My shoulder hurts during push-ups – what can I do?
Most push-up shoulder pain is not a “weak shoulder” – it’s a position problem. Elbows flare out to 90°, the shoulder blades get stuck pinched together and the head drops forward. The shoulder blade then tilts forward, narrowing the space the rotator cuff tendons run through. Change the position and the pain usually changes too.
- Train elevated first. Put your hands on a bench, a box or the kitchen counter (incline push-up). This doesn’t just take weight off – it changes the angle of your arm to your body, so the shoulder rotates and loads differently at the bottom of the movement. Find the height where it’s pain-free, then lower it step by step over the weeks.
- Elbows at 45°, not 90°. From above, your body and arms should look like an arrow, not a “T”. Eric Cressey – who works with MLB pitchers – names flared elbows as one of the main causes of painful push-ups.
- Screw your hands into the floor. Without moving them, try to turn your hands outward (right hand clockwise, left hand counter-clockwise). This creates external rotation in the shoulder and makes the joint stable – a classic cue from physical therapist Kelly Starrett.
- Let the shoulder blades move. At the top, push the floor away until your upper back rounds slightly (“push-up plus”). That trains the serratus anterior, the muscle that holds the shoulder blade on the rib cage. Once you’re pain-free, Cressey uses feet-elevated push-ups, which research by Lear & Gross shows activate the serratus even more.
- Slow down. 3 seconds down, 1 second pause just above the floor. If it hurts, you’ve found the range you need to build up – not the range you need to push through.