Shoulder Pain and
Going to the Gym

Movement is important
but so is safety

When dealing with shoulder pain or injury, exercise can be very beneficial in decreasing pain and improving strength and function. Movement is important and it can help us heal. There are, however, certain do’s and don’ts when recovering from shoulder pain or injury.


Warm up:

  • Cardiovascular warm-ups such as walking, biking or jogging can be beneficial. They increase body temperature and blood flow to prepare muscles and tissues for activity.
  • To decrease risk of injury, perform range of motion exercises and stretch tight muscles. These movement warm-ups can prepare your body for the exercises you are going to do at the gym.
    • Focus on the spine, hips and shoulders.
    • Stretch the pectoralis, lats and posterior shoulder muscles.
  • Perform muscle activation exercises to wake up the muscle groups that stabilize your joints and maintain posture and joint alignment during exercises. This can be done while you are performing your range of motion/stretching exercises.
    • These muscles include your abdominals, glutes, middle and lower traps and serratus anterior (scapular stabilizers).


  • Ensure correct posture and joint alignment with each exercise. Alignment improves your ability to recruit your stabilizers.
  • Engage your core/glutes and “set” your shoulder blades (your physical therapist should have taught you how to do this).
  • A strong core and engaging your stabilizers (scapular retraction) will lead to increased strength in your shoulders and arms.
  • Posture affects our shoulder blade position where the rotator cuff muscles are attached. Good posture prevents impingement, giving space for the rotator cuff to move through when you lift your arms.
    • It also recruits the muscles that attach your shoulder blades to your spine (scapular muscles). When you use these muscles, your rotator cuff has support when you lift your arms or anything of weight. You will be stronger because of this. You can think of this as being like a strong anchor man in a tug-of-war.
    • Without these muscles, your rotator cuff has to strain more to lift your arm/weight which can cause pain or injury.

Scapular stabilizers: incorporate exercises to strengthen your serratus anterior, middle and lower trapezius muscles.

Rotator Cuff: Incorporate rotator cuff strengthening exercises into every workout.



In the gym setting, the focus is often on the large power muscles that we can see (e.g. the pecs, deltoids, lats, etc.). However, excessive training of these muscles can lead to significant muscle imbalance, rotator cuff and scapular weakness, and rotator cuff-related pain.

If you are recovering from shoulder pain /injury these are things you should avoid at the gym or general rules to follow to prevent re-injury:

  • Keep all arm and hand movement in front of your body.
  • Avoid pulling anything behind your head (lat pull-downs) or holding a bar behind your head on your shoulders.
  • Avoid weight-bearing through or loading the shoulder with your arms behind you. This includes tricep dips, reverse crab walk or reverse plank.
  • When doing chest press or pec flys, do not let your elbows move behind your shoulders. A modification of chest press can be done from the floor so the elbows cannot drop below the shoulders.
  • When doing bench or chest press, ensure you retract or bring your shoulder blades under your body before lowering the weight to your chest.
  • Avoid long lever lifting. This includes forward and lateral raises.
  • Avoid heavy loads with your arms outstretched away from your body.
  • Minimize prolonged repetitive overhead activity.
  • Alignment and correct movement pattern is more important than strength. Avoid compensating with other muscles or movements if the load or weight is too heavy. Common compensatory movement includes shrugging shoulders up toward ears or extending your lower spine to lift.
  • When moving your arm, ensure you do not shrug your shoulder toward your ear. Keep your shoulder down when lifting your arm up. This will minimize neck-related issues and stress on the rotator cuff (impingement).
  • It is okay to work into soreness or stiffness when doing exercises but sharp pain, pinching pain or catching is not. You should be stretching to, but not far beyond, the edge of discomfort. Pushing to the proper limit will slowly tell the body where to heal and lengthen to improve mobility.