Last week, an online consulting client of my mentioned that he was getting some shoulder pain when doing scapular push-ups, so I asked him for a video in order to troubleshoot.  Basically, I wanted to know if it was his form or a fundamental structural issue that was the problem.  Here was the video he sent me:

After seeing this video, it was pretty clear why he was getting shoulder discomfort – especially as the set goes on.  If you watch the video again, you’ll notice that the hips/lower back sag a bit toward the floor, thus exaggerating the natural thoracic (upper back) curve.  This forces the scapulae (shoulder blades) to “ride” up as a compensation for a less flexed humerus.  This riding up corresponds to scapular anterior tilt, which increases impingement on the rotator cuff and long head of the biceps.

With scapular anterior tilt, we’re really using pec minor and not serratus anterior.  And, serratus anterior is really our target here, as this muscle really shuts down almost anytime that shoulder pain is present.  Serratus anterior works with lower and upper trapezius to upwardly rotate the scapula, a movement pattern that must be done correctly to ensure safe overhead activity.

Obviously, fixing technique is the first option with this problem – but you can also get immediate symptomatic relief with this by elevating the feet on a box.  So, either get the feet up a bit, or just focus really hard on getting the hips up and bracing the abs hard.