Why pull ups feel ok on your shoulder but overhead pressing doesn’t

Posted on September 19, 2016

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From an email,

“Firstly, thanks for making such thorough content. Keep it up! (Including the cursing)

To the Point:

In a person with irritable shoulders (aggravated with some versions of overhead pressing), why are lat pulls and assisted pull-ups typically pain free?

Details and Thoughts you can skip if you want:

As a trainer, I’ve noticed that it’s really common for people to have some kind of shoulder pain during some versions of overhead press motions. However, these same people can do lat pulls and assisted pull-ups of all varieties without any issue. So obviously it’s not the position alone that’s the problem, but rather it’s something about the forces being applied when in that position that are causing issues.  I’m not sure of much past that though. I have some thoughts (listed below), but no definitive answer. My “solution” right now is to just avoid the painful versions of presses. I also wonder if it’s something about my programming or cues that is causing this to be such a regular issue. But mainly I’m just curious as to why assisted pull-ups commonly don’t hurt someone who has pain during some versions overhead presses.

Guesses

-Overhead press encourages superior glide of the humeral head while assisted pull-ups don’t?

-Scapula not upwardly rotating appropriately during overhead presses, but it naturally does during assisted pull-ups?

Thanks for all you do!”

An interesting thing to do with your clients is stretch them passively. What I used to do regularly was have a client supine on a bench, make sure their arm was completely relaxed, then I’d stretch them into various overhead positions. For those clients with shoulder issues, what you’ll notice is this is almost always much less painful, if at all, compared to active motion.

The first reason for this is when they actively move things like below happen, which don’t passively:

That is, proper upward rotation is an issue, yep.

When actively doing an overhead press, superior glide is a potential issue which is largely mitigated during passive motion too.

Something like the deltoids -which play a role in superior glide- aren’t contracting passively, so they aren’t pulling the humeral head. That’s true too.

Another common thing in pull ups and its variations is compensating with lumbar extension, and or not actually getting the arms overhead. So, while someone is seemingly getting their arms overhead, one way or another they’re really leaning back to get the motion. Their arms are vertical relative to the ceiling, but they aren’t vertical relative to the person’s body. Notice in the below picture how the spine is leaning back, thus the humeri are actually in front of the shoulders. They’re anterosuperior to them, not superior to them.

Chin up lower back arch 1 arms not overhead lines

The green line would be full overhead motion:

chin-up-lower-back-arch-1-arms-not-overhead-lines-with-added-line

In a pull up a person might not be getting overhead enough to get into their issue territory. For instance, between the yellow line of the arms and the green line above.

The other factor is load. This can be further illustrated in having someone do a straight arm, arm raise compared to a bent arm. The bent arm will usually feel better. Bent arm = lesser lever arm = less load.

Raising your arm like the left picture is less work than the right picture:

However, even a bent arm, arm raise can be too much. That is, gravity can be too much. (See the link above for info on how to combat this.)

Doing things like the above also present an opportunity to,

1) Illustrate manual / massage therapy or some passive modality won’t be sufficient, nor is necessary, to correct an issue, because while it may have an influence on things passively, it’s unlikely to change how you actively raise your arm. It’s not going to stop that rhomboid from disturbing full upward rotation.

2) Show load is an issue, where a build up of tolerance is needed.

3) Show movement is the source of, and thus the solution to, the problem. “There’s nothing wrong when your arm is moved for you. It has to do with how you move the arm. We need to change that habit.”

(Not all the above may be true for a given person. Sometimes load is fine, given movement is solid. Sometimes movement is solid, but load is still an issue.)

That said, I’ll only passively stretch clients if they’re having issues “getting it.” It’s an explanation, not a modality for their ailment.

By definition, active motion requires more work than passive. Illustrating there even may be a passive approach is tempting the lesser metabolic cost beast of humans. After passively stretching people I routinely started hearing things like “Can’t you just stretch me?”

You know how people suddenly have the olfaction of a dog upon walking into a mall where Cinnabon is present? Even if that luxurious goo’s smell is emanating from the other side of a mile long shopping center? That’s our seek-out-calorically-dense-food beast. We have just as bad of one whenever it seems we can passively get our way out of something. (Why pills are so popular.)

Furthermore, it’s a route to feeling better for a few hours, maybe a few days, then needing to be stretched by someone else again. (Pop another pill.) While a nice business model for the practitioner, not much of a longterm, self reliant, solution for the person with the bum shoulder. 

Good fucking question!

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Posted in: Shoulder Pain