Pain guide · Shoulder pain

Shoulder pain when doing push-ups: the rotator cuff, the AC joint, hand position and what helps

Shoulder pain when you do push-ups (press-ups) is common, and where it hurts is the best clue. An ache at the front or outside of the shoulder at the bottom of the push-up usually comes from the rotator cuff (often called impingement); a tender spot in the groove at the front, from the biceps tendon; pain you can point to with one finger on top, at the end of the collarbone, from the AC joint (acromioclavicular joint); and deep pain at the back with a clunk, from the joint slipping backwards. Push-ups aren't bad for shoulders: National Health Service (NHS) physiotherapy programmes use them, at a wall, a table, on the knees and then on the floor.

This guide starts with the signs that need help today, from a 999 call for chest pain that feels tight or spreads to your arm, to accident and emergency (A&E) for a shoulder that looks out of place, and a same-day check through the NHS's 111 line (NHS 111) or a general practitioner (GP) for a pop with sudden weakness or pins and needles that don't go away. It then maps the causes by where it hurts, explains what the lab studies show about hand width, elbow angle and inclines and why a scan rarely helps at first, shows how to change your push-up today, and gives a three-stage plan with a 3D demo of every move, from wall push-ups back to the floor.

3-stage exercise plan When to get help 47 sourcesUpdated 28 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.
Call 999: shoulder or arm pain with chest pain that feels tight or squeezing, or chest pain that spreads to your arms, neck or jaw, especially with shortness of breath, sweating or feeling sick. It could be a heart attack.
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
Call 999: you suddenly can't fully lift both arms and keep them there, because of weakness or numbness in one arm, especially if one side of your face droops or you slur your words or sound confused. It could be a stroke. Call even if the signs have stopped.
Same day (GP or NHS 111): sudden weakness lifting the arm after an injury or fall. A rotator cuff tear caused by an injury needs urgent referral to a shoulder specialist. After a dislocation in anyone over 40, the rotator cuff should be checked: about 40% have a tear.
Same day (GP or NHS 111): a sudden pop or snap with pain at the shoulder or upper arm during a lift, with or without a bulge low in the upper arm. It's usually a torn long head of the biceps. Most need no operation, but the rotator cuff can tear at the same time.
Same day (NHS 111 or an urgent treatment centre): a pop or tearing at the front of the armpit or chest during a lift, a dip or a tackle, followed by bruising into the chest or upper arm, a change in the shape of the chest or armpit (a thinner or lost armpit fold, or a chest or nipple that looks uneven), or weakness pushing. Don't wait for it to settle: it can be a torn pec tendon, and repairs done within about 6 weeks did better than later ones.
Same day (GP or NHS 111): sudden or very bad shoulder pain; you cannot move your arm; the arm or shoulder is badly swollen or has changed shape; pins and needles that do not go away; no feeling in the arm; the arm is hot or cold to the touch; pain that started after an injury such as a fall; or severe pain in both shoulders.
Same day (GP or NHS 111): the shoulder or arm is hot, swollen or red, or you have a high temperature (although not everyone has one) or feel unwell. A joint infection needs same-day care.
Same day (call NHS 111, or go to A&E if you feel very unwell): after a big or unusual session, such as hundreds of pull-ups, push-ups, dips or curls, a challenge or a new class, muscle pain, swelling or weakness far worse than the session explains, and dark pee (red, brown, tea or cola coloured), sometimes starting hours or days later. Dark pee isn't always there, so muscles far sorer, more swollen or weaker than the session explains still need the same-day check. It can be rhabdomyolysis, a breakdown of muscle that can harm the kidneys.

See a doctor or physiotherapist if

Pain that is getting worse or has not improved after 2 weeks of looking after it yourself, or it is very hard to move your arm. In many areas you can refer yourself to physiotherapy.
Your shoulder has partly or fully come out of joint, or you worry it might, including a clunk or a feeling it will slip at the bottom of a push-up.
Pins and needles or a cold arm alongside neck pain, or a new loss of strength or feeling in the arm that you cannot explain (a possible nerve problem).
Pain on top of the shoulder at the end of the collarbone that isn't settling after a few weeks of changed pressing: ask about weightlifter's shoulder (distal clavicle osteolysis), which often needs an MRI (magnetic resonance imaging) scan to confirm.
Painful clicking or snapping at the front of the shoulder, or a feeling of something slipping there. The tendon can slip out of its groove, usually alongside a rotator cuff tear, so ask for an assessment.
A shoulder blade that suddenly sticks out, or new weakness lifting, pushing or carrying: see a GP. Nerve tests may be needed to find which nerve is affected and how badly.
A past history of cancer, an unexplained lump or swelling, weight loss, or pain that is constant and does not ease when you change position.
See a GP if you have pain and stiffness for more than a week, especially if you're over 50, it's in both shoulders (often the neck and hips too) and the stiffness lasts longer than 45 minutes in the morning. It can be polymyalgia rheumatica.
Pain with push-ups and lifting your arm that hasn't improved after about 12 weeks of exercise and changed training: ask your GP or physiotherapist about a specialist review. Surgery is rarely the answer, but a review can rule other things out.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

The front or outside of the shoulder and upper arm, worse at the bottom of the push-up, lifting the arm out to the side or overhead, and lying on it

Usually rotator cuff related pain, often called impingement: the commonest cause.

Read: Shoulder impingement (rotator cuff pain) →A tender spot in the groove at the front of the shoulder, sometimes with a snap, worse reaching back for a seatbelt or a coat

Often the long head of the biceps tendon, usually alongside the rotator cuff.

Read: Biceps tendinitis (shoulder) →On top, one finger on the end of the collarbone, worse deep in the push-up, in dips and reaching across your body

The AC joint, including weightlifter's shoulder if you press heavy and often.

Read: AC joint injury and pain →Deep at the back of the shoulder, vague, with push-ups and the bench press, sometimes a clunk or a feeling of slipping backwards

Possibly the joint slipping backwards (posterior instability). Our back of shoulder pain guide maps the back of the shoulder.

Read: Back of shoulder pain →Deep at the front with a clunk, a dead arm or a feeling it will come out, especially after a past dislocation or with very flexible joints

Possibly a loose shoulder (instability).

Read: Shoulder dislocation and instability →Painful clicking or catching deep in the shoulder in someone who also lifts overhead or throws

Sometimes the labrum (the rim of the socket), though labral changes are common on scans of shoulders that don't hurt.

Read: SLAP tear →A pop or tearing at the front of the armpit or chest, then bruising or a changed armpit fold

Possibly a torn pec: get it checked the same day, as the warning signs say.

Read: Pec strain or tear →Sudden weakness lifting the arm after a fall or a jerk

Possibly a rotator cuff tear: get it checked the same day.

Read: Rotator cuff tear →The shoulder blade sticks out as you lower or push

A weak serratus anterior (the muscle that holds the shoulder blade to the ribs) or, less often, a nerve problem.

Read: Winged scapula →From the neck down the arm, with pins and needles, numbness or burning

A nerve in the neck.

Read: Pinched nerve in the neck →An ache in the worked muscles the day after a big push-up session, gone within a week

Muscle soreness. Muscles far sorer, more swollen or weaker than the session explains, especially with dark pee, need a same-day check.

Read: Shoulder pain after a workout →Pain mainly on the bench press or dips

Our bench press guide covers grip, range and bar path.

Read: Shoulder pain when benching →The wrist rather than the shoulder

A bent-back wrist under your body weight.

Read: Wrist pain in push-ups and yoga →

Chest pain that feels tight or spreads to an arm, the neck or jaw, or arm or chest discomfort that comes on with effort and eases with rest

Possibly the heart: see the warning signs.

Understand it

What a push-up asks of the shoulder, and how common the pain isEmerging evidence

A push-up lowers your body between your hands, so at the bottom the arms are behind your body and the shoulder carries about two-thirds of your weight: about 64% of body weight was on the hands in a floor push-up in a lab study of 23 young adults, and about 66% in another of 8 men. Most shoulder pain in adults comes from the rotator cuff and the tissues around it: GRASP, a large UK trial, reports rotator cuff disorders as the cause in about 70% of people.

In people who lift, the shoulder is one of the commonest places to get hurt: up to 36% of resistance-training injuries in one review, and the commonest site (7.4% in 6 months) in a survey of 393 gym members. No study counts how often push-ups themselves cause shoulder pain, or measures the force on the shoulder joint during one, so the map on this page comes from what each condition is known to do.

Sources 1, 2, 3, 4, 5, 6, 7

Where it hurts sorts the causesEmerging evidence

Rotator cuff related pain is the commonest: the NHS describes "pain at the top and the outside of your shoulder", worse when you lift your arm, and a UK care pathway calls it a clinical diagnosis. Pain or tenderness in the groove at the front, sometimes with an occasional snap, points to the long head of the biceps; clinical tests for it are poor, and an ultrasound scan is more reliable.

Pain on top, where the collarbone meets the shoulder, is the AC joint. In people who press a lot, it can be weightlifter's shoulder (distal clavicle osteolysis), a stress reaction at the end of the collarbone: bench pressing was the activity in 49.1% of 483 published cases. Deep, vague pain at the back can be the joint slipping backwards: a review says "The contact athlete will often complain of pain with push-ups and bench press", though this is only 2% to 5% of shoulder instability.

Sources 8, 9, 10, 11, 12, 13, 14, 15, 16

"It only hurts at the bottom"Emerging evidence

The bottom is where the arms are furthest behind the body, the shoulder blade has to tilt and turn the most, and the hands carry the most weight; in 28 strength-trained men, less weight was on the hands at the top than the bottom. That is where rotator cuff, biceps and AC joint pain usually show first (our reading). No study has measured the forces in the shoulder joint at the bottom of a push-up; the nearest is a computer model of the bench press, in which wide grips raised the load on the shoulder joint and the AC joint.

Sources 17, 18, 19

What a scan shows, and what it doesn'tStrong evidence

Scans find a lot in shoulders that don't hurt: rotator cuff tears in 34% of 96 people on MRI (magnetic resonance imaging), more with age; AC joint arthritis in 48% to 95%; and labral tears read in 55% to 72% of people aged 45 to 60. A UK care pathway says subacromial pain "is a clinical diagnosis" and imaging "is not essential to confirm the diagnosis or start treatment".

A scan helps after an injury (a suspected dislocation is X-rayed), for a shoulder that slips that isn't settling (an MRI or an MRI with dye in the joint), and for pain on top of the shoulder in a lifter that isn't settling after changed training. The pathway refers pain that hasn't improved after 12 weeks of non-surgical care to a specialist.

Sources 9, 20, 21, 22, 23, 24, 15, 13

How it usually goesEmerging evidence

In 349 people with new shoulder pain in Dutch general practice, 23% had recovered at 1 month and 59% at 12 months; recovery was quicker after overuse or a slight injury and slower with neck pain or severe daytime pain. A UK pathway says most subacromial pain responds within three months, and in the GRASP trial every group improved a lot over a year. The NHS says shoulder pain can take 6 months or longer to recover, and NHS inform expects new pain to begin to settle within 6 weeks. No one can promise a date.

Sources 25, 9, 5, 12, 26

What helps, and how strong the evidence is

Exercise is the treatment, and simple programmes do as well as long onesStrong evidence

In GRASP (708 adults with rotator cuff pain in the UK), one session of physiotherapy advice with a home exercise programme did as well over a year as up to six sessions of progressive exercise, and a steroid injection helped only at 8 weeks. In 102 people waiting for surgery, specific rotator cuff and shoulder-blade exercises gave a successful result in 69% against 24% with general exercise, and fewer chose surgery (20% against 63%). A single self-managed exercise did as well as usual physiotherapy in 86 people.

Surgery to make room for the tendon did no better than a placebo operation in 313 people, and a UK pathway says one steroid injection "can be considered" if there's no improvement by 6 to 8 weeks. These trials were in adults with shoulder pain, not people whose pain came from push-ups.

Sources 5, 27, 28, 29, 9

Inclines and knee push-ups take weight off the handsEmerging evidence

In a lab study of 23 young adults, the share of body weight on the hands was about 74% with the feet on a 61 cm box, 70% with the feet on a 30 cm box, 64% on the floor, 55% with the hands on a 30 cm box, 49% from the knees and 41% with the hands on a 61 cm box. In 8 men, about 66% was on the hands on the floor and 53% from the knees. These are healthy people in a lab, but they show why the wall, a worktop and the knees are steps back to the floor.

Sources 6, 30, 7

Hand width and elbow angle: lab studies, not trialsMixed evidence

In 16 healthy people, push-ups with the arms held out wide (about 65 degrees from the body, against about 54 when people chose and 36 at the sides) changed how the shoulder blade moved in a way the authors linked with impingement. Narrow hands work the chest and triceps harder and load the elbows more; wide hands work the serratus anterior more. In a computer model of the bench press, very tucked elbows (45 degrees) raised an upward shearing force in the shoulder joint, and in 14 men, push-up handles that keep the wrist straight put more load through the shoulder.

None of these studies measured pain, and no push-up study has tested the common 45-degree cue. An NHS trust's shoulder class teaches hands "a little wider than shoulder width", "slightly turned out" and "elbows tucked in", without a number.

Sources 18, 31, 32, 33, 19, 34, 35

The push-up plus works the shoulder blade muscle hardestEmerging evidence

The push-up plus, an extra push at the top that spreads the shoulder blades, gave among the highest serratus anterior activity of common exercises in studies of 30 and 20 people, and a review of 30 studies agrees; incline push-ups demand the least overall. Whether training the shoulder blade adds much is less clear: scapula-focused approaches helped disability more at 6 weeks but not at 3 months (4 trials, 190 people), and added a small pain benefit to usual physiotherapy (8 trials, 387 people).

Sources 36, 37, 38, 39, 40

Push-ups build strength like the bench pressEmerging evidence

In 30 trained students, band-resisted push-ups and the bench press at matched effort gave similar strength gains over 5 weeks, and in 18 men, push-ups adjusted to a light load matched a light bench press over 8 weeks. Both trials were small and short, and neither measured shoulder loads or pain.

Sources 41, 42

Pain on top of the shoulder in people who press a lotEmerging evidence

In a 2026 review of 8 studies (483 people), most weightlifter's shoulder improved with rest and changed training, and about 14% to 16% had the end of the collarbone removed after about 3 months of other care hadn't worked. For AC joint arthritis, an injection eased pain by about half at a mean of 7.5 months in a review of mostly uncontrolled studies. The cross-body test finds most AC joint problems (77% in 35 people), but a positive test is often wrong.

Sources 13, 43, 14

How much pain is OK while you exercise?

Up to 5 out of 10, back to normal by the next morningEmerging evidence

This guide uses the shoulder hub's rule, from the Holmgren trial: pain up to 5 out of 10 during the exercises is acceptable, and some pain is expected; any increase should settle back to where it was before the next session, or the load comes down. NHS inform's shoulder exercises use the same band (0 to 3 minimal, 4 to 5 acceptable, 6 to 10 excessive), and your pain should be no worse the morning after. An NHS trust's shoulder class says a small amount of pain is fine if it eases within 30 minutes and is no worse the next day. In long-lasting pain, exercise that allowed some pain did no worse than pain-free exercise.

For push-ups (our suggestion, built on the same rule): use the step of the ladder (wall, worktop, bench, knees, floor) where the last reps stay at 5 out of 10 or less and the shoulder is back to normal by the next morning; if it isn't, go back one step, not to nothing. With a shoulder that slips, stop at any feeling of slipping. A pop, sudden weakness, a changed shape, chest pain, or pins and needles that don't go away aren't pain-rule questions: see the warning signs.

Sources 27, 44, 35, 45

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Keep pushing, change the push-up

About the first 2 weeks, at least 4 days a week: push-ups at a wall and then a worktop, a shorter range and comfortable hand and elbow positions (the written steps below), with the rotator cuff and shoulder blade working. No floor push-ups to failure for now. With a diagnosed tear, dislocation or weightlifter's shoulder, that guide's plan comes first; after surgery, your surgical team's plan does.

Wall push-up demonstrated on the 3D figure

3D demoWall push-upBeginner · A wall

8 to 15, 3 sets, starting at the low end · NHS Ayrshire and Arran's wall press-up dose. Hands a little wider than your shoulders, slightly turned out, elbows tucked in, as an NHS trust's shoulder class teaches

Harder: Push-up

Scapular push-up (push-up plus) demonstrated on the 3D figure

3D demoScapular push-up (push-up plus)Beginner · No equipment

2 to 3 sets of 10, at a wall first · As in our shoulder pain guide (editorial). The push-up plus works the serratus anterior; the wall version is the gentlest start

Easier: Dumbbell shoulder-blade punch · Harder: Push-up

Standing band external rotation demonstrated on the 3D figure

3D demoStanding band external rotationBeginner · A band + An anchor point

3 sets of 10 to 15, light band, elbow at your side, once or twice a day · The SELF trial's dose for its loaded exercise; the Holmgren trial used 3 sets of 15 twice a day

Easier: Stick-assisted external rotation (lying) · Harder: Side-lying external rotation

3D demoBand rowBeginner · A band + An anchor point

3 sets of 10 to 15, stopping 2 to 3 reps short of failure · The move page's dose, an editorial starting point

Harder: Supported single-arm dumbbell row

Incline push-up demonstrated on the 3D figure

3D demoIncline push-upBeginner · A bench or box

8 to 15, 3 sets, hands on a worktop or table, a short range at first · NHS Ayrshire and Arran's next step after the wall. Check the surface can't slide, as the move page says

Easier: Wall push-up · Harder: Push-up

Move on when: 3 sets of 15 at the worktop stay within the pain rule, and the shoulder is no worse the next morning (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build the rotator cuff and the shoulder blade, and lower the incline

About weeks 2 to 6, 3 to 5 days a week: stronger outward rotators and shoulder-blade muscles, and push-ups on a lower surface, a notch at a time.

3D demoIncline push-upBeginner · A bench or box

3 sets of 8, 30 s rest, on a table or bench; lower the surface a notch when every set reaches 15 · An NHS trust's table push-up dose; moving down when every set reaches 15 is our push-up guide's rule (editorial)

Easier: Wall push-up · Harder: Push-up

Side-lying external rotation demonstrated on the 3D figure

3D demoSide-lying external rotationBeginner · A dumbbell

3 sets of 15, once a day, lowering over about 3 s · The Holmgren trial's sets and reps, once a day as in its last month; as in our bench press guide

Easier: Standing band external rotation · Harder: Cuban rotation

Scaption raise demonstrated on the 3D figure

3D demoScaption raiseBeginner · A dumbbell

3 sets of 10 to 15, thumbs up, to shoulder height · The SELF trial's dose; as in our shoulder pain guide

Easier: Band lateral raise · Harder: Smith machine upright row

Prone Y-T-W raises demonstrated on the 3D figure

3D demoProne Y-T-W raisesBeginner · No equipment

2 rounds of 8 of each shape · As in our shoulder pain guide (editorial). Keep your neck long, as the move page says

Easier: Wall angel · Harder: Bent-over reverse fly

3D demoScapular push-up (push-up plus)Beginner · No equipment

3 sets of 10, on your knees, then the floor · As in our winged scapula guide (editorial). The floor push-up plus gives among the highest serratus activity

Easier: Dumbbell shoulder-blade punch · Harder: Push-up

Dumbbell floor press demonstrated on the 3D figure

3D demoDumbbell floor pressIntermediate · A dumbbell

2 to 3 sets of 8 to 12, stopping with 2 or 3 reps in reserve · The move page's dose, an editorial starting point. Optional, if you lift: the floor stops your elbows, which limits the bottom position

Easier: Chest press machine · Harder: Bench press with chains

Move on when: Incline push-ups at about knee height pass the pain rule for 3 sets of 12 to 15, and side-lying outward rotation is comfortable with a heavier weight (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Back to the floor, and to your usual training

From about week 6, 2 or 3 push-up sessions a week: knee push-ups, then full push-ups, through a range that grows over the weeks, with the harder versions last, one at a time. No study has tested a return-to-push-ups schedule, so this is editorial.

Knee push-up demonstrated on the 3D figure

3D demoKnee push-upBeginner · No equipment

8 to 15, 3 sets · NHS Ayrshire and Arran's press-ups on the knees, which it progresses "by moving to a full press up". Pad your knees, as the move page says

Easier: Incline push-up · Harder: Push-up

3D demoPush-upIntermediate · No equipment

3 sets at the hardest step you can do for 8 clean reps; move up when every set reaches 15 · Our push-up guide's ladder rule (editorial). Lower only as far as is comfortable at first, a notch deeper each week

Easier: Wall push-up · Harder: Close-grip push-up (close triceps position)

Straight-arm plank (high plank) demonstrated on the 3D figure

3D demoStraight-arm plank (high plank)Intermediate · No equipment

3 holds of 15 to 30 s · The move page's dose. Use a bench under your hands if the shoulder complains, as the move page says

Easier: Knee hover (Pilates tabletop hover) · Harder: Leg pull front (Pilates leg pull down)

Bear crawl demonstrated on the 3D figure

3D demoBear crawlIntermediate · No equipment

4 crawls of 8 to 10 m · The move page's dose. Try it with your hands raised, or leave it out, if the shoulder complains, as the move page says

Easier: Knee hover (Pilates tabletop hover) · Harder: Spider crawl (low push-up knee drive)

3D demoStanding band external rotationBeginner · A band + An anchor point

2 to 3 sets of 15, twice a week, kept going · Editorial: the trials' rotator cuff work, kept as a habit

Easier: Stick-assisted external rotation (lying) · Harder: Side-lying external rotation

Feet-elevated push-up demonstrated on the 3D figure

3D demoFeet-elevated push-upAdvanced · A bench or box

3 sets of 6 to 10, last and optional · Editorial. Raising the feet puts about 70% to 74% of your weight on your hands; leave it out while blood pressure isn't controlled, as the move page says

Easier: Push-up · Harder: One-arm push-up

Move on when: Full push-ups pass the pain rule for 2 weeks: then add one harder version at a time (diamond, decline, archer, clap), and build any push-up challenge up over weeks rather than starting at its top number (editorial). Keep the outward rotation and rows twice a week. If the bench press is your goal, our bench press guide's stages take over.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Your push-up for now (written steps)

Our 3D figure can't show all of these. They come from NHS trust programmes, NHS pages and lab studies; where a step is our suggestion, it says so. No trial has tested a change to the push-up for shoulder pain.

1. Take weight off your hands: a wall, then a worktop or table, then your knees, then the floor, as NHS Ayrshire and Arran's programme does. Hands on a 61 cm box carried about 41% of body weight, against 64% on the floor.
2. Hands a little wider than your shoulders and slightly turned out (an NHS trust's shoulder class).
3. Elbows angled back, not flared straight out to the sides; the NHS trust booklet says "elbows tucked in". Pick a comfortable angle between your sides and about halfway out (our suggestion; arms held out wide changed shoulder-blade movement in a lab study).
4. A shorter range at first: stop above the point that hurts, and go a notch deeper each week (our suggestion).
5. Finish each rep with a small extra push that spreads your shoulder blades (the push-up plus), and "make sure you are drawing your shoulders away from your ears" as you come up (NHS Ayrshire and Arran).
6. Fewer, easier sets: stop 2 or 3 reps short of failure, with no maximum tests or push-up challenges for now (our suggestion). The NHS says don't make up your own strenuous exercises while your shoulder hurts, and in rare cases an extreme session breaks down muscle: 119 students developed muscle pain and dark urine within days of 120 push-ups in 5 minutes.
7. Push-up handles or fists only if your wrists need them: they put more load through the shoulder in one small lab study.
8. Keep using your arm for everyday jobs: the NHS says don't completely stop using your shoulder, and NHS inform says use it more after the first 48 hours.

Sources 46, 35, 6, 18, 36, 12, 47, 34, 26

Dips, the bench and the gym

Leave dips, deep or wide bench pressing and chest flys out while it's sore; our bench press guide covers how they come back. The NHS impingement page says don't carry on with the activities that caused your pain, which is why the push-up changes above make it lighter and shorter, within the pain rule, rather than carrying on as before.

Sources 8, 12

Positions to swap, and why

Habit or position	Why it matters	Instead
Floor push-ups through pain	A floor push-up puts about two-thirds of your weight through your hands and shoulders.	Wall or worktop push-ups first.Try: Wall push-up
Elbows flared straight out to the sides	Arms held out wide changed shoulder-blade movement in a way linked with impingement in a lab study.	Elbows angled back, at a comfortable angle, on an incline.Try: Incline push-up
Hands together (diamond push-ups) while it's sore	Hands together load the elbows more, and the move page says skip it if it pinches the front of the shoulder.	Hands a little wider than your shoulders.Try: Knee push-up
Going to the very bottom while it hurts	The bottom carries the most weight and asks the most of the shoulder blade (our reading).	A shorter range, a notch deeper each week.
Sets to failure, daily maximums and push-up challenges	The NHS warns against strenuous self-made exercise while your shoulder hurts, and in rare cases an extreme session can break down muscle (rhabdomyolysis).	Stop 2 or 3 reps short, 2 to 4 sessions a week.
Clap and other plyometric push-ups	The catch "spikes load through the wrists, elbows and shoulders", as the move page says.	Bring them back last, after full push-ups pass the pain rule.Try: Push-up
Dips while it's sore	Going deeper than upper arms parallel loads the front of the shoulder heavily, as the move page says.	Incline push-ups.Try: Incline push-up
The cross-body stretch with pain on top of the shoulder	It presses on the AC joint, as the move page says.	Turning the arm out against a band.Try: Standing band external rotation
Resting the arm completely	The NHS says this can stop the shoulder getting better.	The stage 1 moves and everyday use.Try: Wall push-up
Pushing through a clunk or a feeling of slipping	It can be a sign the shoulder is loose, which needs checking.	Stop that movement and get it assessed.

Routines to follow

Push-up progression workout

Work up to full push-ups: wall, incline and knee push-ups, then the floor push-up and harder variations.

15 minBeginner8 movesA wall, A bench or box

Shoulder mobility and rotator cuff routine (with a band)

A 25-minute band routine for healthy shoulders: move the shoulder and upper back through their range, then strengthen the rotator cuff and shoulder blades.

25 minBeginner12 movesA wall, A band

Upper back mobility routine

A 12-minute routine for a stiff upper back and rounded shoulders: chin tucks, wall angels, Y-T-W raises and open books.

12 minBeginner8 movesA foam roller, A wall

Push-up challenge workout

A 15-minute push-up ladder for the 30-day push-up challenge: wrist prep, wall to knee push-ups or floor to archer push-ups, and band rows to balance it.

15 minBeginner11 movesA wall, A bench or box

More moves for this area

Questions people ask

Why does my shoulder hurt when I do push-ups?

At the bottom of a push-up your arms are behind your body and your shoulders carry about two-thirds of your weight, so a sore rotator cuff, biceps tendon or AC joint shows up there first. Where it hurts is the best clue: the front or outside points to the rotator cuff, a spot in the groove at the front to the biceps tendon, and the top at the end of the collarbone to the AC joint.

Why does the front of my shoulder hurt during push-ups?

Usually rotator cuff related pain or the biceps tendon, often both. A pop at the front of the armpit with bruising is different: it can be a torn pec and needs checking the same day.

Are push-ups bad for your shoulders?

No. NHS physiotherapy programmes for painful shoulders include wall, table, knee and full press-ups, and the push-up plus strengthens the muscle that holds the shoulder blade to the ribs. Too much too soon is the usual problem, not the exercise.

Should I stop doing push-ups if my shoulder hurts?

Change them rather than stop: put your hands on a wall or worktop, shorten the range and do fewer sets, keeping pain at 5 out of 10 or less and no worse the next morning. The NHS says stopping using a painful shoulder completely can stop it getting better.

How should I place my hands and elbows?

Hands a little wider than your shoulders and slightly turned out, and elbows angled back rather than flared straight out to the sides, as an NHS trust's shoulder class teaches. No study has found one best angle for a sore shoulder, so use whatever is comfortable between your sides and about halfway out.

Why does my shoulder only hurt at the bottom of a push-up?

That's where your hands carry the most weight and your shoulder blade has to move the most. Stop a little above that point for now and go a notch deeper each week. Pain on top of the shoulder at the bottom often comes from the AC joint.

Is it my rotator cuff?

If it aches at the front or outside of the shoulder and upper arm, at the bottom of the push-up and when you lift your arm out to the side, it often is, and exercise is the main treatment. Sudden weakness lifting the arm after a fall or a jerk needs a same-day check.

My shoulder clicks when I do push-ups. Is that a problem?

Painless clicks are common and usually nothing to worry about. A click with pain, a clunk, a feeling the shoulder will slip, or a numb or weak arm needs checking.

Are incline or knee push-ups easier on the shoulder?

Yes: in a lab study, hands on a 61 cm box carried about 41% of body weight, a knee push-up about 49% and a floor push-up about 64%. NHS programmes use them as steps back to full press-ups.

Do I need a scan?

Not at first: a UK care pathway says the diagnosis is clinical, and scans show rotator cuff tears in about a third of shoulders that don't hurt. A scan matters after an injury, for a shoulder that slips, or for pain that isn't settling after about 12 weeks.

How long until I can do push-ups normally again?

No one can promise a date. In general practice, 59% of people with new shoulder pain had recovered at 12 months, and a UK pathway says most respond within three months. Many people keep doing changed push-ups throughout.

When should I see a doctor?

Go to A&E for a shoulder that looks out of place after a fall, call 999 for chest pain that feels tight or spreads to your arm, neck or jaw, and get a same-day check for a pop with sudden weakness or pins and needles that don't go away. See a GP or physiotherapist if it's no better after 2 weeks. In the US, call 911 where this page says 999.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.