“Dear, The Golfing Doc; I’m 45 years old and have been doing pushups daily since I was about 15 years old. Over the past year, the front of my shoulders have been getting more and more painful. I only used to do 25 pushups but now I can’t even do one. Did pushups cause my shoulder problem? I can still golf, but it hurts the next day. Thanks. David D. Seattle, WA”.
This month’s question came with good timing, as I had three patients come in on one day with the same shoulder complaints. They were experiencing pain in the front of the shoulder and a deep, dull ache into the back and side of the shoulder They all had trouble reaching behind themselves and putting a jacket or sweater on. All of them reported that the problem had slowly been getting worse over the past several months. Some stated they were unable to work out, but all of them said they were able to golf with minimal to no pain while playing. One thing they all reported was that they used to do pushups every day. One patient, for just months and the others for several years. At this visit, none of them were able to do any pushups due to pain in the front of the shoulder.
Pushups are a classic exercise to help build strength in the chest, shoulder, arm, back, core, and leg muscles. It’s a great overall exercise for upper body strength. Some people have good upper body strength and are able to do 10 or more pushups, while others struggle or have to work hard to just do one good one. I think we all remember having to do pushups in school as part of a test in gym class. You were either able to do it– or not.
So let’s get straight to the question. Are pushups good or bad for you? My answer is; yes and no. If you are able to do a pushup with correct form and have no underlying chest or shoulder issue, then a pushup would be a great general exercise for you. When I say “proper form”, I am looking at placing the hands beneath the shoulders and slightly wider than shoulder-width. The feet are nicely grounded– either together or shoulder width apart. The lower back is in a good neutral position, with no sagging in the spine. The shoulder blades are squeezed together throughout the entire motion with no “winging” or popping up like when a cat stretches. The head is slightly tucked while the neck is in line with the rest of the spine. And you are able to lower yourself in a nice and controlled fashion without touching the floor. These are just a few features to watch for in a properly executed pushup.
If you are missing any one of these features of good form, then pushups are not good for you. If you have an underlying shoulder problem to start with, then pushups are not good for you. If you modify your positioning (like placing your knees on the floor) and still can’t maintain good form, then pushups are not good for you. Basically; if you cannot maintain proper form, regardless of the exercise, then you should modify or not do that exercise at all.
Chronic shoulder issues such as tendinitis of your biceps, tendon, or rotator cuff muscles commonly occur as a result of doing too many pushups or doing too many bad pushups. The front of the shoulder is a common “hot spot” because most people go down too low.
Here are some pictures demonstrating good and bad pushup form, and also some variations you may want to try. If you experience any shoulder pain or discomfort elsewhere, stop immediately and consult your medical professional.