Here's What's Causing Your Shoulder Pain After Push-Ups

Use proper form when doing push-ups to prevent rotator cuff injuries.
Image Credit: adamkaz/E+/GettyImages

Push-ups are your ticket to stronger pecs, abs, shoulders and arms. But if you're not careful, a few factors can conspire to make you feel shoulder pain after push-up workout.

Previous shoulder injuries, lack of mobility or strength and/or poor form can all turn this bang-for-your-buck exercise into a recipe for shoulder pain and injury, explains Blake Dircksen, DPT, CSCS, a physical therapist at Bespoke Treatments in New York City.

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To help you stay pain- and injury-free, we asked a couple of experts to clarify the top causes of shoulder pain from push-ups. Learn how to fix these common issues before they lead to injury.

5 Reasons You Have Shoulder Pain After Push-Ups

Poor push-up form is one of the top contributors to shoulder pain and injury. If your shoulders twinge after a few sets, chances are you're making at least one of the following push-up mistakes.

1. Your Elbows Are Off

Many people bend their elbows straight out their sides as they lower their chest to the floor. If you were to take a bird's-eye view, their body would look like the letter T.

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"This puts excessive pressure on the front of the shoulder and can cause strain on the anterior [front] deltoid," says Christopher Lauer, DC, a chiropractor and clinic director at Life Time's LifeClinic in Minnesota.

Others bring their elbows right next to their body so they form the letter I. This position also dumps too much weight (read: stress) on the front of the shoulder, which can lead to injury over time, he says.

Your goal: an A. Let your elbows flare diagonally out to your sides as you lower.

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2. You're Not Using Your Lats

The latissimus dorsi, aka your lats, are large, fan-shaped muscles on both sides of your back. As the biggest muscles in your upper body, your lats play a key role in stabilizing your shoulders during pushing movements like push-ups. If you try to do push-ups without engaging them, your shoulders will round forward to compensate.

"This will put excessive strain on the front of the shoulder," Lauer says. As a result, at the end of your workouts, you can feel some nagging pain or discomfort.

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To really engage and use your lats during push-ups, set up with your shoulders braced. As you lower, squeeze your blades down and back to almost "row" yourself toward the floor.

3. Your Hands Are Too Far Forward

If you set up for a push-up with your hands too far in front of your body, you put extra stress on the top and front of your shoulder, according to Dircksen. It also makes it hard for your rotator cuff muscles to do their job, and can lead to aggravation around your shoulder blades.

Set up with your hands directly under your shoulders. Bonus: This will help you best engage your lats.

4. You're Overdoing It

Another top cause of push-up injuries is overload. "As with many injuries, doing too much too soon is a good recipe for injury," he says.

If you don't give your joints and muscles a break from push-ups, they can't recover and rebuild. The result: joint inflammation and pain after push-ups. Chances are your form will break down as well, because key muscles will be too worn out to contribute.

Be a real stickler for form and end your sets at (or before) the first sign of faltering form.

5. You Lack Shoulder Mobility

You may also feel shoulder pain after push-ups if you lack shoulder mobility — specifically, the ability to rotate your shoulder blades inward.

"Any kind of pressing, push-ups included, requires a lot of internal rotation at your shoulder," Lauer says. Without that rotation, your shoulders will round forward, straining the front deltoid.

An easy way to test if you have proper internal rotation is to stand with your hands at your sides. Then, take one hand and move it behind and up your back so your palm faces outward. See if you can touch the bottom of your shoulder blade with the tips of your fingers.

"If you cannot reach your shoulder blade easily in one fluid motion, you have significant rotation restrictions and should be careful of performing a serious push-up routine as it may cause injury," he says.

FYI, most people actually can't get into this position. Or, put another way, they lack some shoulder ability. Even if you can touch both shoulder blades, if your working arm's shoulder blade "wings" or juts out, you may have some restriction.

Try This Simple Stretch to Improve Your Shoulder Mobility

  1. Stand facing away from a kitchen sink and grab the edge with both hands behind you.
  2. While holding the edge of the sink, step forward until you feel a gentle stretch in the front of your shoulders. There should be no pain or strain in this position.
  3. Hold here for at least 30 seconds.

Rotator Cuff Injury From Push-Ups

The rotator cuff contains multiple muscles and tendons that attach to and control the shoulder blade, upper arm and ribs. These tendons help the shoulder joint rotate, which is something you need during push-ups.

Rotator cuff tendinitis, inflammation of one of the tendons in the shoulder joint, is a common injury and can happen due to poor push-up form or overuse. The inflammation can cause the tendons to weaken and, in rare cases, eventually result in a tear in the tendon. Shoulder bursitis is the inflammation of the bursa, the fluid-filled sac that provides cushion between a tendon and an underlying bone. It can similarly cause discomfort or pain after push-ups, Lauer says.

Your best course of action if you have a rotator cuff injury from push-ups: rest.

"You cannot heal in the environment that caused your injury. So you will either need to discontinue the push-up program to allow the tissues to heal or change up your training drastically," he says.

There may be other pressing exercises you can do while you heal, but be sure to ask your doctor before performing any exercise with a rotator cuff injury.

Warning

Shoulder pain during push-ups is also not normal. If push-ups hurt your shoulder, consult your doctor or physical therapist to avoid a bigger injury.

Preventing Shoulder Injury From Push-Ups

Pain is your body's way of asking for help. If you experience shoulder pain from push-ups, your body is telling you to fix your push-up form and/or dial back the amount of work you're doing.

"If poor form is the main driver of your discomfort, then changing that form, and the stress on that tissue may resolve the pain you're feeling," Dircksen says. "It may also be necessary to regress the push-up to a different movement altogether," like elevating your hands to a bench or countertop.

During push-ups and push-up modifications, prioritize quality movement over cranking out high reps. Aim for 3sets of quality reps where you're getting to an RPE (rate of perceived exertion) level of 8 out of 10 (10 is maximum effort) during each set, he says.

Aside from focusing on solid form, you can prevent shoulder pain from push-ups by keeping an eye on exercise volume and frequency, he says. Give yourself at least a day of rest in between push-up bouts to best recover.

To work your way up to pain-free push-ups, try these progressions.

High Plank

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Skill Level All Levels
  1. Start on your hands and knees with your shoulders stacked above your wrists and your hips directly above your knees.
  2. Step both feet back to balance on your hands and toes. Your body should form a straight line from the top of your head to your heels. Tuck your pelvis to engage your core and squeeze your glutes.
  3. Hold this position while maintaining a neutral spine.

Incline Push-Up

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Skill Level Intermediate
  1. Place your palms on an exercise bench or the seat of a chair.
  2. Walk your feet back until you're on your toes to come into a high plank with your core and glutes engaged. Your shoulders should be stacked over your wrists and your hips should be in line with your head and heels.
  3. Bend at the elbows at about a 45-degree angle from your torso and lower your body toward the bench.
  4. On the way down, squeeze your shoulder blades down and together.
  5. When your chest hovers just above the bench (or however far down you can go), press into the bench and push your shoulder blades apart to return to the starting position.

Taditional Push-Up

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Skill Level Advanced
  1. Begin in a high plank with your core and glutes engaged. Your shoulders should be stacked over your wrists and your hips should be in line with your head and heels.
  2. Bend at the elbows at about a 45-degree angle from your torso and lower your body toward the ground.
  3. On the way down, squeeze your shoulder blades down and together.
  4. When your chest hovers just above the ground (or however far down you can go), press into the ground and push your shoulder blades apart to return to the starting position.

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