The great thing about push-ups is that you can stop, drop and do them anywhere. A simple body-weight exercise, it's the perfect addition to almost any workout — or as a simple add-on after a cardio-centric session, like running or cycling.
Plus, adding them into your fitness mix can have a slew of total-body benefits. Not only do push-ups work your arms, upper back, core, legs, hips and chest, but according to a September 2014 study published in the Journal of Sports Science and Medicine, they also encourage muscle activation in the deltoids and pectorals, which attach at the rear, front and side of the shoulder.
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Because of that, if you're experiencing shoulder pain during push-ups, it's likely because you have the wrong form, says Rebecca Louise, fitness coach and author of It Takes Grit. Here, we dive into the most popular form mistakes that could be resulting in discomfort.
You can always modify a push-up to make sure you're getting down the form basics before leveling up to the high plank position. A couple great places to start would be from the quadruped or modified-high plank position, according to the American Council on Exercise (ACE).
1. Your Neck Is Out of Alignment
The goal of a proper push-up is to lower your torso toward the ground, but sometimes in your efforts, it's easy to let your neck make the reach to get to what feels like that bottom position faster. However, when you do this, your shoulders rotate inward which can create unnecessary stress, Louise says.
On the flip side, you may be tempted to look around at something on the television, check your form in the mirror or watch other workout goers). But now is the time to focus on the exercise at hand.
Looking up while performing a push-up can strain the trapezius muscle or increase compression force on your cervical vertebrae, which can lead to lead to shoulder pain after push-ups, says Dan Giordano, DPT, CSCS, and co-founder of Bespoke Treatments.
Remember that the push-up is a full-body exercise, and that the body must remain stable — and in a straight line — as it moves up and down. Instead of looking up, aim for a neutral gaze and neck alignment, keeping your eyes looking straight down at the floor.
Or if you don't feel like you have the core strength to execute the movement in this way just yet, try modifying to your knees so that you don't feel the need to crank your neck.
2. Your Elbows Are Flaring Out to the Sides
Arm placement is integral to correct push-up form. If your hands are too far forward or too wide, it can cause a strain at the shoulders. It can also cause for your elbows to flair out to the sides, resulting in compression at the shoulder, Giordano says.
When you set up in a high plank at the top of your push-up, your hands should be directly under your shoulders. When you lower down, Giordano recommends that the elbows create a 45-degree angle with the body for more stable form.
3. Your Shoulders Are Weak
Weakness, or not being able to tolerate the workload you're asking of your body, is generally the root cause of most injuries, according to Blake Dircksen, DPT, CSCS. Since your shoulders are such an integral component to proper push-up execution, a strength discrepancy can certainly cause some big issues.
Also of note: Sometimes the pain can be because you haven't used those muscles much before, says Louise, who encourages her clients to have patience and grace as they build up a solid base.
Start by doing a modifications that's suitable to develop strength without irritating the joint, Dircksen suggests. A great place to start? A push-up on a bench or on the wall.
"This will decrease the load going into the shoulder, while providing specific strengthening meant to condition the shoulder for a standard push-up," he says.
Or swap in a dumbbell bench press on your back. Choose a load that causes fatigue near the 12 to 15 rep range.
"This dumbbell version is an 'open-chain' variation which allows the shoulder to move more freely, which may be helpful if someone is experiencing shoulder pain," he says.
4. You're Doing Too Many Push-Ups
Doing too many push-ups or trying to move too great of a weight — or a combination of both — can lead to irritation at the shoulder joint. If you're exceeding your shoulder's workload capacity, the joint is going to become inflamed, Dircksen says. And that leads to pain and potentially injury.
"This capacity is relative to the person and dependent on a variety of lifestyle components, including habits surrounding sleep, systemic health conditions, age, nutrition and stress management — among others," he says.
Start slowly. According to ACE, a good rule of thumb is to add 1 or 2 reps each workout until you can perform 10 to 12 with control and proper form.
5. You Have Another Underlying Shoulder Issue
If you're unsure about the root cause of your pain, you may have an underlying shoulder issue like rotator cuff tendinitis (inflammation of one of the tendons in the shoulder joint) or shoulder bursitis (inflammation of the fluid that lubricates the rotator cuff tendons).
Also of importance, Dircksen says, is that just because someone has an underlying shoulder issue doesn't mean that they will have pain with a push-up. If there is no pain, then go for it — he says.
Seek out an opinion of a professional, like a physical therapist. Check out the American Physical Therapy Association to find a physical therapist near you.
"Even one session can confidently get you on the right track," Dircksen says. "This person spends every day regressing and progressing exercises to find the right movement for the individual and can refer out to specialists if any red flags pop up."