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  Fitness > Sports Injuries >  

Four Exercises to Modify or Avoid
(also see Rotator Cuff Tendinitis and What Goes Wrong)

Certain exercises are commonly performed in ways all but guaranteed to traumatize the rotator cuff. These exercises should be modified to reduce their potential to induce cuff injury. In some cases that means eliminating them entirely!


Prime Mover: pectorals
Secondary Movers: front deltoid, triceps

The Bench Press targets the pectoral (chest) muscles but also makes heavy demands on the triceps and front delts. All three muscles—pecs, front delts, and triceps—act to lift the bar. Along with the rotator cuff, all three also stabilize your shoulders during the exercise.

In an effort to ``work different areas of the pecs" and to decrease the involvement of the supporting muscles, athletes have come up with a number of Bench Press variations. Some are O.K. Some are potentially harmful. Let's look at two variations especially likely to produce shoulder injuries:

  • using too wide a grip
  • touching the bar to the chest too high up

Using too wide a gripbpwide.jpg

On the plus side, bench pressing with a wide grip does increase the intensity of pec contraction during the exercise. The position places the pecs on a greater stretch than a shoulder-width grip does, and the greater stretch causes more muscle fibers to be recruited during each rep.

On the minus side, though, is this: Imagine you are holding up a 10-pound weight on the end of a stick one foot long.

Now imagine you are holding up that same weight on the end of a 10-foot stick. Obviously, it's harder. The longer lever increases the force necessary to hold up the load.

The same thing happens when you use a wide grip during the Bench Press, only the stress isn't increased just on the pecs—it's also increased on the shoulder joint itself. The rotator cuff is left holding the bag: the stage is set for injury.

Some athletes are told to use the wide grip early in their athletic careers when many of them don't have sufficient shoulder-girdle strength to withstand the strain. In fact, few athletes are ever able to withstand the torque of the wide grip, and many suffer rotator cuff injuries as a result of using it.

The safest grip for this exercise is a medium grip, which allows all the prime movers to work together, minimizing the strain on the rotator cuff.

Touching The Bar Too Highbpress.jpg

Many bodybuilding books recommend lowering the bar to a point high on the chest during Supine Bench Press to focus on the upper pecs.

Don't do it. The higher you drop the bar on the chest, the greater the stress on your shoulder. High placement may overstretch the joint capsule, the muscles, or the tendons.

If you want to focus on the upper pecs, use the Incline Bench Press instead. Touching the bar high on your chest during a Supine Bench Press can cause more damage than will ever be offset by the yield in development. When doing the exercise, lower the bar to approximately the nipple line or slightly below.


Prime Mover: chest or triceps, depending on body position
Secondary Movers: triceps or chest, depending on body position; front deltoiddips.jpg

Some athletes just shouldn't do dips. Several factors determine whether you are one of those, including your body weight and whether you've ever suffered a shoulder separation.

A shoulder separation occurs at the acromio-clavicular (A/C) joint, where the shoulder blade and collarbone come together just above your front delt. The degree of separation can range from barely perceptible to a complete rupture of the ligaments, requiring surgery and pins or screws to hold it together. Major trauma to the A/C joint can come from falls, car accidents, motorcycle accidents, skiing, and so on. Less-traumatic separations can come from weekend softball or football games. If you played football in high school, you might have had a slight separation that you thought was just a sore shoulder.

The top, or lockout, position during Dips puts vertical stress directly on the A/C joint. This can increase a separation, further aggravating the problem (fig x).

Our advice on this exercise: If you have ever separated your shoulder to any degree, don't dip. If you have pain at the top of your shoulder when performing dips, don't dip (this is not something you can ``work through"). If you have gained a lot of weight, and this exercise does not feel as comfortable as it once did, don't dip.

If on the other hand, you have always been able to dip without pain, you can continue to do so, but allow one set for a special warm-up: Do the first rep barely lowering yourself at all. With each subsequent rep, lower yourself a little further so that by the final rep you are moving through the full range of motion for the exercise.



Prime Mover: lats and triceps
Secondary Movers: pecs


Now here's an exercise with problems!

Pullovers are supposed to ``expand the rib cage." This assumes that ribs will somehow lengthen, or that cartilage will change to allow expansion to take place. Bone just doesn't work that way.

Training of various types can change the vital capacity of the lungs—the quantity of air that can be exhaled by the fullest expiration after making the deepest inspiration. However, much of this change results from the learned ability to use available lung space and from improved control of the diaphragm. Neither factor translates into a larger rib cage. Despite the tremendous vital capacities of opera singers and trumpet players, for instance, they, as a group, still possess normal sized rib cages.

Pullovers won't expand your rib cage; but there's a good chance that, in time, doing them will cause shoulder or other injuries. One example: The exercise can stretch the connective tissue that forms the vertical ``midline" between the abdominals. If that tissue tears, you have a hernia of the median rectus, which produces a slight bulge in the center of your abs that increases in size when you strain. A hernia of the median rectus is of little clinical significance, but it's certainly not what you were trying to develop! (If you have such a bulge in the center of your abs, don't attempt to diagnose it yourself. Several conditions could be responsible.) Pullovers also put tremendous stress on the posterior aspect of the shoulder; even before you sustain a clinical injury, they can cause a great deal of pain.

The bottom line: Pullovers won't enlarge your ribcage, and their high potential to injure the rotator cuff and other structures far outweighs whatever minimal muscular gains they may promote.



uprow.jpgPrime Mover: lateral and anterior delt
Secondary Mover: upper trapezius

One exercise you should eliminate from your weight training program is the Upright Row. This exercise places the shoulder in internal rotation as the arm is raised, a position that does not allow sufficient space for the greater tubercle to clear the acromion.

Supposed ``proper form" requires pulling the elbows as high as possible. This simply increases the degree of internal rotation and magnifies the danger of impingement.

The onset of pain from Upright Rows often is not immediate, although it may be. Usually the inflammation in the tendons and bursae increases with shoulder motion after the workout is over. Pain may develop hours or days later, making it difficult to associate the pain with a particular exercise. People with this inflammation usually feel pain during any stressful shoulder exercise —such as Bench Presses, Incline Presses, Behind-the-Neck Presses, Behind-the-Neck Pull downs, Pullovers, and Military Presses.

Upright Rows accelerate rotator cuff degeneration. If you do them, you risk developing chronic tendonitis or bursitis.

- Also see Rotator Cuff Tendinitis and What Goes Wrong with Your Rotator Cuff


Baechle, Thomas (1994).  Essentials of Strength Training and Conditioning.  Human Kinetics, Nebraska.

Horrigan, J., Robinson, J. (1991)  The 7-Minute Rotator Cuff Solution.  Health for Life, LA, CA.

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