T Nation

Pain w/ Shoulder Press, Not w/ Handstand Push-Up


Good morning,
I’ve searched for possible reasons/resolutions but haven’t found anything quite relating to my issue.
When I do standing presses, single arm or double, after a few days I start to have pain near the biceps tendon (left side only).
I had been told some time ago it was a weak rhomboid. I did months of ring work and months of Croc rows to try to fix the issue. Recently I began a program with single arm kettlebell presses but the issue resurfaced after a few days.

Now, I can do handstand and various position pushups with out any repercussions but upright overhead work seems to be a no go.

Any ideas/suggestions?



I’m guessing the issue is your ROM. If you do presses with full ROM where the bar or DB comes below your chin (or even the top of your head) then you might experience different symptoms than your handstand push-ups.

Who told you it was a weak rhomboid? That sounds like a pretty in depth diagnosis that would require a pretty good evaluation by a specialist…especially since the rhomboid runs from the spine to the shoulder blade and your pain is in the biceps tendon.

Maybe your pain is biceps tendinitis and occurs when you put your delts at a mechanical disadvantage. Once your elbows break 90 degrees the delts are fighting an uphill battle so you start doing the work with other muscles. The biceps probably help since it can help move the upper arm up.


Yes, I went to a functional movement specialist I located on Kelly Starret’s website. I only went twice though as it was $100 a shot. Way too expensive for long term.
She said i have some scapular winging also due to the weak rhomboid. And like you said, the other muscles are compensating when doing presses. I’ve been trying to focus on packing the shoulder properly but maybe I’m not quite getting it.

I guess I’ll just keep doing what I had been doing, avoiding the overhead work that hurts and trying to build up the back more fully.

Thank you for your reply.


You may have issues with scapular winging but I think your pain is a separate issue (possibly caused by the first issue) and needs to be addressed separately.

Look into band pull aparts, face pulls, and reverse fly’s to help correct your scapular issues. Rows are great but these help to take the larger muscles out of the lift. I do reverse fly’s with different ranges of motion to hit different muscles. I also play with retracting and holding my shoulder blades and allowing them to move with they motion. I can actually feel my middle traps and hopefully rhomboids work with these.

Good luck!


good idea, I’ll work on the bands.

Thanks again


Sorry to hear about your pain.

First, you likely aren’t doing Handstand Push-Ups if standing overhead presses cause you pain. A handstand push-up require an elevated surface (like parallel bars or rings) which allow you to descend to the point where your shoulders reach the level of your hands. What you are likely doing is Headstand push-ups.

Second, you should NOT pack your shoulders when pressing overhead (be it with dumbbells, barbells, kettle bells, or bodyweight). The shoulder joint is actually two joints:

  1. The Glenohumeral joint (where the head of the humerus meets the scapulae/glenoid fossa)

  2. The Scapular/clavicle sternum joint

Together the two joints create movement known as “scapulohumeral rythym.” In other words, the two joints are supposed to work in conjunction to create movement of the upper arm.

During overhead movements the scapula are supposed to undergo a movement called Upward Rotation where the top of the scapulae pull somewhat upwards and inwards towards the spine (similar to Elevation) while the bottom of the scapulae pull away from the spine (similar to Protraction).

Attempting to force the shoulder blades down and back (“pack” them) while pressing overhead interferes with this natural Scapulohumeral rythym and can also put the glenohumeral joint at greater risk for impingement (such as the Biceps tendon).

I would suggest trying some lighter overhead presses while not packing your shoulders and see if that still causes you discomfort. If it does, then you may have some biceps tendinitis and unfortunately the only remedy for that is to rest the tendon(s) and stretch them until they are healed (which could take as much as several months).

If however allowing the shoulder blades to move as they should alleviates the pain, then lucky you, you should be able to continue pressing overhead. I would still strongly suggest stretching the biceps, working on shoulder extension ROM, and shoulder Flexion (overhead) ROM if those are lacking though as your overhead pressing longevity is often going to be directly related to how well you maintain proper muscular balance and mobility within your shoulder joints.

Good luck.


Thanks for the reply. I’ll give it a shot. I was recently working with just a 35 lb kettlebell when the pain resurfaced. I’ll go lighter and try what you mentioned.
Thanks again