The definitive guide to neck and shoulder pain when pressing overhead.
It starts with sharp pain. It hurts, but you persist. You must.
Now there is electricity and quite a bit of heat radiating out from the source.
Must. Not. Quit.
Now there is a stream flowing. Except the stream is fire. And it hurts. A lot.
The pain becomes too overwhelming and you are forced to stop. Dejected, you wonder if this is how things will always be.
If you experience anything like this when reaching overhead then we need to talk.
Pain in the shoulder(s) and/or neck when pressing overhead is a common complaint. Is overhead pressing dangerous?
Should you avoid it at all costs like synthetic butter alternatives?
Butter alternatives. Yes.
Overhead pressing. No.
Why do so many people have difficulty pressing overhead and why are some people scared off from ever doing it?
There are reasons why people struggle to press overhead. We will discuss them and show you how to overcome them to press pain-free.
People that say that overhead pressing is bad or dangerous are misinformed. There is nothing inherently dangerous about the movement.
The things that we are going to discuss could cause the movement to become painful. The good news is that the things we are going to discuss are all correctable things.
Yay for you.
Let’s start breaking down the issues and show you how you can press pain-free.
Your posture is terrible
One of the reasons so many people think overhead pressing is bad is because so many people have jacked up posture.
If your posture is off, anything movement over shoulder-height can start to become problematic.
Now, before we go much further, we are going to have to lay out what “normal” and “abnormal” actually mean.
I know plenty of people that will completely discount anything pertaining to posture as having any role in pain.
Part of this, methinks, is because posture can mean so many different things. And, what is normal or abnormal. Those words are also a tad abstract.
Just so we can be on the same page, I will lay out my definitions of each so we have some frame of reference.
For our discussion, your “normal” static posture will be getting into the position below.
Your hips, shoulders and the back of your head should be back against the wall. Your feet do not have to be for now. Get them as close as you can.
In this position, your spine is in a pretty good position. There should be a curve in the neck and low back areas.
This is where I may have my clients work on modifying their neck and low back positions (based on their symptoms).
If this feels weird, that is ok. Most people have poor postural awareness. You think you are in one position but you are actually in a different one.
This movement feeling weird means you should get into this position multiple times every day to get used to it.
If you cannot get into this position, you SHOULD NOT be overhead pressing until you can.
Your “normal” dynamic posture is maintaining that position while you do other things. In this case, we are talking about overhead pressing, but in reality, this is a good practice for all movements.
Maintaining good dynamic posture is not as easy as it sounds. It will require a lot of work and mental energy.
Fixing posture is more abstract in nature and requires some different tools. You cannot just keep throwing a bunch of random exercises at it to correct it.
This is another reason why people shrug off correcting posture. It’s hard and it takes a long time.
But, I have seen the results when it is done right. Neck and shoulder pain are gone.
Shoulder and neck range of motion return to normal.
Numbness, tingling, and pain that once traveled down the arm are gone.
If you could not get into the “normal” static posture position and you have neck and/or shoulder pain, the sections that follow are going to give you some tools to get you out of pain and show you how to press overhead without pain.
Check out the video that breaks down this static/dynamic posture idea.
Can you even 90-90?
Just getting into the static posture position is not enough. It is a start but you need to be able to do more to safely press overhead.
While in your static posture position, can you get your arms up against the wall as seen below?
This is much harder than it looks.
A lot of people cannot get here without doing some other funky maneuvers. Before you freak out, let’s try one additional thing.
Can you get into the same position when paying down? It should look like this.
The inability to get into this position, standing or laying down, suggests that you need to work on some other things before doing much overhead pressing.
The video below will talk more about this. The sections that follow will start to lay out some strategies for improving your range of motion and will show some options for pressing that might work while you are addressing any mobility issues.
Thoracic spine and you. Why you have neck and shoulder pain
Did you know that your shoulder and neck pain often have very little to do with your shoulder and neck?
It probably sounds like I am speaking in riddles but the previous statement is very true.
This is also why you will struggle with shoulder and neck pain far longer than you should. You never actually address the problem.
Issues with the thoracic spine are pretty common. The reason they can fly under the radar is that the thoracic spine doesn’t typically hurt.
Your neck and shoulder(s) will.
The thoracic spine hurts when you test it or apply some pressure to it. There are other ways to obtain this information too but a little pressure on the thoracic spine does give some very useful information.
I have written about this a bunch before.
http://www.ebmfitnesssolutions.com/rehab-blog/how-does-posture-get-so-messed-up
http://www.ebmfitnesssolutions.com/rehab-blog/shoulder-and-neck-pain
http://www.ebmfitnesssolutions.com/rehab-blog/5-best-ways-to-improve-shoulder-pain
http://www.ebmfitnesssolutions.com/rehab-blog/the-complete-neck-and-shoulder-rehab-guide
If you struggle to get into the static posture position, this is where I would start.
Check out the video below to see why the thoracic spine matters.
Punch your muscles in the face
Have you ever had a massage or been to physical therapy and had one of those fine people press on a muscle that hurt so bad you saw stars and dropped a bad word that you had to apologize profusely for?
Did you want to punch that person in the face?
A lot of people have muscles that are in need of some soft tissue work. Like the thoracic spine, you don’t realize how bad they are until some pressure is applied to them.
When muscles need some soft tissue work and they do not get it, they can cause pain, limit range of motion, and start to change how your body moves, in general.
I have talked about the benefits of soft tissue work before.
http://www.ebmfitnesssolutions.com/training-blog/stop-stretching-your-tight-muscles
Soft tissue work is great and often a key part of getting you better. There is one unique rule that applies to soft tissue work and ONLY soft tissue work.
The more it hurts the more you have to do it.
This is true whether you are doing this on your own or are seeing a massage therapist. Muscles should not be that hypersensitive to pressure.
The only way to get them to chill out and sit back down is by applying pressure to get them to relax. It doesn’t have to be max pressure. But it does need to be done consistently.
And soft tissue limitations should be addressed before and while you get back to lifting.
Check out the video to see some ways to get started.
Should you sit or should you stand?
Up to this point, we have talked about a lot of things that can influence your overhead press but nothing about them specifically.
Well, my friend, that is about to change.
The first topic to discuss is whether or not you sit or stand. For some guys, this is a question of efficacy for their morning pee.
It is slightly more complicated than that when discussing overhead pressing.
First off, both are good. If you have good thoracic and soft tissue mobility and have a good sense of your posture, there is no wrong answer
Seated pressing does give you some ways to modify the movement that standing does not. If you are having a hard time, it may be wise to sit.
When sitting on the bench, you can slightly adjust the back of the bench from vertical to one click away from vertical.
Having the bench tilted back slightly will help, especially if you are still working with any limitations in your mobility.
You are also more stable when sitting on a bench. Your body does not have to stabilize and balance itself nearly as much as when you are standing.
Again, not good or bad, just information to use when making a decision.
You can also push back against the bench a little to some help. This is a slippery slope and you must make sure you do not jam the head and neck into the bench as this can irritate what is already irritated.
As I already mentioned, when standing, you must create more stability on your own. And if things are tight, you are probably going to arch your low back when pressing overhead.
This not only compromises your shoulders and neck but also opens up your low back and hips to additional stress.
Check out the video to see what all of this looks like.
Barbell OHP
Now we are going to break down specific types of overhead presses and weather or not they are good options when you have shoulder and/or neck pain.
Let’s start with the granddaddy of them all. The barbell OHP.
Anytime you have both of your hands on the same bar or attachment, you are going to have fewer variables to modify if something is hurting.
This is what makes the barbell OHP a poor option if you have pain. Even if you went from a standing version to a seated version, you still have the same relative hand/shoulder position because the bar locks them into a similar path.
If you have pain, skip this version until your pain has subsided. At that point, you can decide whether to bring it back into the mxi or stick with the other options I am going to discuss.
Check out the video to see what I mean.
DB OHP
Overhead pressing with dumbbells gives you more options and flexibility with the movement as opposed to the barbell.
The first option is to press with one or two dumbbells. In my experience, pressing with one dumbbell gives you more freedom to focus on the injured side and allows getting range of motion, especially at the top of the motion, with greater ease.
You can also play around with your hand/shoulder position to see if one position is more comfortable than the other.
Check out the video to see how the DB OHP really ties the room together.
If you don’t BUP, you don’t know
Now we get to talk about one of my favorite ways to press overhead.
This kind of a press is known as a bell-up press. You basically take a kettlebell and flip it so the bell is up and press with the kettlebell in this position.
Fancy, right?
The BUP offers all the variability of the regular DB OHP. One or two KBs. And you can experiment with your hand/shoulder position to find what works best.
The main difference is the BUP keeps you honest. You really cannot perform bad reps or the KB tips over.
It forces you to stabilize the shoulder differently than with the barbell or DB.
If you are having pain with overhead pressing, this is one of the best options to get back on track.
Check out the video to see the BUP in all its splendor and glory.
You could always play with a landmine
If you have access to one, performing a landmine press is another great option when trying to press overhead with some pain.
The angle of the press is different which makes it a great way to work on your pressing mechanics.
The landmine press can also help with retraining your scapular upward rotation.
Because of many of the things previously mentioned, the mechanics of your press could be hot garbage and needs some remodeling.
If you are unfamiliar, check out the video to get a glimpse of the landline press.
Raise your hands if you’re sure
Well, there you have it. A solid, step-by-step plan to help get you out of pain with your overhead pressing.
Truth be told, these strategies will work for a lot of general shoulder and neck pain as well.
If all of this sounds good but you feel like you need some extra help, never hesitate to reach out through the CONTACT PAGE, FACEBOOK, or INSTAGRAM.
Until next time,
Dr. Tom
