Never lift weights over your head!

GiddyupTim

I play tennis with a guy who says that his doctor, and his sister who is a physical therapist, tell him that one should never do weight training where you lift the weight above your head. They say the shoulder isn't built for that and it is a recipe for disaster!
I am a bit skeptical.
I am of the belief that medical professionals get somewhat skewed ideas about the safety of certain activities because they only see people who are injured. That is, they see two violinists with carpal tunnel (or TMJ or whatever) they come to the conclusion that violin is extremely dangerous, since they have never seen a tuba player with it and they have never had a violinist make an appointment to come in because their wrist is fine.
Anyway, point is, does anyone know of any objective evidence that supports this shoulder advice?
Do weight lifters injure their shoulders at a high rate when they do push presses? Or handstand push-ups? Or snatches?
Is there any evidence that the kind of shoulder injuries you get lifting are likely to create chronic shoulder problems?
The only true objective information that I can find on this says:
1) Weight lifters do get injured; it is a physical activity, after all. But the rate of injury in weight lifting -- both Olympic lifting and powerlifting -- is less than track and field, less than any contact sport. A violent activity, such as throwing is more likely to cause serious, permanent damage to a shoulder, knee, whatever, than pushing a heavy object.
2) A few retrospective studies -- studies where they ask participants to recall their injury history -- suggest that weight lifters most frequently hurt their shoulders, lower back and knees when they get hurt. One study found that powerlifters more frequently hurt their shoulders than their lower back or knees, but that was not the case with Olympic lifters, which seems counter-intuitive if lifting overhead is a problem, since Olympic lifters do nothing but lift over their head. (https://bjsm.bmj.com/content/51/4/211)
3) Only one study I can find compared shoulders in lifters and non-lifters. This study found that recreational weight lifters did indeed have more shoulder injury and pain than non-lifters, but that is a little bit unimpressive because, of course, if you use your shoulder a lot in a demanding activity you are more likely to get a shoulder injury than someone who does not. Of note, this study found that there were two particular lifts that appeared to be associated with shoulder pain and shoulder impingement: upright rows and lateral deltoid raises. Without those, the rate of injury/pain wasn't much different. In addition, one type of exercise was associated with less injury, external rotator strengthening. (https://www.ncbi.nlm.nih.gov/pubmed/24077379)
Can anyone tell me, am I missing something here? Is there a huge database that says that Olympic lifters end up trashing their shoulders after 5-10 years? Or something like that?

FireOpalCO

I wonder if they are mixing up weight training and OSHA?

In OSHA training it's drilled into people to never lift things above their heads (and never store heavy items above eye level). Instead get a step-stool and pull the item into your chest. The risk is the movement of trying to pull a heavy item down from a shelf or push it up onto a shelf (losing control of the lift and injuring your shoulder/back, or foot if you drop it). Heaviest items on the lowest shelves also improves the stability of shelving units.

GiddyupTim

I don't think so. I have heard this from three different people -- this being: My doctor told me to stop doing shoulder exercises where you lift above your head, like shoulder presses. The shoulder is not built for that kind of activity and you will run into "trouble," though trouble isn't really defined. Impingement? That's most likely what they mean. Rotator cuff tears? Impingement can make a person susceptible to a rotator cuff tear, but most rotator cuff tears happen from throwing and swinging activities, or falling on it, as far as I understand.

It just reminds me of the old "never let your knees go past your toes when you squat" advice, and how often I have heard someone say: "My orthopedist says people who are over 50/60 shouldn't run anymore because it is too hard on the knees."
Evidence suggests neither of those things appear to be true. On the contrary, squatting makes your knees strong. Running -- okay, maybe some people cannot -- but in general being active keeps joints more healthy.

There must be a source for this idea. I am wondering what it is. Then we could debate.

kimny72

Honestly, I've never heard that. I'd discount the generic doctor, unless he's an orthopedist or something similar, as medical doctors who don't specialize in this specific area probably don't have much training in it at all. The physical therapist though is a different story. I'd be interested in other folks responses!

aokoye

GiddyupTim wrote: »

I don't think so. I have heard this from three different people -- this being: My doctor told me to stop doing shoulder exercises where you lift above your head, like shoulder presses. The shoulder is not built for that kind of activity and you will run into "trouble," though trouble isn't really defined. Impingement? That's most likely what they mean. Rotator cuff tears? Impingement can make a person susceptible to a rotator cuff tear, but most rotator cuff tears happen from throwing and swinging activities, or falling on it, as far as I understand.

It just reminds me of the old "never let your knees go past your toes when you squat" advice, and how often I have heard someone say: "My orthopedist says people who are over 50/60 shouldn't run anymore because it is too hard on the knees."
Evidence suggests neither of those things appear to be true. On the contrary, squatting makes your knees strong. Running -- okay, maybe some people cannot -- but in general being active keeps joints more healthy.

There must be a source for this idea. I am wondering what it is. Then we could debate.

It sounds like you need to find people who specialize in sports medicine/working with athletes.

CSARdiver

GiddyupTim wrote: »

I don't think so. I have heard this from three different people -- this being: My doctor told me to stop doing shoulder exercises where you lift above your head, like shoulder presses. The shoulder is not built for that kind of activity and you will run into "trouble," though trouble isn't really defined. Impingement? That's most likely what they mean. Rotator cuff tears? Impingement can make a person susceptible to a rotator cuff tear, but most rotator cuff tears happen from throwing and swinging activities, or falling on it, as far as I understand.

It just reminds me of the old "never let your knees go past your toes when you squat" advice, and how often I have heard someone say: "My orthopedist says people who are over 50/60 shouldn't run anymore because it is too hard on the knees."
Evidence suggests neither of those things appear to be true. On the contrary, squatting makes your knees strong. Running -- okay, maybe some people cannot -- but in general being active keeps joints more healthy.

There must be a source for this idea. I am wondering what it is. Then we could debate.

I doubt there is a source. Medicine is not science and finds its roots within engineering. So much of medicine tribal knowledge with little to no evidence to base the process upon.

lorrpb

A friend who is a trainer has mentioned this to me. I didn't quiz her on the source.

mackfoo

Don't tell Crossfitters. Clean and Jerks are pretty standard.

Just spent lunch doing Turkish Getups

GiddyupTim

lorrpb: You gotta quiz her!

BrianKMcFalls

Oh, it's a thing, not an idea based on any evidence, but it's something lots of educated people believe.

Here's a quick video of how pressing (properly) is actually good for the shoulder. https://youtu.be/5cnyRkZTtoM

MikePTY

I find that with both fitness and weight loss in general, there are a lot of "things people say" that don't really have any basis in fact or reality.

Bronty3

The skeletal elements that make up the shoulder are they way that they are so that we can lift over our head or move like that so I don't know why anyone would say this.

rileyes

mackfoo wrote: »

Don't tell Crossfitters. Clean and Jerks are pretty standard.

Just spent lunch doing Turkish Getups

TGUs are single-arm lifts. Your alignment can adjust for the lift unlike the OHP. Learning proper alignment for a tennis serve prevented impingement for me.

I lift as heavy as I can overhead with proper form. It doesn’t hurt at all. I wonder if there is wear over time like McGill pointed out with the sit-up. Maybe the doctors over at BarbellMedicine.com can offer insight into the overhead press.

JAYxMSxPES

18-months of Exercise Science program, never heard this. The closest that I've ever heard something like this are from Strength & Condition coaches (e.g. Eric Cressey) who prefer to not prescribe overhead pressing for pitchers or throwing athletes because for some it affect their overall shoulder health when combined with their sport. Honestly, things like a close-grip upright row and certain types of dips are worse for your shoulders than overhead pressing. I would prescribe a military press long before a close-grip upright row.

lorrpb

Here is the line of thought from one source.
https://www.ironmanmagazine.com/the-case-against-overhead-presses/

maverick4x4

My surgeon says as long as you can see your hands, it's ok. I have a left side SLAP tear (since '09), no more overhead squats for me. I didn't tear it lifting weights. (for the record, I did overhead presses and squats for 24 years with no injuries before I tore it in an unrelated activity...and actually, I believe the injury occured because my shoulders were weaker at the time due to time off for tendonitis in the other shoulder due to another non-weight training activity)

RealWorldStrengthLLC

Zydrunas Savickas says otherwise.

I'm listening to the guy who can put more weight over his head than I can deadlift currently, and my deadlift isn't exactly weak.

Azdak

I think a lot of these caveats come from overgeneralizing and overstating some common concerns.

A large number of people—perhaps even a majority—have pretty crappy mechanics when it comes to shoulder movements, scapular stabilization, etc. If they cannot learn to move properly, then, yeah, I would say that those people should not be doing overhead lifts.

But if you can control your scapula and not arch the back when pressing overhead, then you should be fine.

While I wouldn’t put overhead lifts into the “never” category, I wouldn’t say there is a compelling reason to do them either.

SCoil123

I have chronic tendinitis and joint stability issues with my right shoulder. PT never told me I can’t overhead press. I have been told to focus on form over adding weight - but that should be the case with any lift. Honestly upright row and bench irritate my shoulder more so my weight progression is slower with those lifts

RealWorldStrengthLLC

SCoil123 wrote: »

I have chronic tendinitis and joint stability issues with my right shoulder. PT never told me I can’t overhead press. I have been told to focus on form over adding weight - but that should be the case with any lift. Honestly upright row and bench irritate my shoulder more so my weight progression is slower with those lifts

@SCoil123 the arching the back thing is something I'm having an issue with - I'm teaching a friend how to lift, and this is something he does on standing barbell OHP - he's not using much weight right now, about 65lbs, but I have been trying to correct his form on this and he keeps *kitten* doing it. Any tips on how to teach this? I know he can learn, his deadlift and squat form are actually really good now and I've only been teaching him a couple of weeks.

comptonelizabeth

Azdak wrote: »

I think a lot of these caveats come from overgeneralizing and overstating some common concerns.

A large number of people—perhaps even a majority—have pretty crappy mechanics when it comes to shoulder movements, scapular stabilization, etc. If they cannot learn to move properly, then, yeah, I would say that those people should not be doing overhead lifts.

But if you can control your scapula and not arch the back when pressing overhead, then you should be fine.

While I wouldn’t put overhead lifts into the “never” category, I wouldn’t say there is a compelling reason to do them either.

This! I'm currently seeing a physiotherapist because of lower back issues and have had to stop my lifting program. I'd assumed it was things like deadlifts were the cause but, having looked at my form, she told me I arch my back when doing ohps. Apparently a common thing in people whose shoulders are not stable - the back arches to compensate. However, she didnt tell me I should stop doing them forever, just that I need to work on strengthening my shoulders

SCoil123

youcantflexcardio wrote: »

SCoil123 wrote: »

I have chronic tendinitis and joint stability issues with my right shoulder. PT never told me I can’t overhead press. I have been told to focus on form over adding weight - but that should be the case with any lift. Honestly upright row and bench irritate my shoulder more so my weight progression is slower with those lifts

@SCoil123 the arching the back thing is something I'm having an issue with - I'm teaching a friend how to lift, and this is something he does on standing barbell OHP - he's not using much weight right now, about 65lbs, but I have been trying to correct his form on this and he keeps *kitten* doing it. Any tips on how to teach this? I know he can learn, his deadlift and squat form are actually really good now and I've only been teaching him a couple of weeks.

One of the best things that helped improve my form was videos. I watched videos and I video myself. Every time I make a gradual weight increase I film myself to check my alignment and make sure I’m engaging both sides of my body equally. It really helps to see yourself doing it rather than trying to understand while someone else describes what they see you doing. I’ve worked with PT and trainers and really this was a game changer for me. Also making sure to practice form with mirrors. I always go for the weight rack that has the clear mirror in front and to the side of me so I can check myself now

Cherimoose

GiddyupTim wrote: »

They say the shoulder isn't built for that

Ask them how they get their luggage into the overhead bin on flights.

BrianSharpe

I'm usually the first one to say that the plural of anecdote is not data but given the number of age group power lifters who are still competing I'm thinking that your doctor is giving bad advice. Lots of them still think that running wrecks your knees too......

I would suggest that lifting with bad form (crossfit, I'm looking at you) and trying to progress to heavier weights too quickly may be problematic.

CSARdiver

BrianKMcFalls wrote: »

Oh, it's a thing, not an idea based on any evidence, but it's something lots of educated people believe.

Here's a quick video of how pressing (properly) is actually good for the shoulder. https://youtu.be/5cnyRkZTtoM

Great video. I work with an orthopedic surgeon who helped me when I got serious about lifting. I was concerned with a dislocated shoulder that never really healed right. After a year of implementing OHP and above the shoulder lifts all my symptoms are gone and the improved musculature aided in aligning my shoulder closer to the ideal.

He was very cautious about starting with low weights until I got the movements and form precise. He was also very strict about not loading more than 5lbs/week. I hired a professional to ensure my form was perfect for the first month and then checked in every month afterwards.

GiddyupTim

lorrpb wrote: »

Here is the line of thought from one source.
https://www.ironmanmagazine.com/the-case-against-overhead-presses/

AHA!
I think this must be it.
Thank you.
The reasoning seems to make some sense, though, again, I'm not sure I buy it.
It would suggest that rotator cuff injuries are super common in weight lifters. Are they?
The study I referenced above, a look at recreational weightlifters, said that shoulder was the location of 36 percent of all the weight training injuries. Well, that doesn't sound like an exorbitant percentage to me, given that probably about half of the exercises most people do in the gym are upper body exercises, where the shoulder is being used in some way or, at least, somewhat. Plus, my sense of the study is that these "injuries" were mostly just strains and things that interfered with training, not necessarily serious injury that led to a long-term problem or required medical help.
I still feel like I am going to kinda put this 'advice' in the category of "never do squats past parallel," and "never let your knees go past your toes when squatting," and "running is bad for your knees, too much pounding." Yeah, there might be a grain of truth in those statements, ie that there is some risk of injury in doing those things. But the risk is overstated and there is actually health in doing those things.
People who don't move have bigger problems, more frequently. I had surgery on my knee for a ruptured ACL and torn meniscus that happened while I was playing soccer, an activity with inherent risk. But I will guarantee you that, over the course of my lifetime, I have been to the doctor a whole lot less than anyone who has not engaged in physical activity.

cwolfman13

OH press can cause shoulder impingement pretty easily if form is bad. Form is really important with the OH press. I see a lot of people using too wide of a grip and flaring their elbows and also not fully locking out at the top and not shrugging the shoulders towards to ceiling to engage the traps.