After the success of my lower-back article, I had to do something on the shoulder. It is one of the most common areas injured in weight training, especially with bodybuilders. Fortunately for you, I have injured both my shoulders (nothing more than soft tissue injuries, but long and incapacitating) a couple of times, which means I have something to say on the subject. Every single injury I have had has taught me something. You hear things like rotator cuff, teres minor, supraspinatus and you think “Gee, how am I going to make sense of all of this?” I was once just as confused as you were. Shoulder prehab and rehab doesn’t need to be complicated though. I don’t even need to go all anatomical on you to give you a few clues. Most shoulder injuries are caused by a lack of stability or muscle imbalances (which create instability). Let’s see how to increase stability and structural balance in the shoulder.
The movements of the shoulder
If you move your shoulder around, you are going to notice that your arm can rotate on its axis as well move in all directions. Unlike your elbow or your knee, which both flex and extend in the same plane of movement, the shoulder can do anything, which is awesome. Without this, we wouldn’t be able to play tennis and we would never have seen Federer play, ever. Humanity would be pretty sad indeed.
The problem with all these movements is that different muscles affect and stabilize them, making structural balance and stability important to avoid injury. Someone can be able to bench 220 pounds but be unstable at the top of the rep. Give it time and if stability isn’t addressed, soft tissue injuries will occur, very often to the muscles responsible for stabilizing the movement. As Louie Simmons says regularly, “A pyramid is only as tall as its base.” In other words, you should work on making your shoulder stable and bulletproof before you try to bench heavy.
OK, a little bit of anatomy 


I’m going to try and make this as simple as I can. Imagine your shoulder has a socket. It is held in this “socket” by muscles called the rotator cuff muscles. These muscles are responsible for internal and external rotation of the shoulder. The supraspinatus is also responsible for raising the arm in conjunction with the deltoid. These muscles are small compared to the lats and pecs, but they assist in heavy movements so they are going to be the weakest link in a lot of heavy movements. As Zatsiorski put it “you are only as strong as your weakest link,” which means that making sure the rotator cuff is balanced with the large muscles is paramount to gain strength and avoid injuries.
To make things simple, let’s take the external rotators, namely the infraspinatus and teres minor. They are relatively small muscles when you compare them to your pecs for example. Fortunately they are generally assisted by your scapula retractors but if internally rotating your shoulder is easier for you than rotating it out, you can understand why you can end up with internally rotated shoulders and poor movement patterns. If everything is in balance, you have a more stable shoulder, and a lowered likelihood of injury.
Testing for muscular balance
The test above shows someone doing a wall slide properly, meaning that the person shows sufficient mobility to press a weight overhead without compensating with the lower-back. His elbows are against the wall and his spine as well. That’s generally a good indicator of muscular balance but there are other tests that can show you your weaknesses.
Charles Poliquin has come up with tests that work pretty well to determine the upper-body balance between the anterior chain and the posterior chain. You have a full process and a whole list of lifts on this link, but the three lifts I am going to give you can already tell you if you’re balanced or not. You first test your shoulder-width bench press max. You can test your true max or, if you are afraid of hurting yourself and already have a painful shoulder, you can just warm-up and hit a 6 or 8RM and extrapolate from there. The formula is quite simple, if you have done six reps and failed on the 7th rep, you take the weight you have hit, multiply it by 100 and divide by 85. If you have done 8 reps and failed on the 9th, do the same and divide by 80. Once you have your number, you have two goals with two lifts, the single-arm bent-over trap 3 raise and the single-arm dumbbell external rotation.
Your goal should be to perform 8 clean reps with a 4-second eccentric of the single-arm external rotation with 8% of your bench press max (shoulder-with so narrower than most of the time). This shows balance between the external rotators of the shoulders and the pecs, which are internal rotators (and arms adductors).
With the bent-over trap-3 raise, your goal should be 8 clean reps past your ear with a 4-second eccentric and no momentum with 10% of your bench press max. This will show balance between the scapula retractors and depressors (rhomboids and lower-fibers of the traps) and the pecs.
I suggest 2 light warm-up sets before attempting the 8-rep max on those two lifts. Few people pass the test. They are often out of balance so make sure the movement pattern is understood and the muscles are warm before trying it. Clean reps mean that nothing is moving except what should. Swinging a little is not an option, as it will compromise the results of the test.
If you have imbalances, don’t worry. Most people do. That’s what coaches are here for. That doesn’t mean you should work on the lifts tested. I have found external rotations to do more harm than good when used too much. You don’t really have to isolate these muscles to strengthen them. What it means is that the way you structure your program has got to change. You probably spend too much time on muscles that cause internal rotation and too little on exercises that cause external rotations. Most people do. Even if the pulling and pushing is balanced, the external rotation is not worked on. Pulling works the lats and the lats are internal rotators, like the pecs. Pulling works the scapula retractors, but few people actually depress the scapula as well. You have to rethink a few things.
Shoulder pre-hab and rehab movements
When your shoulder is painful, few movements don’t give you pain. Fortunately, isometric holds can be pain free. One thing I like to include in my clients program very quick is an overhead farmer’s walk or an overhead step-up (which can be set on different heights, depending on the person’s strength). This forces the lower-traps to activate and stabilize the weight and prepares the person for future overhead work.
The next step is to challenge the shoulder on different planes of movement. For that, the most bang-for your buck exercise is the Turkish get-up. Pavel teaches it with a shoe on his clench fist. If you are able to keep the shoe on your fist, you are ready to use a kettlebell. The ultimate stage is a Turkish get-up with a bottom-up kettlebell. The video above explains to you the proper technique of a Turkish get-up, along with other kettlebell movements. If you don’t want the entire video, just go to 4.45mn, that’s where the Turkish get-up is explained.
When your feel comfortable with the Turkish get-up, you can plank on unstable surfaces like medicine balls. While I am not a fan of unstable surfaces for the lower-body, they have proved useful to increase the scapular stability so they can be good prehab and rehab tools. Side planks are also powerful shoulder stabilizers.
When you are ready to start pressing again, the landmine press is the easiest on the shoulder. Then comes the bottoms-up kettlebell press and the regular kettlebell press. When you are able to increase your weight on a kettlebell, you can use dumbbells and then a barbell. I would hold the overhead position of the overhead press for several seconds on an overhead press to increase stability.
I stole the landmine press from Cressey performance so it’s normal that I include Eric Cressey in the explanatory video, since he explains it so well:
Balancing a program
You may have heard of the pull/push ratio for healthy shoulders. As a general rule, you should always do more pulling than pushing. There are more muscles in your upper back than there are on your chest so it makes sense. The problem is that even if you have a 2/1 pulling to pushing ratio, your shoulders are always performing internal rotations. Both the lats and the pecs are internal rotators of the humerus. Pulling doesn’t cut it, even if it is important.
The face-pull, a good exercise to counterbalance pressing movements.
The pattern that you definitely want to include in your program is the action of bringing the humerus to your head. The snatch, the face pull, the trap-3 raise all work that movement pattern. To some extent, the kettlebell swing works it as well, even when you don’t swing overhead. If the kettlebell is heavy enough the action of swinging the weight up will work the lower-traps as well. Few people actually think of including this movement pattern and yet it makes all the difference in the world.

The bench press is known to cause shoulder problems, but that doesn’t mean it should be ditched. It is a competitive exercise for powerlifters, and it is one of the best chest builders. What you have to realize is that the bench press should be balanced with the rest of the program. No more than 20% of total training time should be spent in a supine position. The majority of people spend 50% of their training time on the bench press because they want a big chest. It doesn’t happen that way. Muscle imbalances prevent you from reaching your maximum potential. If you don’t want the bench press to give you pain, include a lot of variations, especially with dumbbells.
The overhead press is also a movement pattern that should be included in the program. The problem is that not everybody can overhead press safely. A person should be able to extend their arms overhead, with their biceps to their ears without arching their back or compensating anywhere else. Very often, people have a tight thoracic spine and tight lats so they need to mobilize these two suckers before they can hit an overhead press safely. Core strength also has to be sufficient for the person to be able to hold the weight overhead without hyperextending your spine. Anti-extension exercises such as the ab-wheel do wonders for that. For those who can’t do an overhead press, choose an easier variation like the bottoms-up kettlebell press and progress your way to an overhead press.
Since the weakest link in the bench press is very often the anterior deltoid, getting a stronger overhead press will increase your bench press so you shouldn’t worry about benching too little. Consider this, Westside Barbell is the most successful powerlifting gym in the world when it comes to making people freakishly strong. They hold several records and the most successful powerlifters have trained there. They spend 80-90% of their training time on assistance work. Turn your weaknesses into strengths and you will be stronger. Stick to one lift and you will get overuse injuries and be weaker.
Form check
A lot of shoulder injuries can also be traced back to bad form. There are misconceptions when it comes to overhead pressing, or even pulling for that matter. Pulling a weight is more complicated than people think and there are ways to pull that can wreck a shoulder. Let’s first turn to the bench press because this one gets screwed over and over.
There is a 7-part video on the bench press by Dave Tate on Youtube. It’s free of charge so enjoy. Dave Tate is worth gold. His recommendations are for powerlifters but we can use a lot of them for regular gym goers. What you want to avoid at all cost in a bench press, or any movement for that matter in the head of the humerus coming out of it “socket.” On a bench press that will force you to retract as much as possible, and the best way to do it is by arching your back as much as possible. What you should feel against the bench is your upper-back and your glutes. That’s right, your feet should always be on the floor. I cringe when I see people bench pressing with their feet up. You are not benching to work your abs so arch your back and keep the shoulders back.
The dumbbell shoulder press is often butchered as well. People think that they have to squeeze their shoulderblades tight so they bring their elbows out wide, which creates an internal rotation of the shoulder at the start of the movement. I always teach people to keep the elbows forward. This is why I prefer the hammer grip for a dumbbell press. It teaches people to keep the elbows in front. The chest should be open but there is no need to squeeze the shoulderblades like crazy, it’s not a bench press.
Pulling movements get butchered as well and my favorite is of course the one-arm row. The only time I have seen it performed correctly was when I was visiting Cressey Performance. Even then, Eric was bringing a few corrections to his athlete. For every pulling movement you do, there is no need to squeeze the shoulderblades like they owe you money. What you have to do is keep your chin in, as if you wanted to make a double chin, and open your chest. Think sternum forward and chest wide open, the rest generally takes care of itself. If you’re squeezing your shoulderblade but shrugging your shoulders, you’re not doing any good. If you’re bringing your sternum forward, your shoulderblades automatically depress and retract enough to allow a safe movement. It’s the same for bent-over barbell row, chin-ups, and any pulling movement.
Wrap-up
Don’t ignore minor shoulder pain. It is usually a first sign that you are doing something wrong. Assess your imbalances and work on stabilizing the joint. Make sure that you use proper form for your upper-body movements. You will last longer and be stronger. Remember that you are only as strong as your weakest link so sometimes you have to do things that are not so fun if you want to progress. Give it time and you will end up preferring the overhead press over the bench press. I know I do, and it wasn’t always the case.