Push-Ups: Understanding Shoulder Pain, Correcting Form, and Building Strength

Am I doing push-ups wrong if I feel it in my shoulders?

Feeling your shoulders during push-ups is common, as the anterior deltoid is a synergistic muscle, but if they are excessively dominant, painful, or the only muscles you feel, it often indicates suboptimal form, muscle imbalances, or underlying mobility issues that need addressing.

Understanding Push-Up Mechanics: The Primary Movers

To determine if your shoulder sensation is problematic, it's crucial to understand the primary muscles responsible for the push-up movement. The push-up is a fundamental compound exercise that primarily targets the pushing muscles of the upper body.

• Pectoralis Major: The large chest muscle, responsible for horizontal adduction (bringing the arm across the body) and shoulder flexion. This should be the main driver of the movement.
• Triceps Brachii: Located on the back of the upper arm, responsible for elbow extension. It works powerfully to straighten the arms.
• Anterior Deltoid: The front head of the shoulder muscle, which assists the pectoralis major in shoulder flexion and contributes to pushing. While it's a synergist, it should not be the primary muscle experiencing fatigue or pain.
• Stabilizers: Muscles like the serratus anterior (for scapular protraction), rotator cuff muscles (for shoulder stability), and the entire core musculature (for maintaining a rigid body line) play critical supporting roles.

When push-ups are performed correctly, you should primarily feel the effort and fatigue in your chest and triceps, with a secondary contribution from the anterior deltoids.

Why Your Shoulders Might Be Dominating

Excessive shoulder sensation during push-ups often stems from a combination of biomechanical errors and physiological factors:

• Common Form Errors:
  • Elbow Flare: If your elbows point straight out to the sides (forming a "T" shape with your body), it places significant stress on the shoulder joint capsule and over-activates the anterior deltoids and rotator cuff, rather than the chest. Aim for an "arrow" shape (elbows tucked to about 45-60 degrees from your torso).
  • Hands Placed Too High: Positioning your hands too far forward or too wide shifts the emphasis away from the chest and onto the shoulders, particularly the anterior deltoids.
  • Lack of Scapular Control: Failing to properly retract and protract your shoulder blades (scapulae) can lead to shrugging or winging, destabilizing the shoulder joint and forcing other muscles to compensate.
  • Insufficient Core Engagement: A weak or disengaged core can lead to sagging hips or an arched lower back, altering the body's alignment and putting undue strain on the shoulders to stabilize the movement.
  • Neck Hyperextension: Looking too far forward or shrugging your shoulders can create tension and poor alignment that impacts the entire kinetic chain.
• Anatomical Considerations & Muscle Imbalances:
  • Weak Pectorals/Triceps: If your chest and triceps are relatively weak compared to your shoulders, your anterior deltoids will naturally try to compensate and take over the movement.
  • Limited Shoulder Mobility: Tightness in the lats, pectorals, or internal rotators can restrict proper shoulder movement, forcing compensatory patterns that stress the deltoids.
  • Poor Scapular Stability: Weakness in the serratus anterior or lower trapezius can compromise the stability of the shoulder blade, leading to shoulder impingement or discomfort.
  • Rotator Cuff Issues: Pre-existing weakness or injury in the rotator cuff muscles can manifest as shoulder pain during pushing movements.

Identifying "Bad" Shoulder Feeling vs. "Good" Engagement

It's important to differentiate between normal muscle engagement and problematic discomfort.

• Normal Engagement: A sensation of fatigue or a "burn" in the front of your shoulders (anterior deltoids) is acceptable, especially as you approach muscle failure, as they are synergistic movers. This should feel like muscle work, not joint pain.
• Red Flags (Indicating Potential Problems):
  • Sharp, Stabbing Pain: Especially during the movement or at the end range.
  • Joint Pain: Pain localized deep within the shoulder joint, rather than in the muscle belly.
  • Clicking, Popping, or Grinding Sounds: Accompanied by pain.
  • Pain that Lingers: Discomfort that persists long after your workout.
  • Pain in Specific Positions: For example, only when your elbows flare out.
  • Pain Radiation: Pain that travels down your arm or up into your neck.
  • Feeling only your shoulders: If your chest and triceps feel no significant fatigue, your shoulders are likely overcompensating.

Correcting Your Push-Up Form for Optimal Chest Engagement

Refining your technique is the most effective way to shift the emphasis to your chest and triceps.

• Hand Placement:
  • Place your hands slightly wider than shoulder-width apart, with your fingers pointing forward or slightly outward.
  • At the bottom of the push-up, your hands should be roughly in line with the middle of your chest, not up by your shoulders.
• Elbow Angle:
  • As you lower, tuck your elbows back and down, creating an "arrow" shape with your body (approximately 45-60 degrees from your torso). Avoid letting them flare out to the sides.
• Body Alignment (Plank Position):
  • Maintain a straight line from your head to your heels throughout the movement. Engage your glutes and brace your core as if preparing to take a punch. Avoid sagging hips or an arched back.
• Scapular Control:
  • As you descend, allow your shoulder blades to retract (come together) slightly. As you push up, protract them (spread apart), finishing with a strong push through the floor, rounding your upper back slightly at the top to fully engage the serratus anterior.
• Full Range of Motion:
  • Lower your chest until it's just a few inches from the floor (or as deep as your mobility allows without pain). Push all the way up until your arms are fully extended and your shoulder blades are protracted.
• Breathing:
  • Inhale as you lower, exhale forcefully as you push back up.

Progressions and Regressions for Form Mastery: If standard push-ups are too challenging to maintain proper form:

• Incline Push-Ups: Perform push-ups with your hands elevated on a stable surface (bench, box, wall). The higher the elevation, the easier it is.
• Kneeling Push-Ups: Perform push-ups from your knees, maintaining a straight line from your head to your knees. Conversely, if standard push-ups are too easy, you can increase the challenge by elevating your feet or adding external resistance.

Addressing Underlying Issues

Beyond immediate form correction, consider addressing any underlying physical limitations:

• Improve Shoulder Mobility:
  • Thoracic Spine Mobility: Exercises like cat-cow, foam rolling the upper back, and thoracic rotations can improve your ability to extend your upper back, which is crucial for proper shoulder positioning.
  • Shoulder External Rotation Drills: Exercises using a light resistance band (e.g., band pull-aparts, face pulls) can strengthen the external rotators and improve shoulder health.
  • Pec Stretches: Gentle stretches for the pectoralis muscles can improve chest flexibility and allow for better shoulder mechanics.
• Enhance Scapular Stability:
  • Scapular Push-Ups: Perform push-ups where only your shoulder blades move (protraction and retraction) while your elbows remain straight.
  • Y-T-W-L Exercises: Lying prone and performing arm movements that target the lower traps and rhomboids.
• Strengthen Prime Movers:
  • Targeted Chest Training: Incorporate dumbbell presses (flat, incline), cable flyes, and variations of push-ups to build specific strength in your pectorals.
  • Targeted Triceps Training: Exercises like triceps pushdowns, overhead triceps extensions, and close-grip push-ups can directly strengthen your triceps.

When to Seek Professional Guidance

If you consistently experience sharp pain, persistent discomfort, or if pain prevents you from performing push-ups correctly despite trying form corrections and accessory exercises, it's advisable to consult a qualified professional. This could include:

• A Certified Personal Trainer/Strength Coach: For in-depth form analysis and personalized exercise programming.
• A Physical Therapist (Physiotherapist): For assessment of underlying musculoskeletal imbalances, injuries, or mobility restrictions, and a tailored rehabilitation plan.
• A Sports Medicine Physician: For diagnosis of more serious injuries or conditions.

By understanding the mechanics, diligently refining your form, and addressing any underlying physical limitations, you can transform your push-ups from a shoulder-dominant exercise into a powerful chest and triceps builder, minimizing discomfort and maximizing results.