Pain with Horizontal or Vertical Pushing?

Written on July 14, 2009 at 6:25 am, by Eric Cressey

Last week, I published a post on shoulder issues with overhead pressing, and got two good comments as replies:

1. In HS I separated my AC joint during the first game of junior year. I played the rest of the year with out letting it heal, and to this day I have still have shoulder issues (college ball didn’t help the issue much either). It seems my shoulder allows me to overhead press/push press/jerk and incline press, but flat bench is out of the question unless I’m using DBs. Is this typical of this type of shoulder injury, or am I an outlier and most individuals show the same symptoms as yourself? Granted we each have different injuries but same local area.

2. I have pain doing flat bench presses with barbell and upright rows. Decline barbell press is also sometimes uncomfortable, but incline press and overhead press is working fine.

This is actually pretty typical of acromioclavicular (AC) joint problems.  Folks will have problems with exercises like full-ROM bench presses and dips, as they force full humeral extension. Decline bench pressing requires less humeral extension on the eccentric than regular bench pressing and dips, so that would explain the decrease in symptoms.

That said, overhead pressing will usually be okay because it doesn’t require so much humeral extension (nothing past neutral).  However, some folks will have other related problems (e.g., rotator cuff injury during the AC injury), so both horizontal and vertical pushing movements may become problems.

So, obviously, not all shoulder problems are created equal.  However, a lot of the time, they can be treated with similar means: good scapular stabilization movements, a focus on thoracic spine mobility, and dedication to strengthening the rotator cuff and improving soft tissue quality.

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3 Responses to “Pain with Horizontal or Vertical Pushing?”

1. Cassandra (Cass) Says:
   July 14th, 2009 at 6:39 am

   Thank you for posting this EC, I was wondering the same thing as I have the same symptoms as these guys. Does this mean we should avoid horizontal pushing just like you avoid OH pressing?

2. Eric Cressey Says:
   July 14th, 2009 at 6:41 am

   Cass – Not necessarily. You probably just have the most pain with full extension of the humerus, so push-ups (particularly b/c they are closed-chain), board presses, and floor presses may very well be okay.

3. Cassandra (Cass) Says:
   July 14th, 2009 at 9:22 am

   That seems to be exactly my issue. So much for my goal of a 150 lb bench press. I’ve got some work to do. Pushups are great though. Thank you Eric!