How to Train Around Shoulder Pain
Shortly after graduating with my degree in Exercise Science, I found myself shadowing and assisting Physical Therapists at a local sports medicine clinic. One of my favorite conversations I often heard the PT’s having always went like this: The patient would complain about a movement that caused pain and the PT’s response was always something along the lines of “well stop doing that if it hurts.” They would usually say it with a light-hearted laugh and then provide a better alternative.
As simple a fix as that sounds, that’s really all it takes! This rule carries over to the weight room as well. Find alternatives to the exercises that hurt and continue to work on other aspects of your physical fitness. The tricky part is finding those alternative exercises that don’t cause any pain, but that’s why you pay your health & fitness professionals the bug bucks. Obviously before you resume any type of exercise routine, I always recommend having a medical professional evaluate your pain. Let’s say you’ve already done that, you’re clear to lift, and you’re ready to get back in the gym. Here’s how to get started:
Skip the whole palms down/up routine and shoot for a neutral (thumbs up) grip; you’ll be surprised at how much better your shoulder feels. The neutral grip externally rotates your arm just enough so that it can clear some of the structures in your shoulder. Which leads us to the next lifting modification.
Try to limit how often you lift overhead (OH). Lifting overhead is not bad for you, you’re just most likely not ready for it. Try shoulder raises with a neutral grip as an alternative until you have built up your shoulder’s capacity to perform OH lifts with proper form. Shoulder Raises are harder anyway and they’re better at isolating your deltoids/rotator cuff.
You most likely need to add some exercises to optimize your shoulder’s movement capacity. So, while you’re using all those neutral grip exercise variations and limiting how often you lift overhead, you should be simultaneously working on shoulder stability along with some thoracic spine mobility.
For shoulder stability, that means quite a handful of exercises. Remember, shoulders have lots of muscles and parts involved. You’re going to need to strengthen your rotator cuff, your mid and

upper back muscles, shoulder muscles (deltoids), and serratus if you would like to return to OH lifting. Put extra focus on performing closed kinetic chain exercises like pushups, inverted rows, planks, etc. These exercises are considered more functional and help to stabilize the shoulder.

Your shoulder blade must be able to glide across your ribcage as you perform movements in the gym. If your thoracic spine (t-spine) is not mobile enough to facilitate these movements, you may run into problems. Make sure to add t-spine extension and rotation movements to your daily warm-up AND workouts.
Sometimes your muscles/tendons are beat up from daily use and the best fix is to simply modify the daily/weekly training load for a couple of weeks. Try simply cutting your training volume in half to facilitate recovery. For example, bench pressing an average of 185 for 5 sets of 10 (9250 lbs. total) can be reduced to 170 for 2 sets of 15 (5100 lbs. total). Not only have you decreased the total training volume, but you’ve also decreased the intensity by dropping 15 lbs.; giving your muscles and tendons a chance to repair and recover. Slowly work your way back up to an optimal training volume/frequency over the next few weeks.
Coach Shain