Therapy Thursday-Overhead Press

Many patients and athletes report difficulty with overhead pressing. Neck pain and shoulder pain are common, but even low back pain is frequently reported with this challenging exercise. Especially if done in standing with a barbell.

Common faults

  • Anterior bar path
  • muted hips
  • hyperextension of spine
  • forward torso

The anterior bar path is seen when the neck can not be retracted, the Thoracic spine is limited or the lats are tight. So all these movements need to be assessed when checking an athlete's press capacity

The spine needs to be braced during entire movement and glutes should be engaged as well to provide a stable base

Many people develop problems in the low back if they hyperextend their spine to compenate for lack of movement elsewhere.

Shoulder pain?

If your shoulders hurt with barbell overhead press, consider using dumbbells or kettlebells in a neutral position. The barbell requires sufficient External rotation and if your shoulder is limited, or lats are tight you may develop impingement when you use a barbell. Also train unilateral to reduce any diffences between left and right shoulder girdle

One of my favorites is using the landmine for shoulder press. The bar path is fixed, so its easier to stabilize and you dont need full flexion or external rotation

Back pain?

If you have back pain, you might want to consider performing the OH press seated on a bench with a back support. You need to really focus on bracing the core and keeping a good posture during the press

Here is how I program different shoulder presses for my patients and athletes. From easy to hard. So if they have difficulty with push press, I might go back to just overhead press, etc.

Dr. Pieter de Smidt, PT, DPT

Do You Have Pain? Schedule a Free Assessment | Dr. de Smidt has over 30 years of experience as a Physical Therapist. He has achieved certifications in Mckenzie Mechanical Diagnosis and Therapy, Manual Therapy and Sports Therapy. With his Post-Professional Doctorate in PT he specialized in management of musculoskeletal injuries of the neck, back, shoulder, hip and knee.