Starting Strength

supraspinatus and the infraspinatus, overlay the head of the humerus and underlay the subacromial bursa and these bony knobs, most PTs believe that the potential for mashing the bones together and trapping the tendons in between (impinging the tendons) is so high that the exercise is dangerous and should not be performed.

    Figure 3-5. The anatomical relationship of the traps, the scapulae, the arms, and the bar in the press.

    This dogma ignores the anatomical facts about a properly performed press. The scapula is attached to the rest of the shoulder girdle at only one point, the clavicle at the AC joint. Except for the acromioclavicular ligament, the scapula essentially “floats” freely through its range of motion in a sheath of fascia and muscle, so that its position can change relative to all the other structures of the back and the humerus. The scapula can move from a position of extreme adduction, as in the bench press, to being pulled forward, as with the start position of a barbell row , to the shrugged-up, rotated-in-at-the-top position used at the top of the press.
    When you press overhead, you finish the movement by shrugging your shoulders up toward the bar. This motion engages the trapezius muscles that connect the spinous processes of the vertebral segments in the neck and upper back to the scapulas, and this actively reinforces the traps’ support for the shoulders and the bar. In effect, the bar is supported overhead by the locked-in-line arms, the scapulas hold up the arms, and the traps hold up the scapulas, so the shrugged traps actively support the weight of the bar. When the traps contract, they pull the scapulas together at the top so that they rotate medially, and the shrug pulls them upward. This motion points the glenoid cavity upward to directly support the humerus from below, and pulls the acromion and coracoid processes away from the humerus. If you press properly, the shrugged-upward scapulas are thus positioned to support the arms and the bar overhead while making impingement of the cuff tendons impossible ( Figure 3-5 , Figure 3-6 ).

    Figure 3-6. The lockout position in the press. The force of gravity drives the humerus into the glenoid.

    The claim that presses impinge the shoulder is therefore not correct. Pressing incorrectly is not the same thing as pressing – you don’t get to redefine the exercise and then claim that it’s dangerous. Driving a car is dangerous if you drive it into a great big rock.
    There are several excellent ways to impinge the shoulder, none of them involving the press. All you have to do is hold the scapula in position while letting the humerus wedge itself into the bony processes. Bench pressing with an incorrect elbow position and certain gymnastic movements, like ring dips and ring pushups in the absence of adequate strength preparation, are good ways to put the shoulder in an anatomically or mechanically dangerous situation that you cannot control. Powerlifting is hard on the shoulders’ long-term health, and the recent fascination with gymnastic exercises by novice athletes has been responsible for many surgical procedures that would otherwise not have been necessary. Sports that use an overhead position, like tennis, swimming, and volleyball, but which do not typically use the press to prepare the body for the stress of that position, experience high rates of shoulder injury and surgical repair. But amazingly enough, shoulder injuries are quite uncommon in Olympic weightlifting, where the point of the sport is to put as much weight overhead as possible. Weightlifters learn very quickly how to hold a weight overhead, while tennis players have perhaps been actively discouraged from learning the safe way to work in this position.

    Figure 3-7. Impingement of the shoulder with incorrect position of the shoulder in the ring dip. The force of gravity drives the A/C joint down into the humerus, and moment force created by the lateral motion of the arm can produce severe shoulder problems.

    Shoulder injuries do occur with significant frequency, and the press has been used for decades to rehabilitate injured shoulders, particularly injured rotator cuffs. Rehabbing this way works for the same reason that it is safe to press, and for the same reason that pressing actually strengthens the rotator cuff muscles. Physical Therapy usually addresses shoulder rehab with direct exercises on the rotator cuff involving rubber bands and 2-pound dumbbells, an