Behind-the-Neck Press: Understanding, Risks, and Safer Alternatives

What is the Shoulder Exercise Behind the Head?

The shoulder exercise performed "behind the head" typically refers to the behind-the-neck press, a variation of the overhead press where a barbell or dumbbells are lowered behind the head instead of in front, primarily targeting the deltoids and triceps.

Understanding the Behind-the-Neck Press

The behind-the-neck press is a strength training exercise that involves pressing a weight (most commonly a barbell or, less frequently, dumbbells) from behind the head to an overhead position. It is a compound movement that has been a staple in bodybuilding and strength training for decades, though its popularity has waned due to increasing awareness of potential risks.

Historically, this exercise was believed by some to provide a unique stimulus to the medial head of the deltoid muscle, leading to broader shoulders. It can be performed seated or standing, with the seated variation often preferred for stability, especially when using heavy loads.

Muscles Worked

The behind-the-neck press primarily targets the muscles of the shoulder and arm, with significant contributions from stabilizing muscles:

• Primary Movers:
  • Anterior Deltoid: The front part of the shoulder muscle, responsible for shoulder flexion and internal rotation.
  • Medial Deltoid: The middle part of the shoulder muscle, crucial for shoulder abduction (lifting the arm out to the side).
  • Triceps Brachii: The muscle on the back of the upper arm, responsible for elbow extension.
• Synergists and Stabilizers:
  • Upper Trapezius: Assists in shoulder elevation and upward rotation of the scapula.
  • Serratus Anterior: Crucial for scapular protraction and upward rotation, stabilizing the shoulder blade against the rib cage.
  • Rotator Cuff Muscles (Supraspinatus, Infraspinatus, Teres Minor, Subscapularis): These deep muscles stabilize the glenohumeral (shoulder) joint and control the movement of the humerus. They are under significant stress during this exercise.
  • Core Musculature: Engaged to maintain spinal stability, especially during the standing variation.

How to Perform the Behind-the-Neck Press

Given the inherent risks, proper form is paramount. This exercise should only be attempted by individuals with excellent shoulder mobility and no history of shoulder pain.

• Setup:
  • Bar Position: Place a barbell on a squat rack or power cage at a height that allows you to unrack it from behind your head.
  • Grip: Use a pronated (overhand) grip, wider than shoulder-width. A common guideline is to place your hands so that your forearms are perpendicular to the floor when the bar is at its lowest point.
  • Stance: Sit on a bench with back support or stand with feet shoulder-width apart, engaging your core for stability.
  • Head Position: Maintain a neutral spine and keep your head slightly forward to allow the bar to pass, but avoid excessive neck flexion or extension.
• Execution:
  • Descent: Slowly lower the bar behind your head, aiming for the upper trapezius or just below the ear level, depending on your shoulder mobility. Ensure your elbows track directly under the bar. Do not let the bar drop excessively low if it causes discomfort or forces your elbows far back.
  • Press: Drive the bar upwards, extending your elbows fully without locking them out, until your arms are straight overhead.
  • Control: Maintain control throughout the entire movement, avoiding momentum or jerky motions.
  • Breathing: Inhale during the eccentric (lowering) phase and exhale during the concentric (pressing) phase.

The Controversy: Risks vs. Perceived Benefits

The behind-the-neck press is one of the most debated exercises in strength training due to its biomechanical demands and potential for injury.

Risks and Biomechanical Considerations

The primary concern with the behind-the-neck press stems from the position the shoulder joint is forced into during the lowering phase: extreme shoulder abduction combined with external rotation.

• Shoulder Impingement: This position significantly narrows the subacromial space, the area where the rotator cuff tendons and bursa pass. Repeatedly compressing these structures can lead to inflammation (tendinitis, bursitis) and, over time, rotator cuff tears.
• Rotator Cuff Strain/Tears: The rotator cuff muscles are placed under extreme stress, particularly the supraspinatus, which is susceptible to impingement.
• Glenohumeral Joint Instability: For individuals with pre-existing shoulder laxity or hypermobility, this exercise can increase the risk of shoulder dislocation or subluxation due to the compromised joint position.
• Cervical Spine Stress: If shoulder mobility is insufficient, the body compensates by pushing the head forward or excessively arching the neck, placing undue stress on the cervical spine.
• Poor Posture: The exercise can reinforce an anterior (forward) head posture and rounded shoulders if not performed with strict attention to thoracic extension.

Perceived Benefits

While some proponents claim the behind-the-neck press offers unique benefits, these are often outweighed by the risks for most individuals:

• Targeting Medial Deltoid: Some believe it more effectively isolates the medial deltoid, contributing to shoulder width. However, the front overhead press and lateral raises can achieve this with less risk.
• Strength Development: It is a challenging compound movement that can build significant shoulder and triceps strength, provided it's performed safely and with adequate mobility.

Who Should (and Shouldn't) Perform It?

Who Might Consider It (with Caution):

• Individuals with Exceptional Shoulder Mobility: Only those who can comfortably achieve full external rotation and abduction without pain or compensation.
• Advanced Lifters with Perfect Form: Athletes or bodybuilders who have spent years developing shoulder stability and proprioception, and who understand the nuanced demands of the movement.
• Specific Athletic Training: In some highly specialized contexts, like Olympic weightlifting, variations of the behind-the-neck press (e.g., press from behind the neck) are used as accessory movements to improve overhead stability and strength for the snatch and clean & jerk, but these are often performed with specific technique nuances and by highly conditioned athletes.

Who Should Avoid It:

• Beginners: Lack the foundational strength, stability, and mobility.
• Individuals with Limited Shoulder Mobility: Trying to force this movement will lead to compensation and injury.
• Anyone with a History of Shoulder Pain or Injury: Especially impingement, rotator cuff issues, or instability.
• Individuals with Neck Pain or Poor Posture: The exercise can exacerbate these issues.
• Those without Access to Proper Spotting or Safety Equipment: A missed lift can be extremely dangerous.

Safer and Equally Effective Alternatives

For the vast majority of individuals, safer and equally effective exercises can achieve the same muscular development and strength gains without the elevated risk of injury.

• Overhead Press (Front Press): This is the gold standard for shoulder strength. Performed with the bar in front of the head, it allows for a more natural and safer shoulder position.
• Dumbbell Shoulder Press: Using dumbbells allows for a more natural range of motion and independent arm movement, which can be beneficial for those with slight asymmetries or limited mobility.
• Arnold Press: A dumbbell variation that incorporates rotation, providing a comprehensive deltoid workout.
• Lateral Raises: Excellent for isolating the medial deltoid, contributing to shoulder width, with minimal joint stress when performed correctly.
• Face Pulls and Band Pull-Aparts: Crucial for strengthening the posterior deltoids and rotator cuff muscles, balancing the shoulder joint and promoting overall shoulder health.

Conclusion

While the behind-the-neck press has a place in the history of strength training, its high-risk, potentially low-reward profile makes it unsuitable for most fitness enthusiasts. The extreme demands it places on the shoulder joint significantly increase the risk of impingement, rotator cuff strain, and other injuries.

As an Expert Fitness Educator, I strongly advocate prioritizing joint health and longevity. For developing strong, well-defined shoulders, the front overhead press, dumbbell presses, and targeted isolation exercises like lateral raises offer superior benefits with a significantly lower risk of injury. Always assess your individual mobility, listen to your body, and opt for exercises that support long-term joint health over those that might compromise it.