6 Ways to Reduce Shoulder Pain During Squats

shoulder painThe squat may be the king of all lower body exercises, but if you’ve ever squatted heavy, you know that it’s extremely taxing on the upper body too. So taxing, in fact, that many people experience shoulder pain during squats at one point or another.

That nagging feeling in the front of your shoulder makes it tough to move big weights. Sometimes the irritation makes its way into your biceps or even your elbows.

Pain kills force production, so it’s nearly impossible to perform at your best when something hurts. And it’s rarely something that will go away on its own, so you’ve got to be proactive if you want to get rid of the pain.

How do you reduce shoulder pain during squats? It’s a combination of:

  • Improving thoracic spine (upper back) positioning
  • Improving scapulohumeral (shoulder blade and arm bone) motion
  • Not squatting like an idiot

That last point is harder than it sounds. It actually deserves to be on the top of the list. You can perform all the elaborate movement assessments and shoulder screens in the world, but if you use the wrong squat technique, you’ll never escape your pain.

Read on to learn six ways to reduce your shoulder pain during squats so you can get back to moving big biscuits.

DISCLAIMER: If you’re injured, go see a doctor. You can’t diagnose or fix your pain with a blog post, but these methods can help you train AROUND pain. 

SHOULDER PAIN MECHANISMS EXPLAINED

ac-joint-gray326First, let’s talk about WHY you get shoulder pain when squatting. If you don’t know what you’re trying to avoid, it’s hard to fix it.

[Geek alert] If you don’t like science-y stuff, skip ahead.

The glenohumeral joint (where the “ball” and the “socket” of your shoulder meet) is one of the busiest intersections in your body. There’s a lot of stuff vying for space, including muscles, bones, tendons and ligaments. Poor alignment (i.e. bad posture) on top of poor movement (i.e. bad squat technique) often leads to impingement, which is a general term for when one or more of the rotator cuff muscles or tendons rub against the acromion (see top right of the picture) and/or the humerus (see bottom right of picture) in a way that causes pain.

Impingement usually results from the “ball” (head of the humerus) moving too far up and/or forward in the “socket” (glenoid fossa). This could be due to poor positioning of the shoulder blade and/or rib cage, poor movement of the “ball” itself, or a combination of the two. The pain you feel while squatting is often due to a combination of these motions as you reach back to hold the bar.

TL;DR: If your posture/shoulder mobility sucks plus you use a squat technique that’s not well-suited for your body, you’re gonna have a bad time. 

Now, onto the solutions:

1. BAR POSITION

In my experience, many lifters simply try to carry the bar too low on their back. A low-bar position BEYOND what an individual’s mobility can handle forces several things:

  • Thoracic flexion (rounding of the upper back)
  • Scapular anterior tilt (shoulders slouch forward)
  • Shoulder extension (the “ball” glides forward in the “socket”)

That looks something like this:

low bar squat

This shoves the head of the humerus into the front of shoulder socket, which can irritate the biceps tendon. It also puts a ton of stress on the inside of the elbows, which is another battle you want to avoid.

The solution? Carry the bar higher across the upper back. This allows the lifter to stay more upright, which lets the shoulder blades sit snuggly to the ribcage and doesn’t dump the shoulders forward into a lousy position. The bar doesn’t have to be on top of the traps a la Olympic weightlifters, but high enough to allow the shoulders to sit in a non-painful position.

Another solution? Front squat. It’s not the same as back squatting but it’s more shoulder friendly and can preserve your strength while you get your shoulders healthy.

2. HAND POSITION

Similar to bar position, attempting to squat with the hands too close together can dump the scapula into anterior tilt and the humerus into anterior glide. While pulling the hands in close can help keep your upper back tight, this is a quick way to piss of your shoulders, wrists and elbows if your shoulder mobility isn’t on point. This is NOT a good bar position:

squat hands too close

There’s always a tradeoff between active and passive stability. Active stability means getting tight by contracting your muscles (hard to do), while passive stability means getting into near-end-range positions to stay tight (easy to do). A narrow hand position uses passive stability which can help you stay upright, but it can hurt your shoulders if you force it. A wider hand position means you’ll have to work harder to squeeze your upper back muscles, but it’s worth it if it alleviates your shoulder pain.

Check out this Technique Tuesday for an explanation of active vs. passive stability during the squat:

 

 

3. HEAD POSITION

I’m constantly coaching head position during every exercise because it makes a huge impact on spinal alignment from top to bottom. The head is the boss of the body. If the head is out of position, you can bet the upper back and lower back will be out of whack too.

Lots of people squat with their head up because they’re taught the old myth of, “Look up, stand up.” Throwing your head to the heavens may sound good in theory, but cranking your neck into extension is a surefire way to put your upper back (and therefore your shoulders and elbows) into a bad position.

On the other hand, many people take it to the other extreme by packing the neck and looking down. Very few good squatters look down for the simple reason that your body tends to follow your head, and if you look down, you’ll likely drift forward and lose your balance under big weights.

The answer is somewhere in the middle: what head position allows you to keep your upper back, shoulder blades and arms in a position that’s pain-free and doesn’t crumble under heavy weights? That’s a little different for everyone, but start by looking straight ahead and making a double chin. Move your head and eyes up or down slightly from there until you find something you like that doesn’t hurt.

Here’s another Technique Tuesday that explains the importance of head position:

 

4. SPECIALTY BARS

We deal with a ton of athletes with shoulder pain at Cressey Sports Performance, so we use lots of specialty bars to train around it. If you have access to bars like the Safety Squat Bar, Duffalo Bar or Giant Cambered Bar, it’s worth using them frequently to spare your shoulders.

If you experience occasional shoulder pain, it’s a good idea to use a different bar for accessory work like lunges, split squats, good mornings, etc. to minimize time spent with a traditional barbell on your back. If you’re really banged up, using a specialty bar exclusively can help you continue to train the squat while you heal.

5. IMPROVE THORACIC SPINE POSITIONING

Your thoracic spine (upper back) position is the first place to look when your shoulders hurt. The shoulder blades sit on the upper back section of the ribcage, and the humerus (arm bone) should follow the shoulder blade. So if the t-spine is off kilter, the entire shoulder will be too.

And while most people aim to improve t-spine extension (i.e. pulling the chest up), that’s not always the answer. Sure, you need to keep your chest up during squats. And sure, most desk workers need more t-spine extension because they’re slouched over all day. But many athletes and lifters are constantly in a position of extension and need to get out of extension to improve shoulder function.

Take a look at these two photos. Do these athletes have the same t-spine positioning?

t-spine-flat-vs-kyphosis

The lifter on the right has a rounded upper back and needs to extend his t-spine if he wants to get his shoulders in position to squat. Drills like the Bench T-Spine Mobilization would help him.

The lifter on the left has a “flat t-spine,” meaning his upper back is extended beyond a normal position. This moves the ribcage away from the shoulder blades, making it tough to tip the shoulder blades back into a position where he could comfortably hold the bar during a squat. Rounding the upper back with a drill like the All Fours Belly Lift will help reposition the ribcage so the shoulder blades can move properly.

Attacking the shoulder blades first is a lost cause if the t-spine can’t get where it needs to go. Once these lifters have established a better t-spine position, they can move on to their specific shoulder blade mobility drills.

6. IMPROVE SCAPULAR & HUMERAL MOTION

If you want happy shoulders, your shoulder blade (scapula) and your arm bone (humerus) need to work together. Unfortunately, many people can’t get their scapula in position so their humerus can move without irritating the front of the shoulder. If you can’t get your scap and humerus to play nice, you’ll have a hell of a time getting into position for a back squat. 

Most people can lift their arms up and squeeze their shoulder blades together, but it’s posterior tilt of the scaps and external rotation of the humerus that gives them trouble. Luckily, there are some awesome exercises to work on these.

Posterior tilt

Posterior tilt is the action of the shoulder blade tipping back like a seesaw on the ribcage. Good posterior tilt is essential for preventing pressure on the anterior shoulder (specifically the biceps tendon). My favorite drill to work on posterior tilt is the Prone Trap Raise because you won’t be able to lift your arm all the way up unless you properly posteriorly tilt the scap. Try 2-3 sets of 8 reps per arm as part of your warm-up.

External Rotation

External rotation at the shoulder is similar to the action of cocking back the throw a baseball. We often lose external rotation because of tight chest muscles or because we simply don’t use this motion much in day-to-day life. The Cable External Rotation is a great drill to groove this movement pattern and strengthen the rotator cuff muscles that externally rotate the shoulder. Do 2-3 sets of 8 reps with very light weight during your warm-up or later in your upper body workout to strengthen the cuff. Make sure only your arm bone is moving (NOT your shoulder blade) and that you only feel the BACK of your shoulder doing the work (NOT the front).

CONCLUSION

To wrap up, reducing your shoulder pain requires:

  • Proper bar position
  • Proper hand position
  • The right bar for YOU
  • Good thoracic spine positioning
  • Good shoulder motion

A combination of any of these things can contribute to shoulder pain, and addressing them will help you get back to squatting pain-free.

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