T Nation

Why Is Overhead Pressing Potentially Dangerous?

First off, let me clarify that I know that any exercise done incorrectly is dangerous, and there is always a level of risk associated with any sort of lifting, well it’s risky just walking down the street but i digress.

I’ve noticed that it seems to be common knowledge that if you want to keep your shoulders healthy and relatively pain-free for as long as possible, you overhead press with retracted scapula and only take the DBs as low as your upper arms being parallel to the floor. In fact, this is the style I have recently adopted. My question is: Why does, physiologically speaking, overhead pressing, especially when consistently taken below this point, usually wind up giving people shoulder problems?

I’m thinking it has something to do with the bicep tendon and it’s connection with the shoulder capsule…but I’m merely posturing here, I don’t know enough about anatomy, yet, to really understand. And I’m thinking there’s people on this board that do understand.

I think it has more to do with the anterior portion of the shoulder capsule being stretched and/or impingement.

Going much past arms-parallel will put a lot of strain on the AC joint, much like a dip will. Other than that, the guys that you see doing them behind their head are just asking for a rotator cuff injury.

[quote]ucallthatbass wrote:
I think it has more to do with the anterior portion of the shoulder capsule being stretched and/or impingement.[/quote]

An impingement is due to a weakening of the rotator cuff muscles, and is most noticable with repeated overhead movements like playing tennis or swimming without addressing the muscles of the rotator cuff.

Hmmm, I put a lot of emphasis on keeping my scapula and my rear delts strong, I’m pretty sure that is a plus.

Retracting the scapula isn’t the name of the game so much as depression…

But yes, the answer to the question is as stated - usually impingement.

The shoulder and the hip are both similar joints in structure, however the hip needs to be very strong and because of this it loses a lot of mobility.
The shoulder on the other hand is the opposite, it is designed to be mobile but due to that it loses a lot of strength/integrity.

There is that, plus the structure of the rotator cuff in relation to the deltoid and the sub-acromial space… they (the muscles of the rotator cuff) are NOT trained as much as the deltoid is in standard weight training regimes, and as such the deltoid then ‘takes over’ much of the work in shoulder support from the ‘cuff’.

This is not the purpose of the deltoid and as it is such a powerful muscle (in comparison) it can pull the head of the humerus into the Glenoid Fossa (shoulder joint).
This leads to impingement in most cases.

Impingement is when a soft tissue becomes trapped between structural (or hard!) tissue… the sub-acromial bursa, supraspinatus, infraspinatus and subscapularis are the 4 soft tissues liable for shoulder impingement (the teres minor does not pass throuight the sub-acromial space).
The space in the shoulder joint is the smallest with the shoulder flexed or abducted… and if the humerus has been pulled up into the joint due to the deltoid becoming disproportionately strong, this will lead to impingement when the arm is lifted in this manner.

Also inflammation can increase the size of certain cuff muscles leading to impingement - often due to repetitive use, say weightlifters, swimmers, etc. The sub-acromial bursa is the most common for this type of injury i believe.

Focusing on the external ‘show’ muscles with little understanding of the more structural tissues will eventually lead (in most cases) to injury (‘i keep my rear delts strong’).

It is ALWAYS wise in programs where you do a lot of pressing (and generally in programs based on muscle strength and/or size and physique training) to:

  1. Do lateral and medial rotation work to train the rotator cuff directly.
  2. To do as much pulling (vert. and horiz.) as you do pressing (vert. and horiz.).

how would you strengthen the cuff to prevent injury?

these don’t seem like they’d do much http://www.aafp.org/afp/980215ap/980215a.html

The supraspinatus (external rotator) has to fit through a hole in the scapula. If you train it for hypertrophy, it won’t fit anymore. That’s the way I understand impingement, anyhow.

A few things determine your risk factor. Size/shape of the acromion process of the scapula, size of the supraspinatus itself, shoulder flexibility, and exercise form. If you lift in a way that forces the supraspinatus to bear weight during the movement (elbows behind the bar) you’re increasing your risk (and probably selling yourself short on the lift).

That being said, try to hold your hands behind your head as if doing a behind-the-neck press. Unless you have freaky shoulder flexibility, your elbows are going to drift behind your hands. Same with upright rows.

A lot of people can get away with it, others end up in pain.

wo, upper arms parallel to the floor? I always go lower than that

I just tried to see what the ROM is like only going that far down, and its barely even a shoulder exercise anymore is it?

Impingement is largely a result of dysfunction. The shoulder is a very mobile, and very complex joint, though it is the muscles that attach to the scapula that are the most important. Lower trapezius and serratus weakness or inhibition is one of the biggest issues that lead up to impingement because there is nothing pulling down on the scapula. Infraspinatus adhesions and weakness can also cause problems, though these are somewhat further removed from impingement syndrome.

In fact, alot of issues related to shoulder pressing (not necessarily impingement) can be directly linked to poor infraspinatus function. Simply put, if you cant internally rotate your humerus well, this problem is compounded the further down you travel when doing an exercise such a dumbell shoulder press. If you have excellent mechanics, solid tissue function, there is a very good chance you wont have issues going lower on this exercise.

Do the DC towel stretches.

I’ve had a lifetime of shoulder problems, but it wasn’t until I started doing the DC towel work that my shoulders have improved dramatically.

EDIT: Here’s a vid. But I prefer a rolled up towel over the broomstick. Also, the kid goes too fast. I move slowly and hold for a moment in the most stretched position.

[quote]Iron Dwarf wrote:
Do the DC towel stretches.

I’ve had a lifetime of shoulder problems, but it wasn’t until I started doing the DC towel work that my shoulders have improved dramatically.

EDIT: Here’s a vid. But I prefer a rolled up towel over the broomstick. Also, the kid goes too fast. I move slowly and hold for a moment in the most stretched position.

Yeah I do these fairly regularly, usually after pressing days my shoulders will feel little tight so i’ll bust these out for a while.

How bad is overhead press for shoulder impingement when compared to upright rows or dips? I know most view upright rows as the devil.

[quote]WestCoast7 wrote:
How bad is overhead press for shoulder impingement when compared to upright rows or dips? I know most view upright rows as the devil.[/quote]

It is because you have medially rotated the humerus that it is so much worse.

Without checking IIRC this will pull the supraspinatus around the head of the humerus and then as you raise (abduct) the arm it is much more likely to trap the muscle.

I think it is that… but it may be something else… :wink:

[quote]J-J wrote:
WestCoast7 wrote:
How bad is overhead press for shoulder impingement when compared to upright rows or dips? I know most view upright rows as the devil.

It is because you have medially rotated the humerus that it is so much worse.

Without checking IIRC this will pull the supraspinatus around the head of the humerus and then as you raise (abduct) the arm it is much more likely to trap the muscle.

I think it is that… but it may be something else… ;)[/quote]

I’ve had both shoulders surgically repaired due to impingement. Mil. press never bothered me, however dips, bench, uprt rows, even pull ups killed me. I do believe I created most of my damage due to work. Running printing presses with the work that is involved tore both of mine up.

Since the surgeries I’ve not a stitch of a problem. I will say it has weakened my bench a bit.

Looks like that guy is dislocating his shoulders in that stretch.

[quote]print wrote:
J-J wrote:
WestCoast7 wrote:
How bad is overhead press for shoulder impingement when compared to upright rows or dips? I know most view upright rows as the devil.

It is because you have medially rotated the humerus that it is so much worse.

Without checking IIRC this will pull the supraspinatus around the head of the humerus and then as you raise (abduct) the arm it is much more likely to trap the muscle.

I think it is that… but it may be something else… :wink:

I’ve had both shoulders surgically repaired due to impingement. Mil. press never bothered me, however dips, bench, uprt rows, even pull ups killed me. I do believe I created most of my damage due to work. Running printing presses with the work that is involved tore both of mine up.

Since the surgeries I’ve not a stitch of a problem. I will say it has weakened my bench a bit.[/quote]

I already cut upright rows from my splits (as much as I loved 'em), if I was being overly cautious do you think it would be wise to cut dips as well? What other exercises should be avoided in an attempt to prevent shoulder impingement?

never had a problem with standing OHP (only one of two people who does them in my gym). dips used to give my shoulders problems untill i started doing dislocations and other stretching and mobility stuff, now theyre my best pressing movement.