29 Nov The Overhead Press – Is It Bad For The Shoulders?
Is the overhead press bad for the shoulders? That’s a common question and often a very debated one.
Should you avoid this exercise?
And, what are the benefits versus the risk?
I’ll give you my perspective, as both a strength athlete and former PT (physical therapist). I’ll tell you why I love this exercise, but it may not be right for you.
I’ll talk about pressing in the context of using a barbell, which can be viewed as the most demanding on the shoulders.
THE GENESIS OF THIS ARTICLE
When I was doing one of my clinical rotations many years ago as a physical therapy student, I was fortunate to work with an outstanding orthopedic physical therapist named Martin Kelly.
Martin just happened to be one of the top PT’s in the area of shoulder joint dysfunction in the country. You can imagine that working under his mentorship was one of the most valuable learning experiences of my career as a clinician.
He’s one of the smartest guys I ever had the pleasure to work with. He’s the co-author of the great book, Orthopedic Physical Therapy of the Shoulder.
One of major lessons I learned from Martin was about role of rotator cuff and scapular imbalance in shoulder joint dysfunction.
If there is muscle imbalance in the shoulder, it can cause many problems that lead to pain and dysfunction. So, normalizing muscle firing patterns and recruitment is a key to shoulder health.
This is one major reason why I love the kettlebell get-up so much for optimizing the shoulder.
It tends to clean things up, with regards to shoulder strength and imbalance.
Anyway, I recently came across an article reviewing a long list of reasons we should avoid doing the overhead press.
Well, let’s just say I didn’t agree with it and I’ll explain why I feel this way.
I do realize it was simply written with a lack of understanding about the shoulder or the proper technique required for an efficient overhead press. Let’s press on here.
RISKS – SHOULDER IMPINGEMENT
For clarification – the overhead press does not cause shoulder impingement.
Shoulder impingement can certainly be worsened by overhead pressing movements, but in most cases is not caused by pressing overhead.
Shoulder impingement is a common painful shoulder condition in which the subacromial space (area underneath the acromion) can become encroached that leads to pain.
The soft tissue structures (tendons and bursa) can become damaged, irritated, inflamed, or degenerative.
Shoulder impingement can be caused by extrinsic factors (mechanical wear and tear with repetitive motion – with lack of optimal rotator cuff or scapular function) or intrinsic factors (degenerative factors such as aging of the rotator cuff). Muscle imbalances that cause poor motor control or an irregular shaped acromion (hooked acromion) are also causative factors in shoulder impingement. There are other factors, as well.
If any shoulder dysfunction is present (as just mentioned), then overhead pressing is not the wise choice in exercise selection – until the underlying dysfunction and pain symptoms are completely resolved (if they can be).
I have a simple rule about training. It’s not rocket science, but it’s often disregarded.
If it hurts – don’t do it.
Find something else that does NOT cause pain.
We have plenty of exercises to choose from, so choose one that doesn’t cause pain.
Common sense right? But, common sense is not always common practice.
AC JOINT COMPRESSION
The acromioclavicular (AC) joint in the shoulder is the joint between the acromion and the distal end of the clavicle.
The most common injuries to the AC joint are the result of direct trauma injuries (fractures) or separations.
That can lead to long term problems in the joint such as degenerative osteoarthritis, for example.
Motions that can aggravate the AC joint include reaching across the body toward the other arm (horizontal adduction).
If you’ve had a previous AC joint injury and you lift, then you’re at higher risk for problems there.
In a normal, healthy individual that has NOT had any history of AC joint injury, there should not be problems associated with the AC joint, as long as proper lifting technique is used (in this case, with the overhead press).
LOW BACK STRAIN
Low back strain should be mentioned here because of the tendency to lean back with heavier loads during the standing press.
This is just a result of improper technique, to be honest.
A slight backward lean with heavy standing military presses is acceptable and even necessary, but when it becomes excessive – that’s a problem.
In my opinion, low back strain is a weak argument for avoiding the overhead press.
BENEFITS OF THE OVERHEAD PRESS
Just a few days ago I was putting boxes up in the attic.
They were large, heavy boxes and I had to hoist them up overhead to get them up.
Again, I had to lift heavy boxes overhead (yes, this is a functional activity folks).
You know what was going through my mind as I was lifting these irregular shaped boxes overhead?
Having the overhead strength to do this makes it a helluva lot easier.
That’s just one example of functional strength.
FULL BODY STRENGTH, STABILITY, AND MOBILITY
Performing a standing press is not just a shoulder exercise.
This is often a misconception about the exercise.
If you do the press correctly, the glutes, abs, thighs, lats, arms, and much more are firing at a high level.
Just to stand with the bar in the proper set up takes a great amount of stability and strength.
And, when you press overhead, you need full upper body mobility to get the weight up in the lock-out position.
SUPPORTS OTHER LIFTS
Many lifts go overhead.
Kettlebell snatches, jerks, the get up, and the bent press finish overhead. There are others.
For the classic Olympic lifts and many assistance exercises, you must go overhead.
I can’t really imagine not going overhead with exercise training. Our shoulders are designed to have full range of motion – and this means elevating the shoulder above 90 degrees.
The standing press is a foundation for total body strength and integrity when it comes to strength training and performance.
IT’S ONE OF THE MOST POWERFUL EXERCISES YOU’LL EVER DO
Much like the squat or deadlift, there’s an incredible feeling of power when you press heavy weight overhead.
While it’s an exceptional upper body developer, it goes beyond that.
So, why don’t most people do the overhead press?
Well, it’s a hard and demanding exercise.
There are some technical nuances to perform it correctly.
And, honestly, I’m just not sure the majority of people really understand the value of this lift – which is why you typically don’t see most people in commercial gyms performing the standing overhead press.
By contrast, you will see more many people in a seated press machine.
Fundamental lifts for all humans are:
- squat variations
- press variations
Sticking to the fundamentals is what produces the best results. It’s important we remember that.
1-BASELINE SHOULDER HEALTH
You should be asymptomatic with overhead motion, this goes without saying.
This means no pain or provocation of pain symptoms with overhead elevation or shoulder pressing motion.
If you have pain when you elevate your arm or go overhead, then the press is not a good exercise for you right now.
Proper shoulder mobility and stability must also present, as well as thoracic mobility to go overhead.
Baseline shoulder health is essential to press overhead and if you have that, then the next consideration is technique.
While the standing press may seem simple, it’s the little details in the lift that really matter.
This is a lift that needs to be executed with proper technique and that’s a problem for most.
If there’s not full body tension under the bar, the technique will not be optimal.
The use of proper breathing, muscular tension, and a proper set up is critical for pressing success.
There are many nuances to the overhead press, that are beyond the scope of this article.
What’s important to understand, is that like any other key lift or exercise, technical mastery matters a great deal.
Dan John recently revealed the answer to an important question is his book Before We Go.
The question was “if you could only do one exercise, what would it be?”
The answer was the one arm press.
He also defined great lifting as the inclusion of these 3 things:
- Picking up stuff from the ground
- Lifting weights overhead
- Carrying objects for distance – or time
You can see that lifting overhead is one of the 3 essential elements in successful training.
I can’t think of any respectable training book or program that doesn’t include some variation of pressing, can you?
It’s fundamental, but there are considerations.
For me, I’ve been doing heavy overhead pressing for over 30 years now with no shoulder issues to this point.
I confess to spending substantial time on shoulder optimization exercises like the get-up, for example. I believe this greatly helps in keeping my shoulders healthy and strong.
The quick summary points in this article are these 2 things.
1-DON’T DO IT IF IT HURTS.
2-LEARN TO LIFT THE BAR (OR BELL) OVERHEAD CORRECTLY.
Is the standing overhead press bad for the shoulders?
The overhead press is an outstanding exercise, providing you have good shoulder health and you have to perform it the right way. You need requisite mobility and stability.
Another article I found discussed that you have to “earn the right” to overhead press.
Like any exercise you perform, know why you do it.
If you can’t answer – why I am doing the shoulder press – then it’s probably not a good exercise for you right now.
Hopefully, I’ve given you some reasons to consider.
*NOTE: If there is an “optimal” overhead press for the health of the shoulder, the kettlebell press would be it. Why? It’s a natural groove of motion to press from. That means we tend to press the kettlebell in a more natural plane of motion for the shoulder joint (the scapular plane).
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JamesPosted at 18:00h, 15 February
“I recently came across an article reviewing a long list of reasons we should avoid doing the overhead press.
It was pure nonsense.”
Usually, it helps to cite a source when attacking an idea. Functional movement is all about moving in ways that our bodies evolved to. When in our evolutionary past did we perform heavy overhead lifting, especially at volume? Look at our closest living relative. They hang and rotate at the shoulder, they throw things, they pull things, but how often do they lift heavy things overhead? Very rarely. Humans became bipedal and ventured out as hunter-gatherers. We fashioned throwing objects to hunt and fight and in the process, we lost our external tails and grip strength and gained much more endurance in the lower body. At what point was overhead lifting a routine part? Throwing supplies over the shoulder-sure, the occasional lift overhead with weight could probably be seen in the slave lines building the pyramids-perhaps. But have our bodies evolved for it? The answer is no. You may be genetically gifted, but the vast majority of people who routinely do overhead lifts, even with proper form, mobility, and stability, eventually have injuries. Eventually, the smart ones learn to train more in accordance with the natural movement patterns of our ancestors.
ScottPosted at 20:24h, 18 February
I strongly disagree with this, but I really don’t want to go back and forth debating this point either. If you don’t think a press is beneficial for shoulder health – then don’t press and don’t teach it.
Every individual is different and I wouldn’t teach a press for someone who shouldn’t press overhead or wouldn’t benefit from it.
The press – and other overhead movements (turkish get up, for example, which would replicate “natural movement patterns” as you mention) – are extremely valuable for the shoulder, especially healthy ones – in my experience. I don’t press for the hell of it and I wouldn’t teach it just for the hell of it. There’s always a reason why. There are many good reasons to perform a press, but “it depends.” It always depends on a LOT of things.
(I didn’t list the article because I didn’t want to “bash” that particular article, didn’t think that would be too cool, you know?)
Appreciate your opinion.
PatrickPosted at 15:11h, 12 September
This is consistent with much of what I read on the OHP. It actually promotes shoulder health…. IF everything is in working order, basically all the time, and IF your technique is pretty gold on most every rep.
Because most of us sit a lot of the time (or have for years) our shoulders a touch hunched and because many of us have at least slightly less than ideal shoulder health, I think it’s a pretty high risk exercise for MOST people. Just seems pretty difficult to negate all of those risks *all the time* to keep optimal shoulder health and mechanics.
As a 33 year old amateur without the money for a coach, I’ve chosen to just stick with bench press variations (mainly lower risk ones like floor press, narrow grip, and DB variations) and push up variations and hit lat raise variations for the side delta. I realize the bench press isn’t good for the shoulders but it seems like those risks could be mitigated with intelligent programming, choosing shoulder-friendly options, and hitting upper back hard. I don’t feel confident I could mitigate OHP risks.
But maybe I’m wrong.
Appreciate the article either way.
ScottPosted at 10:21h, 18 September
Excellent feedback here, thank you. One thing I’ll share in regards to the bench press is that I think this can be a really bad option for many people, *if “shoulder-saving” technique isn’t used there. What I mean is that I never really learned the important technical nuances with bench pressing until many years later into lifting. Surprisingly, my shoulders are fine, but I can see how standard bench press techniques can cause real shoulder issues.
Also, overhead pressing is individualistic – as is any exercise. The 2 big questions – why? why not?
Good stuff Patrick and I value your feedback.
PatrickPosted at 06:22h, 19 October
I just circled back to this and was surprised (and excited!) to see you replied!
Your last question about “why” or “why not” is important and maybe through how I answer it you can help me decide if I should do it.
My goa is to build and keep muscle while staying healthy and avoiding injury. I realize weightlifting has inherent risks but I’m trying to be as smart as I can. I’ve put on 20 pounds of muscle in two years without any shoulder pressing and feel my shoulders look okay.
The only reason I still sometimes want to OHP is from reading articles that say how good it is for the shoulder, how it incorporates a lot of the rotator cuff muscles and strengthens all those. I’m tempted to start doing standing (or seated but without back support) dumbbell presses with a neutral grip to increase shoulder heath. When I do them they don’t hurt, but Since I work out alone I’m never confident that I’m keeping the back straight enough on every rep, locking out with the shrug up top properly on every rep, going straight over top instead of having my arms drift forward every rep, and if I have good functional scapular mechanics on every rep. So as I do it I’m kind of fearful I’m not doing it right and will end up irritating my shoulders over time.
Without OhP, I had just been trying to do at least one set of push up variation for each set of bench press to work the serratus and keep scapular movement. Then try to keep the 2:1 pull:push ratio. Do a bunch of band pull aparts on days off. And stick to shoulder friendly bench variations.
Think it’s worth doing the Db OhP despite the risks for the purpose of improving shoulder health?
Gabe ReyesPosted at 13:42h, 31 December
I am doing PT right now for a shoulder tendon issue (I believe the supraspinatus), with some impingement, and I am at the point where I’m mostly pain free and transitioning back into more strength training and not just the PT exercises. My PT is saying I shouldn’t do too many overhead movements, and I appreciate that it might not be wise to do lots of overhead pressing shortly after recovering (don’t want to re-injure it!), but I get the sense that he thinks I should not do much overhead movements at all. Prior to the injury I was doing overhead pressing once a week, but I think what caused the injury was holding a kind of heavy antennae overhead for wildlife tracking for work, several hours a days, several days a week for 2 months! I will need to do this again, and I hope to strengthen myself so I don’t reinjure it next field season (will also try to use better technique, etc…)
I guess my question is, if overhead pressing wasn’t the original cause of the injury, and I have a job requirement that requires holding something overhead quite a lot (and it’s a part of my job that I love! Not something I want to get out of with a doctors note or whatever), would it make sense to just gradually ease into these overhead movements? I was thinking get ups paired with pull ups for a while, to strengthen the shoulder and back in that range of motion. I started doing yoga and downward dog feels really good on it as well. Still continuing with my PT exercises! I know you’re not my PT, so in a more general sense, is there just an overall fear of overhead pressing movements of any sort in the PT world? I did years of get ups, kb presses, snatches, etc, and feel like they made me stronger in that range of motion, and only recently had this shoulder issue so it seems weird to just think that overhead movements are out for me for the rest of my life! I’m also generally injury prone (tendonitis, IT band syndrome, etc…)
Liked this article and it makes sense to me! But curious what you’d recommend for the people who maybe shouldn’t be overhead pressing right now…