Other/Mixed Painful push-ups - front delts

[Anna C]

As someone who has had issues with both shoulders at varying times, may I offer a perspective that gets missed a lot.

@Anna C sre you familiar at all with the principles of PRI (postural restoration institute)? You may not have many of the patterns they discuss, but the principles behind shoulder function and how it relates to your rib cage and pelvis are something I almost never hear people bring up. These principles saved my shoulders.

When you do things like Olympic lifting, you spend a LOT more time in systemic extension: shoulders back, an “arch” through the spine, neck in extension, etc. however, for the scapular to function well on the rib cage, to find a stable base, you actually need a degree of flexion. It seems counterintuitive at first, because the fitness world places so much emphasis on “t-spine mobility,” but an emphasis on extension in that manner makes the back of your rib cage “flat.” Your scapular are not flat. See where this is going? I’m short, if your scaps cannot stabilize well against your ribs, the slack is going to manifest in the glenohumeral joint. When I began to apply pri principles and learned to expand my ribs, especially in my back, things started to improve.

Rather than ramble on I’ll post some links and see if that sheds any light on your issue.

The Scapula and Thoracic Spine: A Classic Love Story To Improve Your Overhead Position | Juggernaut Training Systems

If an athlete is to have a strong, pain free overhead position, the shoulder blade and the upper back must have a healthy relationship. Like any beautiful couple, if there is disharmony, then problems will arise. The focus of this article will be working to attain full shoulder elevation with a...

www.jtsstrength.com

How To Achieve Optimal Resting Position of the Scapulas - PRI Trainer

Proper resting position of the scapuals is dependent on the proper position of the ribcage below them.

pritrainer.com

This is fascinating! I'm going to study this for sure.

I love this:

 

[Anna C]

Without seeing your movement or k owing your training history I would recommend:
1. KB armbars
2. KB deltoid and pec smashing
3. Thompson BowTie...pulls the shoulders back and releases the anterior pulling

Thank you @DocMike. The first two I will do for sure! I have something like the BowTie of another brand... and wearing a loaded backpack seems to do a bit of that, too. I'll add that back into some of my walks.

 

[bluejeff]

This is fascinating! I'm going to study this for sure.

I love this:

View attachment 15204

Yes, it’s something that most people seem to never think of.

This are just my personal thoughts, with the info I’ve been exposed to this far:

While I think thoracic mobility is important, and a great deal of folks need some more of it, there’s something I notice a lot of in videos of people overhead pressing. What I see is everyone doing a very inclined chest/bench press. If someone can that without issue, more power to them. I don’t think that’s wrong, HOWEVER, IMO though, they’re not training the shoulder girdle as much as if they keep the ribs strictly DOWN, not allowing that slight arch through the back to occur. The reason I think we don’t see much of that is basically ego. Anyone who has done a z-press will tell you that the weight you can press from that position is drastically lower than you can do standing. That’s because you CANT arch back very much at all; the shoulder girdle had to do allllll the work alongside your core, which fights to pull the ribs down and keep you from tipping back. This is what I think of as TRUE shoulder flexion. When folks really keep their ribs down and don’t allow arching of any kind, most can’t get their arms to that “180°” position. I’ve been there.

Landmine pressing is great to feel this as well. Keep the ribs DOWN and press at an angle where you can. The shoulder blade should rotate around the ribs, staying tight against them. Once you get the hang of this you can also apply the same thing to push-ups.

Edit: I realize that barbell overhead pressing must have some arch so you don’t smash your chin, so much of this applies to dumbbells or KBs or things like HSPU. Also for anything anterior, as we are discussing.

 

[the hansenator]

Is this what you guys have in mind when you say yoga push-ups?

Yes, that’s the one. Down dog by itself is troublesome for me, my shoulder kind of shifts out of position, but when I push up into it like that it’s fine.

 

[Anna C]

Yes, it’s something that most people seem to never think of.

This are just my personal thoughts, with the info I’ve been exposed to this far:

While I think thoracic mobility is important, and a great deal of folks need some more of it, there’s something I notice a lot of in videos of people overhead pressing. What I see is everyone doing a very inclined chest/bench press. If someone can that without issue, more power to them. I don’t think that’s wrong, HOWEVER, IMO though, they’re not training the shoulder girdle as much as if they keep the ribs strictly DOWN, not allowing that slight arch through the back to occur. The reason I think we don’t see much of that is basically ego. Anyone who has done a z-press will tell you that the weight you can press from that position is drastically lower than you can do standing. That’s because you CANT arch back very much at all; the shoulder girdle had to do allllll the work alongside your core, which fights to pull the ribs down and keep you from tipping back. This is what I think of as TRUE shoulder flexion. When folks really keep their ribs down and don’t allow arching of any kind, most can’t get their arms to that “180°” position. I’ve been there.

Landmine pressing is great to feel this as well. Keep the ribs DOWN and press at an angle where you can. The shoulder blade should rotate around the ribs, staying tight against them. Once you get the hang of this you can also apply the same thing to push-ups.

Makes sense. I'm not sure how to apply that in my current context. What I've been doing a lot of overhead is snatches and jerks. Here are some key positions from my biggest lifts at last weekend's meet, would be interested to see if that lends any clues to what you're saying there.

Note, the jerk overhead position is not as far back as it should be. I've been working on that recently.

 

[Steve W.]

Good series! Thank you.

The on the capture below causes a fair amount of discomfort on both arms where I marked with a red arrow. I feel that same discomfort when I raise my arms out to the side. I've had this since early this year. Not sure if it's related to the push-up problem or not. No, wait....
Actually... I just tested push-ups, and I feel that same pain there with push-ups, as much as, or more than, the front delts. Might be onto something there.


View attachment 15203

The verbal instruction in the video is to drive the elbows into the sides. I never have my elbows out away from my body like in that picture, even though he's supposedly to be demonstrating the correct way to do it. When I do these pulls (with both pronated and supinated grips) I make sure to literally drive drive my elbows into my sides and use that contact point as the fulcrum.

 

[Kenny Croxdale]

One SF guy told me once that big pulls play a big role in a big press.

Not really.

 

[Anna C]

The verbal instruction in the video is to drive the elbows into the sides. I never have my elbows out away from my body like in that picture, even though he's supposedly to be demonstrating the correct way to do it. When I do these pulls (with both pronated and supinated grips) I make sure to literally drive drive my elbows into my sides and use that contact point as the fulcrum.

Hmm... yes. If I do that movement without the band, hands in that position, driving the elbows into my sides without moving my hands is fine. But moving my hands outward from that 90 degree position (externally rotating the shoulder) hurts the outside of my arm where I drew the red arrows in the previous post. The farther I go, the more I feel it.

Deltoid insertion seems to be the location that I'm feeling it with this movement:



Definitely could be onto something, because that kind of matches with the pain with deltoid contraction with the push-ups.

I should probably get a proper hand-on diagnosis! I'll made an appointment with my primary care doc and if he can't figure it out I'm sure I'll get a referral to PT.

 

[bluejeff]

Makes sense. I'm not sure how to apply that in my current context. What I've been doing a lot of overhead is snatches and jerks. Here are some key positions from my biggest lifts at last weekend's meet, would be interested to see if that lends any clues to what you're saying there.

Note, the jerk overhead position is not as far back as it should be. I've been working on that recently.

View attachment 15205

The one thing to keep in mind is that (**based on my understanding**) olympic lifting requires you to be somewhat "extended." Other wise you couldn't hit overhead squats or catch the bar in the jerk. Extension isn't problematic on its own, it's just when you're unable to get out of it when you need to, much like any other postural issue. If you don't have issues during O-lifts, and only with things like pushups, to me that a clue that the position(s) you need for the latter maybe aren't where they should be.

$0.02 here is to make sure you practice enough "trunk flexion." You don't neccesarily need to strength-train it, just apply it in warm ups, cool downs, etc. The "camel" portion of cat-camel, for instance (hold it and take deeeeep breaths into your back while pushing into the floor). If you dig around a bit, there are lots of PRI drills you can find. I believe there are a few through those links I posted earlier. PT will hopefully point you in the best direction.

 

[Anna C]

The one thing to keep in mind is that (**based on my understanding**) olympic lifting requires you to be somewhat "extended." Other wise you couldn't hit overhead squats or catch the bar in the jerk. Extension isn't problematic on its own, it's just when you're unable to get out of it when you need to, much like any other postural issue. If you don't have issues during O-lifts, and only with things like pushups, to me that a clue that the position(s) you need for the latter maybe aren't where they should be.

$0.02 here is to make sure you practice enough "trunk flexion." You don't neccesarily need to strength-train it, just apply it in warm ups, cool downs, etc. The "camel" portion of cat-camel, for instance (hold it and take deeeeep breaths into your back while pushing into the floor). If you dig around a bit, there are lots of PRI drills you can find. I believe there are a few through those links I posted earlier. PT will hopefully point you in the best direction.

Yes I definitely think you may be onto something there. I have been guilty of the mindset that we have "too much" thoracic flexion and must always work that to achieve the elusive good/improved thoracic extension. Particularly with Olympic lifts, it's always "chest up" posture even in positions where it is tough to do, like the first pull of a snatch off the floor. After training this for almost 2 years, I have a lot better T-spine extension! But I never really work on flexion, and since I'm not going to the gym for any group fitness classes anymore I don't even get my once a week yoga class where I used to do cat/camel and other variety movements and poses. I also think the movement of my shoulder blades is somewhat limited. Not sure how to measure or assess that, but maybe I can improve it just be doing things that purposely move them around more.

So many good suggestions in this thread! Thank you all very much for your ideas and help. I'll report back in a few weeks on changes or improvements.

 

[Anna C]

An interim progress report... I am glad to report that I am doing pain-free push-ups!

The push-ups I was trying to do a week ago are still just as painful. But two modifications have helped find a way to start doing them again.

The first is changing form to allow elbows out at 45 degrees, rather than straight back and close to the ribcage. I have to credit my weightlifting coach Randy for that fix, since I checked in with him about it after this discussion. Now, is this something specific to weightlifting and weightlifters (Olympic lifting)? I don't know, but I suspect it might be. I've been doing that type of training for two years now, and I'm sure that my shoulder muscles have been effectively remodeled to be different than they were in past years. The muscles around the shoulders are used for EVERYTHING in weightlifting because the bar is always either in the hands or on the shoulders. I found StrongFirst in 2014 I've been doing push-ups with elbows straight back and close to the ribcage ever since. I thought this was the better way. Now, not so sure. Maybe some people (or some shoulders) are actually built for a different movement.

The second is a push-up board. I got a nice push-up board, Shenaboard from Primal6 . I'm not sure why it helps, but it does. So, thanks for that suggestion, @North Coast Miller.

I still need to work back to OAPU for my StrongFirst Elite recert in April 2022, so I'll still work towards the way I was trying to do them, but this at least gets me going to build back some pushing strength.

 

[oab]

The pushup board tends to better position the hands-arms-shoulders and can also result in greater irradiation.

One cue given is to bend the board, another is to rotate the tip of the elbow so it faces in the general direction of the feet. The board also changes the position of the wrist and the balance of contraction in the hands\wrist forearm. Overall greater recruitment and this might be helping. Bending the board and rotating tip of elbows can also result in changing the shoulder position subtly ie toward the rear away from the floor. Just some ideas to think about ie whether you are doing all of this already (due strongfirst training and experience) or if you can access further improvements.

Anyway, good luck with your training.

 

[North Coast Miller]

Hmm... yes. If I do that movement without the band, hands in that position, driving the elbows into my sides without moving my hands is fine. But moving my hands outward from that 90 degree position (externally rotating the shoulder) hurts the outside of my arm where I drew the red arrows in the previous post. The farther I go, the more I feel it.

Deltoid insertion seems to be the location that I'm feeling it with this movement:

That's also right on top of the insertion for the 'lower' pec...

Imma suggest that you just keep going with whatever upper arm angle is most comfortable. The more in your elbows are the more the anterior delt has to do initially, but the more the lats can contribute as well. As the elbows get away from the ribcage the line to the pecs becomes straighter and they can do more, but the lats don't engage as hard (they won't hardly engage at all if you don't go deep).

FWIW when I use my board my upper arm is probably about 30° - my elbow can't get right tight to the ribcage due to my lat muscle hogging the space.

When I first started going heavier with the sandbag loaded pushups I would let my elbows drift out a lot further at the bottom, coming up I would then pull them in as a first step, really firing the lats. With time I intentionally eliminated that initial outward drift and just used a lot of lat to assist with breaking off the board. For me it feels about a 35/65 Lat/Chest ratio, my lats get pretty pumped from these.

One of the things you'll come to appreciate about using a PU board is the clearance for your face - it makes it a lot easier to get low. It also ties the hands together in a way that regular PUs never did for me. Drives home the fact that it is a true closed-chain movement as opposed to benchpress. Lastly, it makes it a lot easier to change how far out over your hands you get, can go from the mechanics of a decline to an incline bench with very small changes in how you set up on the board and not have to fuss with wrist/hand angles very much - have fun with that!

 

[Brett Jones]

Late to the discussion here but was going to suggest looking at pushup form in particular and glad you are doing pain free pushups Anna.

Theoretically there could have been any number of reasons but practically you have to see what is happening.

 

[Rick213]

The first is changing form to allow elbows out at 45 degrees, rather than straight back and close to the ribcage. I have to credit my weightlifting coach Randy for that fix, since I checked in with him about it after this discussion. Now, is this something specific to weightlifting and weightlifters (Olympic lifting)? I don't know, but I suspect it might be.

Yes! I have found something very similar! After years of practicing "tucked elbows" for bench and pushups, I finally played with technique and found letting them "drift" out some alleviated a great deal of stress on my shoulder.

I am glad you found some fixes!

 

[bluejeff]

The first is changing form to allow elbows out at 45 degrees, rather than straight back and close to the ribcage.

when I use my board my upper arm is probably about 30°

Just thinking “out loud” here; perhaps the reason for this is that it is more in line with the scapular plane. I’ve experienced the same sort of effect. In my case, I notice greater serratus involvement which should create greater scapular stability. Elbows in really tight feels like there’s “not enough space for everything to work right” ( don’t know how else to put it). But having them out just a bit feels like my shoulders are wrapping nicely around the ribs as I push.

 

[North Coast Miller]

Just thinking “out loud” here; perhaps the reason for this is that it is more in line with the scapular plane. I’ve experienced the same sort of effect. In my case, I notice greater serratus involvement which should create greater scapular stability. Elbows in really tight feels like there’s “not enough space for everything to work right” ( don’t know how else to put it). But having them out just a bit feels like my shoulders are wrapping nicely around the ribs as I push.

Its a strange dynamic. With PU I pull my elbows in and it feels like everything becomes way more stable. I can't really go any tighter than about 30°, at that point it feels snug. There's no daylight between, and at a full bottom out I can feel tension on my lats ready to go.

As my elbows move away from my body there's a sensation of losing stability. My shoulder joints begin to feel like they're on their own.

However, when I bench press if I try to pull my elbows in that tight it feels less stable. I strongly suspect there is an open/closed chain sort of difference at work here, am not sure what else would explain it.

 

[Period]

Whenever I had shoulder problems (usually from impacts in wrestling), I went on a diet of around-the-worlds with a weight plate (Around the World Exercise) and looked for variety in push-ups, trying to cover all angles. I especially like a little circuit one of my wrestling coaches suggested (it's mainly meant for parterre defense, but it also works for other applications). The original circuit is ten reps of each on the feet, no breaks, but it can of course be scaled (less/more reps, on the knees, hands elevated, feet elevated, extra weight/rubber bands, fewer/more variations, one arm [although I haven't seen that one done for the full circuit as of yet ] etc.).
1. conventional push-ups
2. wide push ups
3. side-to-side pushups
4. diamond push-ups with hands under the head (lowering the nose into the diamond made by the fingers)
5. hindu push-ups
6. reverse hindu push-ups (similar to the recovery of a divebomber)
In addition, use appropriate ointments, warm up very thoroughly and apply heat (if it is a muscle or tendon problem) or cold (if it is a joint problem) frequently.
I should point out that this is by no means medical advice, just an anecdotical description of what has worked for me so far. If you choose to try it, you could either go fairly light on it and do it before your OAPU practice as an extended warm-up (I'd especially recommend the around-the-worlds here), or go somewhat heavier and do it in separate sessions.

 

[Anna C]

Whenever I had shoulder problems (usually from impacts in wrestling), I went on a diet of around-the-worlds with a weight plate (Around the World Exercise) and looked for variety in push-ups, trying to cover all angles. I especially like a little circuit one of my wrestling coaches suggested (it's mainly meant for parterre defense, but it also works for other applications). The original circuit is ten reps of each on the feet, no breaks, but it can of course be scaled (less/more reps, on the knees, hands elevated, feet elevated, extra weight/rubber bands, fewer/more variations, one arm [although I haven't seen that one done for the full circuit as of yet ] etc.).
1. conventional push-ups
2. wide push ups
3. side-to-side pushups
4. diamond push-ups with hands under the head (lowering the nose into the diamond made by the fingers)
5. hindu push-ups
6. reverse hindu push-ups (similar to the recovery of a divebomber)
In addition, use appropriate ointments, warm up very thoroughly and apply heat (if it is a muscle or tendon problem) or cold (if it is a joint problem) frequently.
I should point out that this is by no means medical advice, just an anecdotical description of what has worked for me so far. If you choose to try it, you could either go fairly light on it and do it before your OAPU practice as an extended warm-up (I'd especially recommend the around-the-worlds here), or go somewhat heavier and do it in separate sessions.

Sounds good... However, I am still a ways away from any of that. Currently I can do a set of 5 regular 2-arm full push-ups with the push-up board and elbows out to 45 degrees. I can't believe how hard it is... when 3 years ago I could do a set of 30 in about a minute and a half. Anyway just trying to add to that build some volume for the next month or two.

 

[Period]

Sounds good... However, I am still a ways away from any of that. Currently I can do a set of 5 regular 2-arm full push-ups with the push-up board and elbows out to 45 degrees. I can't believe how hard it is... when 3 years ago I could do a set of 30 in about a minute and a half. Anyway just trying to add to that build some volume for the next month or two.

Well, you have to start somewhere If I were you, I'd definitely build some volume with regular push-ups on the side, since I've never seen someone who was able to do a OAPU who couldn't do at least 20 (rather 30, to be honest) regular PU with two hands. I'd start with the hands elevated and work my way down progressively. The easiest way to achieve a seamless progression is either a sling trainer or one of those adjustable doorway pull-up bars.