As common and low-risk as the conventional push-up is known to be, there are still several instances where an exerciser may complain of pain or instability due to an error they are likely making in their form.
One example of such symptoms is shoulder pain that is experienced during or after performing a set of push-ups. If this is happening to you, it is best to immediately stop performing the exercise until you are certain as to its cause, as well as how to go about curing it.
Shoulder pain after push-ups is most often caused by poor form during the execution of the exercise, especially regarding shoulder rotation and excessive flaring of the elbows.
Both of these errors - alongside several others - can lead to sharp and near-immediate pain radiating from the internal tissues of the shoulder itself, indicating that the exerciser has performed the movement incorrectly.
The push-up is a bodyweight compound movement accessible to all types of individuals of any training level, age or gender. The push-up is frequently included into novice-level or athlete-focused training programs due to its relatively low level of impact in comparison to the sheer amount of volume that is made possible through it.
Push-ups are capable of targeting the pectoral muscle group, the deltoids, the triceps brachii and abdominal muscles due to its plank-like position and relatively large range of motion that makes use of elbow flexion and extension.
In practice, the push-up is quite safe and effective at its role as a novice-level resistance exercise, or as a more advanced muscular endurance training tool.
To perform a repetition of the push-up, the exerciser will enter a plank position on the ground with their hands set slightly wider than shoulder-width apart on either side. The core and gluteal muscles should remain tightly contracted and the feet should be placed as close together as possible for greater abdominal muscle tension.
Then, bending at the elbows, the exerciser will lower their chest to the floor in a slow and controlled manner, all the while keeping their elbows close to the sides of their torso rather than flaring them outwards.
The eccentric phase of the repetition ends once the chest has come within a hands-breadth of the ground. Once this point has been reached, the exerciser can then push through their hands, returning their arms to a state of full extension and thereby completing the repetition.
Pain rarely occurs for no reason - especially in the case of light weight exercises like the push-up, where any sort of discomfort may be indicative of mistakes being made during the exercise itself.
Fortunately, the majority of these mistakes are easily correctable and can often be done mid-repetition if the exerciser realizes they’re making them - so long as no injuries have been incurred. In the latter case, it is best to cease performing the exercise until a full recovery has been achieved.
The most common cause of shoulder pain experienced during or after a set of push-ups has to do with the angle of the elbows in relation to the torso.
Excessive flaring (such as if the body were to form the letter “T”) can cause the shoulders to rotate improperly or at a disadvantageous angle, straining the rotator cuff, deltoid muscles and any other soft tissues present within the joint.
To correct this, the exerciser should strive to keep their elbows pointing in a horizontally parallel direction as the torso, aiming for a more tucked position without causing elbow impingement or turning the exercise into a close-grip push-up.
Whether by mistake or not, rotating the shoulders internally - such as towards the midline of the body - can directly lead to rotator cuff irritation and poor deltoid muscle recruitment, further causing pain and discomfort due to the high volume of a regular push-up set.
Generally, any sort of excessive internal rotation during resistance training is a poor idea - and generally a sign of back muscle or posterior deltoid head muscular weakness.
In order to avoid this from occurring, the push-up form may be modified by drawing the shoulderblades closer together, thereby forcing the shoulders to remain at a more neutral rotation throughout the repetition.
In addition to this alteration in form, exercisers suffering from shoulders that internally rotate during the push-up should take the time to perform additional shoulder mobility work of the dynamic nature, as well as perform dumbbell rows or similar upper-back targeting exercises.
On the same end as internally rotating shoulders is an error in form of the distal nature; the exerciser placing their hands too low in relation to the shoulders, resulting in the aforementioned internally rotating shoulders alongside other issues like greatly reduced training volume and more stress being placed on the elbow joint.
While this is indeed a legitimate factor used by advanced calisthenic athletes to increase the triceps brachii recruitment of the push-up, it is not suitable for individuals whose wrists and shoulders have yet to adapt to the stress therein.
As such, it is best to perform the exercise with the hands either vertically parallel with the shoulders, or slightly wider with the elbows somewhat tucked inwards, depending on your body proportions and wrist mobility.
The opposite issue to the hands being placed too low, exercisers performing the push-up with the hands too high or too far forward can cause just as much stress to be placed on the shoulder joint and internal rotator cuff.
This can lead to tissue inflammation and other physiological causes of pain in the shoulder, as well as greatly reduce the effectiveness of the push-up in terms of triceps brachii training stimulus.
To correct this problem, the exerciser should strive to maintain a hand position that is vertically parallel with the shoulders, or one that is somewhat wider while remaining within a straight line to the deltoids so as to reduce excessive rotation in either direction.
One particularly severe mistake made by novice exercisers is performing bilateral movements unevenly, meaning that one side of the body will move at a different time to the other. This will not only lead to greater stress being placed on the joints of the initially-moving side, but also fewer repetitions as the muscles of the body fatigue at a more rapid pace.
While a muscular imbalance or neurological issue may be to blame for this particular mistake, in most cases, it is simply a matter of poor exercise habits, and is otherwise entirely correctable through careful practice.
In the case of push-ups, this equates to the exerciser simply performing slow and careful repetitions while focusing on moving both sides of their body at once.
So long as no actual injuries of the shoulder have been sustained, the exerciser should see a marked decrease in any symptoms of pain therein.
Though more of a general blanket cause rather than anything specific, performing insufficient or no mobility work prior to performing a set of push-ups can lead to pain, reduced range of motion and instability throughout each repetition.
Even for individuals with minor symptoms, it is vitally important to ensure that your body is sufficiently flexible enough to perform the exercises of your workout program. To do so, perform dynamic mobility movements targeting not only the shoulders but all parts of the body.
In particular, shoulder extensions and internal/external rotation stretches are quite important for avoiding shoulder pain during or after a set of push-ups.
As the muscles and connective tissues of the shoulders are among the main sources of force within the movement of a push-up, it should be no surprise that failing to alot sufficient time for recovery will lead to discomfort in such tissues.
Depending on the exerciser’s experience level and the relative intensity of their workouts, taking one to two days off between workouts should be sufficient recovery time to avoid overtraining or any related symptoms therein.
Further recovery methods like perfecting one’s diet, performing off-day release and stretching work as well as ensuring enough time is spent sleeping will all aid in avoiding shoulder pain or other symptoms of overtraining.
Though a muscular imbalance can occur for exercisers of all experience levels, they are most often seen in novice or beginners where errors in their training programming or factors in their day to day activities can cause one side of the body to develop greater muscle mass than the other.
This can lead to a host of different symptoms, with pain being one of the most immediately noticeable - especially in regards to the shoulder joint.
Muscular imbalances will often lead to issues in push-up form, or otherwise to one side of the body reaching a state of fatigue far faster than the other. They can occur for a variety of reasons, and are difficult to correct without a training plan specifically structured to combat whatever sort of imbalance is present.
The severity and location of muscular imbalances will vary widely, and as such it is best to avoid treating any but the most minor of cases yourself. Instead, seek out the advice of a professional who may aid you in rehabilitating the imbalance.
In the event that the pain you are experiencing is accompanied by other worrying symptoms like numbness, tingling, a “grinding” sensation or discoloration of the affected area, it may be time to seek out the advice of a medical professional.
While the majority of cases of shoulder pain are not a cause for concern, there is always a small risk of soft tissue damage having occurred - requiring physical rehabilitation in order to rectify and ensure that the full range of motion of the rotator cuff is retained.
In the interval before your doctor's appointment, it is a good idea to cease any sort of strenuous exercise or movement involving the injured shoulder, as well as to take steps to reduce swelling and inflammation, such as utilizing compression and ice.
Yes - it is entirely possible to damage the soft tissues of the shoulders with push-ups alone.
While the majority of sufferers will not be permanently affected or experience excessive discomfort, there are indeed cases where the attention of a physician or physical therapist will be needed in order to retain the original health of the shoulder.
Fortunately, rehabilitating an injured shoulder is quite easy - so long as no permanent or surgery-requiring injuries have been incurred, it is likely that simple physical rehabilitation and rest should be sufficient enough to cause a cessation of all symptoms.
Injuries of the rotator cuff - whether from push-ups or otherwise - should be a cause for concern.
While it is likely that your injured or irritated rotator cuff will recover by itself, seeking out the advice of a medical professional is the best course of action, as certain types of injuries may degenerate further without the right kind of treatment being administered.
If you suspect that your rotator cuff or other nearby structures have sustained damage, cease any sort of strenuous activity and contact a physician.
Yes - the deltoid muscles that make up the shoulders are indeed recruited to great effect by the push-up exercise, though not to the same extent as the pectoral and triceps muscles.
It is entirely normal for the shoulders to become fatigued or sore while performing a set of push-ups, but any sharp pain or unusual sensation may be a sign that you are overdoing it, and that it is best to cease performing the exercise until you have ascertained that no injury has occurred.
Checked your form, gave it some healing time yet still feeling shoulder pain after a set of push-ups? It may be time for professional help.
Whether or not you suspect it is a matter of form or something more serious, eliminating the chance of injury by consulting with a doctor is the best course of action.
Once you’ve ascertained that your shoulders are indeed physically healthy, it is a good idea to have an experienced friend or professional coach assess your push-up form, or to otherwise seek out an alternative exercise that is more compatible with your physiology.
1. Kowalski KL, Connelly DM, Jakobi JM, Sadi J. Shoulder electromyography activity during push-up variations: a scoping review. Shoulder & Elbow. 2022;14(3):325-339. doi:10.1177/17585732211019373
2. Kinsella R, Pizzari T. Electromyographic activity of the shoulder muscles during rehabilitation exercises in subjects with and without subacromial pain syndrome: a systematic review. Shoulder & Elbow. 2017;9(2):112-126. doi:10.1177/1758573216660038