What’s Your Push Pull Ratio? It may be the cause of your shoulder pain

Ever wonder why your shoulders are tight and always hurting even though your doctor says everything looks fine and you regularly train chest and shoulders? Heck, you even do exercises to stretch and strengthen your rotator cuff.  But it seems as though the more you try to get your shoulders strong and healthy, the tighter and more painful they become. What gives?

Let me tell you a little story about my friend Mike who also has this problem and also wonders, “What gives?”

A few weeks ago I was chatting with Mike who is preparing to compete with his basketball team in the 2017 Senior Olympics. Mike is 62 and in great shape. But like nearly everyone else over the age of 40 who likes to push their body, he has a few things that are bothering him.

I offered to take a look at his overall training program and see what changes he could make to reduce his risk of injury and step up his overall performance.

Mike’s chief complaint is tightness and pain in the front of his shoulder. It stops him from being able to do pull-ups and pressing overhead.  But first, I wanted to hear about his past and present injuries and surgeries to give me a better understanding of what movement issues he may have. To paraphrase Physical Therapist Gray Cook, “Past injuries are a great indicator of potential future injuries.” There’s also a herniated a disc in his lower back that he needs to be careful of, not to mention the bionic knee he had installed this past year.

The second thing I did with Mike, is audit his training program to see what he is and isn’t doing. I also wanted to see what he looks like when he does them. There were several interesting things that came up and I’d like to share all of them with you in the next few blog posts but, for today, we’ll focus on what I saw as a glaring, likely cause for the pain and tightness in his shoulder.

Just by looking at Mike standing I could see how his shoulders were pulled into a forward shoulder posture. Take a look below at these photos of me. The photo on the left shows a good balanced position. The photo on the right demonstrates forward shoulder posture. If you go ahead and imitate the photo on the left right now, you can feel how your pecs engage. And for people with this postural issue, it’s because their pecs don’t disengage.

 

Forward shoulder posture

If this is an issue you’d like to delve further into after this piece, I have a whole other post on forward shoulder posture.

Push pull ratio

Usually, the main cause for this type of dysfunctional posture is your push to pull ratio. Specifically, horizontal (forward and back) pushing and pulling, not vertical (up and down). 

The vast majority of people perform far more repetitions of pushing exercises compared to pulling exercises, causing a strength imbalance that pulls the head of their humerus forward. So I asked to see Mike’s training programs and sure enough, that was it. Big time.

The last program he did contained 7 different horizontal pushing exercises such as bench press, dumbbell flyes and incline press, for 4 sets each. That’s a total of 28 sets. Guess how many different horizontal pulling exercises he did…2. 4 sets of dumbbell rows and 4 sets of rear flyes for a total 8 sets.

28 pushing exercises vs. 8 pulling exercises is a 7:2 push/pull ratio.

But wait, it gets better. We then looked at his current program which is all body weight and done at home. It contained, among others, 10 sets of 10 push-ups and not a single pulling exercise. I think he does this about four times per week. That’s 400 push-ups each week and no pulling to balance it out.

Now Mike is a really smart, hard working guy. He didn’t just make shit up himself. Mike values expertise so he got this from another personal trainer online. And I’m not at all surprised by the trainers oversight. Most fitness professionals are so focused on making you sweaty and sore that they don’t even know whether the programs they give you are balanced.

Having an equal ratio of pushing and pulling isn’t even a truly balanced program. A good training program has you doing a 2:3 or a 1:2 ratio push/pull ratio.  And that’s because modern life throws us so out of balance before we even get to the gym.

We spend all day reaching forward doing chores, working on the computer, texting, grabbing a steering wheel… and how much pulling do we do? Starting the lawnmower? Heck, even then you pull the cord 2 or 3 times and push the mower for an hour!

No wonder why 4 of the top 25 orthopedic procedures involve the shoulder.

So what do you do about it? Well, the first thing you need to do is audit your training program. Hopefully you have a training journal to look at. If you don’t, I recommend you start one today. Having a record is extremely useful to refer to especially when “things don’t feel right”.

Look at all your pulling and pushing exercises throughout the entire week and multiply the sets by reps. What’s your ratio?

If your push/pull ratio is looking like Mike’s, start replacing some push exercises with pulling until the ratio is 2:3 or 1:2.

Some of my favorite pull exercises are; single arm dumbbell rows, cable rows, chest supported rows, rear dumbbell flyes, the batwing and facepulls.

 

The other important thing to do, is release trigger points and fascial restrictions in the chest and front of shoulders, followed by stretching the pecs and anterior deltoids like the ones pictured below. You can press a tennis ball into the tender spots on your chest or go see a good massage or structural therapist.

Release Tight Pecs with Tennis Ball

 

Pec Stretch

Of course there may be other things going on to cause your shoulder pain and you should look into them as well. But identifying and correcting an obvious training imbalance is a good place to start.

I’m curious…did you do the math to figure out your push pull ratio? What is it? Let me know by dropping the number in the comments box below.

4 comments

  • Jamie, have gotten lots from your videos, thanks!

    The biggest problem I find is that no health club I’ve seen has warm up abilities. No separate area or equipment like resistance bands, or lower weights, and no stretching class or leadership. Everything is geared towards machines and newer fancy equipment that looks cool. So after injuring my shoulders and ending up with frozen shoulder, I quit the “gym” and began a fitness class – one hour, 2 or 3 times a week. It has full body stretching and light strengthening, with aerobic and balance also included. I also briskly walk around the neighborhood 1 or 2 times a day. You might notice I dropped the word “senior” from the fitness class because active people of all ages need this, not everyone can or wants to use the high powered classes in health clubs that say, but really aren’t, for all levels of ability.

    Note I combine this class with home stretch exercises for frozen shoulder 2 to 3 times a day that I see plentiful on the internet. I first do 15 minutes of my class stretches to warm up. Some may want to start with PT for guidance on the exercises to start off, and from what I read the recommendation is, after a month, reduce PT to once a week or even once a month, depending.

    The fitness class first half hour is warm up stretches for all muscles that get progressively faster. Start with shoulder rolls and arm swings, bringing in marching in different directions while moving shoulders and arms in different patterns. The second half hour is repeating some – like bicep, triceps – with hand weights (2 to 5 lbs depending on your progress), then repeat with resistance bands controlling resistance as needed. Some of the hand weight exercises, where you press a weight upwards, includes lifting and lowering a leg, then holding to also strengthen your balance.

    I realize your audience seems to be large muscled men, and you use heavy weights, but some of us need guidance for full body stretching and lighter strengthening. Adding aerobics and balance makes it complete.

  • Thanks for this Jamie! Man – you got me here: I do 600 push-ups a week, 100 bench presses, planks – AND – I sit at a computer for 40+ hours a week! Obviously my push/pull ratio is WAY out of wack. And guess what – I suffer from upper back and shoulder tightness and discomfort – constantly. Gonna change the ratio! Thanks, MM

  • Mike,

    Wow, you certainly have a great work ethic! Now you can refocus it better. Thanks for sharing your numbers.

    Jamie

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