my DPT and I am curious on the path you took out of school to get into Sports Performance Physical Therapy. That is the area I want to specialize in. It looks like you have been successful in opening your own practice and any tips would be appreciated!

John Rusin
Posted on: Mon, 10/06/2014 - 15:17

Great to hear, Marc. Give the single arm face pulls a try, I prefer them over the bilateral movement for most people!

John Rusin
Posted on: Mon, 10/06/2014 - 15:16

Greg, Thanks for reading. Shoulders can be a bitch, and that's why I focus on them with my training clients, physical therapy patients and online coaching and writing. Check out a few more articles from me focusing on shoulder joint centration and internal stability:, and keep an eye out for another article on the shoulder and upper extremity spiral effect! Let me know how this works for you!

Marc Coletti
Posted on: Sun, 10/05/2014 - 14:52

Great article recently had to take a month off due to a strained ac joint. Face pulls and doing rotator cuff exercise has helped immensely. No more shoulder pain.

Posted on: Sun, 10/05/2014 - 13:06

this came at the right time. I am taking a week off to recover because I am starting to feel chronic shoulder pain. I am not a meathead high school kid wannabe by any means. I focus on form and am always careful so as not to injure myself. This summer I went to daily workouts, a body part a day (except bis and tris, which I do as superset. Day 1 is chest, 2 is legs, 3 is shoulders, 4 is bis and tris and 5 is back. Anyway, I worked hard this summer to add to my bench press as my chest is a weak feature. I brought my one rep max to 230 and my regular routine is 200-210 on bench press (I am 6'5 and weigh 220). I have good depth and form but the shoulder has been starting to hurt lately. Hopefully these tips will help. I am also wondering if doing weights everyday could be contributing to the pain? Point being that everything except legs involved some shoulder use so perhaps I should be going to every other day with weights again. My point do doing daily was to stimulate some growth. And it worked, but now I'm hurting.

John Rusin
Posted on: Sat, 10/04/2014 - 10:31

Hey Marianne, My evidence is based on my many case studies in my years of clinical practice with amateur to elite athletes. Doctorate in Physical Therapy! Thanks foe reading!

Posted on: Fri, 10/03/2014 - 10:56


I'm curious: Do you have any evidence for your claims in the "Why your shoulders hurts" section?

Also, what is your Doctorate in?