Tip number one: Focus on the little muscles.
It’s time for your favorite strength class and you’re pumped for it. First move on the docket? Overhead presses. You’ve got this, you tell yourself. But as soon as you lift your dumbbells skyward, a sharp twinge shoots through your shoulder, stopping you in your tracks.
Though certainly unpleasant, having shoulder pain or discomfort while lifting weights is fairly common, physical therapist Maria Borg, PT, CSCS, supervisor at UCHealth Sports Physical Therapy in Colorado, tells SELF. And there are a host of reasons why this can happen.
But bottom line? Experiencing shoulder pain during exercise doesn’t mean you need to give up strength training altogether. In fact, there are lots of small things you can do to make weight lifting more enjoyable for sensitive shoulders—and we’ve got all that important intel right here.
Ahead, everything you need to know about shoulder pain and weight lifting, as well as what you can do to keep it at bay.
What causes shoulder pain while weight lifting?
There are several reasons you may feel shoulder pain or discomfort while strength training. But perhaps two of the most common culprits are instability and weakness in your shoulder and surrounding areas, Kellen Scantlebury, DPT, CSCS, founder of Fit Club NY, tells SELF.
First, a brief anatomy refresher: Your shoulder is a ball and socket joint, and the muscles of your shoulder are surrounded by tendons (which attach the muscles to bone) and bursae (fluid-filled sacs that help reduce friction, sort of like your body’s own personal lube). Bursae are found on all the major joint junctions—hips and knees too.
The shoulder joint is the most mobile one in your body. “So with that comes inherent instability,” which can lead to pain, Scantlebury explains.
Weakness, particularly in the rotator cuff, can play a role as well—and not just for baseball pitchers, who often injure this area with the repetitive throwing motion. The rotator cuff is made up of four different muscles that function to keep the shoulder in its proper place. If those muscles aren’t strong enough, then your shoulder may be sitting in a less-than-ideal placement. Then, when you move your shoulder, particularly overhead, you can experience discomfort, Scantlebury says.
Borg explains it this way: The shoulder is a ball and socket joint that is supposed to roll and glide as you move your arm to shoulder height, above your head, or while lifting your arm away from your body. But when you have rotator cuff syndrome (basically, any injury or condition that affects the rotator cuff), the rotator cuff muscles aren’t doing their job to keep the ball in the socket. Instead of the shoulder rolling and gliding when you raise your arm, the ball of the joint will press the soft tissues of the rotator cuff tendons and bursae between the ball and the top of the shoulder blade. That, in turn, can create pain and discomfort.
Issues stabilizing your scapula, or your shoulder blade, can also contribute to shoulder pain, since the stabilizing muscles on the backside of your shoulder assist with proper positioning of the joint. When these stabilizers aren’t functioning optimally, you can have higher risk of issues like shoulder impingement (common in swimmers, when the top of your shoulder blade rubs against your rotator cuff), tendinitis (when your tendons get inflamed or irritated), and bursitis (when your bursae gets inflamed or irritated)—all of which can lead to shoulder pain.
Another cause of shoulder pain is overuse, which can happen when you fatigue muscles that haven’t been worked hard in a while. Scantlebury says he’s seen an increase in elbow, wrist, and shoulder injuries and pain during the pandemic due to people going way too hard during at-home workouts. Say, for instance, you’re programming push-ups or planks into every single routine. “Someone who hasn’t done [those exercises] in a long time, or ever, just going from zero to hero, that is just a lot of intensity on that joint,” he says.
Is shoulder pain while lifting weights serious?
It could be. If you continue to do a movement that’s eliciting that sensation, it can lead to strains or tears. Strains occur when the muscle is overstretched, while tears are more severe and can involve a complete tearing of the muscle. Strains and tears can develop because the shoulder muscles aren’t strong enough to keep the joint in its proper place, and when the joint isn’t in the correct place, the muscles can get compressed.
Over time, this compression can lead to small tears in the rotator cuff that, if not addressed, can snowball into larger tears, Scantlebury explains. And these larger tears can leave you completely out of the weight room for a significant amount of time—or may even require surgery.
When should you see a professional about shoulder pain when lifting?
The best way to determine whether it’s okay to continue working out involves weighing the pain or discomfort on a scale of 1 to 10, with 10 being ultimate, excruciating pain. If doing exercises like pull-ups, overhead presses, or chest presses triggers pain that’s a 4 out of 10 or higher, then you should stop the workout and see a licensed physical therapist, Scantlebury says.
You should also see a professional if you notice sudden weakness in your shoulder that is increasing, as well as numbness or tingling in your arm, Borg says. And if you have pain or discomfort that persists more than 24 hours after your workout, even if it’s mild, you should also consider seeking care.
But what if your discomfort is just clocking a three or below? In that case, you can continue—with caution. “I don’t want people to be scared to move,” Scantlebury says. “Some pain gets better spontaneously with increased strength, especially low-level pain.” Just keep an eye on your discomfort level, and if it persists or increases, that’s your sign to call in the pros.
What are the best weight lifting tips for people with sensitive shoulders?
Now that you know what causes shoulder pain and discomfort during a workout, let’s talk about how you can alleviate it. Here are some strength training tips to consider.
1. Focus on the little muscles—after a good warm-up, of course.
You may think that doing traditional shoulder exercises that target your anterior deltoid (the front of your shoulder), like overhead presses or Arnold presses, may be the key to strengthening your shoulders and thus alleviating pain, but that’s actually not the case. Like we mentioned, a lot of shoulder pain is caused by rotator cuff dysfunction, so it’s often the muscles on your back that you want to target to help alleviate shoulder issues.
To target the rotator cuff, Scantlebury suggests moves like shoulder external rotation, shoulder internal rotation, shoulder flexion, and shoulder extension, all of which require a resistance band. Program these exercises into your routine three to five times a week, he advises. Do three sets of 10 to 15 reps each. You can also try this four-move workout specifically designed to hit your rotator cuff muscles.
Important note: Like with any workout, it’s important to incorporate a dynamic warm-up before focusing on working the muscles around your shoulder, Borg says. Gently taking your muscles through their ranges of motion can warm your tissue and reduce chances of experiencing injury or pain during a workout. We suggest this upper-body warm-up.
2. Incorporate targeted upper back work.
It’s also a good idea to focus on strengthening the middle and lower parts of your trapezius, Scantlebury says. The trapezius is a large muscle that runs across the back of your neck and upper back and assists with shoulder motion and mobility. A lot of people have surprisingly strong upper trapezius muscles (meaning, the muscles on the tops of your shoulders), thanks to typical everyday movements that cause us to lift our shoulders toward our ears—think: hunching over a phone or computer.
This means the middle and low part of the traps, which make up your upper back, aren’t always as strong. Taking the time to strengthen them, through moves like prone Ts and prone Ys (which you’d also do for three sets of 10 to 15 reps each), can help improve the overall functioning of the trap muscles. Program exercises that target your mid to lower traps three to five times a week.
3. Include scapular stabilization too.
Before we jump into exercises for scapular stabilization, a quick note on how it feels to engage your scapula. Have a friend place their hand on the middle of your back, and try to squeeze their hand with your scapula—that movement is known as scapular refraction, and it’s important for stability.
Moves like mountain climbers, high planks, forearm planks, rows, and scapular push-ups (push-ups where you keep your elbows straight and squeeze your shoulder blades together) can help boost your scapular stabilization. Incorporate these into your routine every other day by doing three sets of 20 to 30 seconds per exercise, Borg suggests. Make sure these moves don’t cause pain or clicking, she adds. If they do, then modify your range of motion, decrease the number of reps or sets you’re doing, or switch to a different exercise for now.
4. Use light weights for your smaller shoulder muscles.
When targeting the small muscles around your shoulder, like the rotator cuff muscles as well as the middle and lower traps, make sure you’re using light weight, Scantlebury says. Go too heavy, and you’ll recruit bigger muscles to assist with the movement—like your lats or pectorals—which will negate the purpose of the exercise. Start with one to two-pound weights, or even just your bodyweight. Keep the weights to less than five pounds to ensure you’re targeting the right muscles. You can also use light resistance bands.
5. Modify your range of motion.
For many people, doing movements below 90 degrees (so, below shoulder level) rarely causes pain. By switching the angle of an exercise, or how far you’re moving in a range of motion, you can reduce your chances of pain while still getting lots of benefits, Borg says.
“Use the mantra of pain-free, click-free ranges,” Borg says, meaning: Do exercises in ranges of motion that don’t cause any pain or clicking in your shoulders. For instance, if doing lateral raises to 90 degrees is too much for your shoulders, then modify to, say, 60 degrees.
6. Aim for a good ratio of pull to push moves.
Most of our daily movements are very anterior-dominant—meaning they favor the frontside of our body, like our chest muscles and the front of our shoulders. The backside of our body, known as the posterior chain, is often neglected, Scantlebury says.
And that’s a shame for your shoulders because the upper back, in particular the middle and lower traps, is super important to shoulder health. One way to help find this balance is to incorporate just as many (if not more) pulling movements as pressing movements into your upper-body workouts. Pulling movements, like rows, target your posterior chain muscles, while pressing motions, like push-ups, chest press, and overhead press, target your anterior chain.
7. Keep moving.
If shoulder pain keeps getting in the way of your workouts, you may be inclined to stop exercising completely. But that may only exacerbate your discomfort. “Really anything you do that increases blood flow to the area, or to your whole body, is indirectly helping that region of pain,” Borg says. “Focus on what you can do and not what you can’t do.”
For instance, if doing any type of upper-body strength work is too much for your shoulders right now, consider hopping on your indoor cycling bike or go for a walk instead of canceling your workout altogether.
8. Monitor your pain.
To ensure your workout routine isn’t worsening your shoulder pain, monitor your pain level before and after exercise. Temporary increases in pain or discomfort are okay so long as they dissipate within 24 hours, Borg says. If pain lasts longer than 24 hours, then you may have overdone it in your workout, in which case you should scale things back next time and check in with a doc or physical therapist as needed.