Shoulder Injuries

The shoulder is the most mobile joint in the human body—and this mobility comes at the cost of stability. In calisthenics, the shoulder is constantly challenged through pulling, pushing, and stabilization demands. Understanding shoulder injuries is essential for any serious practitioner.

Red Flag Warning: Seek immediate medical attention for: inability to move the shoulder at all, visible deformity, severe pain at rest, numbness/tingling down the arm, or symptoms following significant trauma.

Shoulder Anatomy Overview

Before discussing injuries, a brief review of shoulder anatomy helps contextualize the problems.

The Glenohumeral Joint

The main "ball and socket" joint of the shoulder consists of:

• Humeral head: The "ball" at the top of the upper arm bone
• Glenoid: The shallow "socket" on the scapula (shoulder blade)
• Labrum: Fibrocartilage ring that deepens the socket
• Joint capsule: Connective tissue envelope surrounding the joint

The socket is remarkably shallow—often compared to a golf ball on a tee—which allows great mobility but requires muscular stability.

The Rotator Cuff

Four muscles that stabilize the humeral head in the socket:

• Supraspinatus: Initiates arm abduction (lifting sideways)
• Infraspinatus: External rotation
• Teres minor: External rotation
• Subscapularis: Internal rotation

These muscles work constantly during calisthenics movements to center the humeral head and prevent impingement.

The Scapulothoracic Joint

The shoulder blade moves on the ribcage, controlled by:

• Serratus anterior
• Trapezius (upper, middle, lower)
• Rhomboids
• Levator scapulae

Proper scapular movement is essential for healthy shoulder function.

Common Shoulder Injuries in Calisthenics

Rotator Cuff Tendinopathy

What it is: Irritation, degeneration, or partial tearing of rotator cuff tendons, most commonly the supraspinatus.

How it happens in calisthenics:

• High-volume pulling (pull-ups, muscle-ups, front lever training)
• Repeated overhead pressing
• Insufficient external rotation strength relative to internal rotators
• Poor scapular control during movements

Symptoms:

• Pain on the front or side of the shoulder
• Pain with overhead movements
• Weakness with specific rotator cuff tests
• Night pain (especially lying on the affected side)
• Pain that warms up initially but worsens with continued training

Contributing factors:

• Training through early warning signs
• Excessive volume without adequate recovery
• Poor posture (rounded shoulders)
• Insufficient warm-up and activation

Shoulder Impingement

What it is: Compression of soft tissues (rotator cuff tendons, bursa) between the humeral head and the acromion (bony roof of the shoulder).

Types of impingement:

• External impingement: Compression under the acromion during overhead movements
• Internal impingement: Compression at the back of the shoulder during extreme positions

How it happens in calisthenics:

• Muscle-up transitions with poor technique
• Dips with excessive forward lean or depth
• Handstand work with poor shoulder positioning
• Skin-the-cat and German hang with insufficient preparation

Symptoms:

• Painful arc (pain in the mid-range of arm elevation)
• Pain reaching behind the back
• Clicking or catching sensations
• Pain with pushing movements at certain angles
• Gradual onset, worsening over time

Contributing factors:

• Poor scapular upward rotation
• Tight posterior shoulder capsule
• Weakness of rotator cuff
• Poor thoracic mobility

Labral Injuries (SLAP Tears, Bankart Lesions)

What it is: Damage to the fibrocartilage ring (labrum) surrounding the glenoid socket.

Types:

• SLAP tear: Superior Labrum Anterior to Posterior—affects the top of the labrum where the biceps tendon attaches
• Bankart lesion: Damage to the front-bottom of the labrum, often from dislocations

How it happens in calisthenics:

• Sudden loading (catching yourself from a fall, failed muscle-up)
• Repetitive strain from overhead positions
• Dislocation or subluxation events
• Extreme ranges of motion under load

Symptoms:

• Deep, hard-to-localize shoulder pain
• Clicking, popping, or catching
• Sensation of shoulder "slipping" or instability
• Pain with specific movements (often overhead or behind-back)
• Weakness and loss of confidence in the shoulder

Important note: Many labral "tears" found on MRI are asymptomatic and don't require intervention. Symptoms and function matter more than imaging findings.

Shoulder Instability

What it is: Excessive movement of the humeral head in the glenoid, ranging from subtle "microinstability" to full dislocations.

Types:

• Traumatic instability: Following a dislocation event
• Atraumatic instability: Develops from repetitive stretching or congenital laxity
• Multidirectional instability: Loose in multiple directions

How it happens in calisthenics:

• Aggressive mobility work (German hangs, skin-the-cat)
• Falls or failed attempts at skills
• Training through instability symptoms
• Congenitally hypermobile individuals pushing ranges too far

Symptoms:

• Sensation of shoulder "slipping" or "moving too much"
• Apprehension in certain positions
• Aching after activity
• Difficulty with positions requiring stability (handstands, planche)
• Fatigue with sustained positions

Contributing factors:

• Previous dislocations
• Hypermobility/joint laxity
• Weak stabilizing musculature
• Excessive passive flexibility work

Prevention Protocols

Rotator Cuff Strengthening

External rotation exercises:

Side-lying external rotation:

• Lie on your side with a small towel roll under your armpit
• Elbow bent 90 degrees, arm against your side
• Rotate forearm toward ceiling
• 2-3 sets of 15-20 reps daily

Band external rotation at 90 degrees abduction:

• Arm out to the side, elbow bent 90 degrees
• Rotate forearm from pointing down to pointing up
• Control the movement in both directions
• 2-3 sets of 12-15 reps

Internal rotation exercises:

Band internal rotation:

• Similar setup to external rotation
• Rotate toward your body against resistance
• Important for subscapularis strength

Full rotator cuff program: Include exercises for all four muscles:

• Supraspinatus: Empty can raises (or full can if empty can is painful)
• Infraspinatus/teres minor: External rotation variations
• Subscapularis: Internal rotation variations

Scapular Stability Training

Scapular control is often more important than rotator cuff isolation.

Scapular push-ups:

• Push-up position, arms straight
• Let shoulder blades squeeze together, then push apart
• Focus on serratus anterior activation
• 2-3 sets of 10-15 reps

Wall slides:

• Back against wall, arms in "goalpost" position
• Slide arms up and down while keeping contact with wall
• Focus on upward rotation of scapulae
• 2-3 sets of 10-15 reps

Prone Y-T-W raises:

• Lying face down on floor or bench
• Arms in Y, T, and W positions
• Small range of motion, focus on scapular positioning
• Light weight or bodyweight only

Band pull-aparts:

• Hold band at shoulder width, arms straight
• Pull apart while squeezing shoulder blades
• 2-3 sets of 15-20 reps

Mobility Work

Thoracic spine mobility:

• Limited thoracic extension forces the shoulder to compensate
• Foam roller extensions, cat-cow, thread the needle

Posterior shoulder stretching:

• Cross-body stretch (with proper form—don't shrug)
• Sleeper stretch (lying on your side)
• Hold 30-60 seconds, gentle intensity

Avoid excessive anterior shoulder stretching:

• The front of the shoulder is often already loose in calisthenics practitioners
• Excessive stretching can increase instability

Movement Quality

Pull-up technique for shoulder health:

• Initiate with scapular depression and retraction
• Keep shoulders packed throughout
• Avoid excessive kipping or swinging
• Full range of motion, but not hanging loosely at the bottom

Dip technique for shoulder health:

• Control the descent—don't drop into the bottom position
• Keep elbows tracking over wrists
• Avoid excessive depth that puts the shoulder at risk
• Maintain slight forward lean to reduce shoulder strain

Handstand positioning:

• Open shoulder angle (arms by ears)
• Active shoulders—push the floor away
• Don't let shoulders collapse toward ears

Return-to-Training Guidelines

After Rotator Cuff Issues

Phase 1: Pain reduction (1-4 weeks)

• Avoid painful movements
• Ice/heat as needed
• Light mobility work
• Rotator cuff activation exercises (pain-free)

Phase 2: Strength restoration (2-6 weeks)

• Progressive rotator cuff strengthening
• Scapular stability exercises
• Gradually reintroduce modified training movements
• Focus on movement quality over load

Phase 3: Return to training (2-8 weeks)

• Gradually increase volume and intensity
• Monitor for symptom recurrence
• Continue maintenance prehab work
• Address underlying contributing factors

After Impingement

Principles:

• Avoid provocative angles initially
• Address scapular dyskinesis
• Improve thoracic mobility
• Gradually expand available range

Progressions:

• Start with horizontal pulling/pushing before vertical
• Progress depth in dips gradually
• Rebuild overhead positions systematically

After Instability

Critical principles:

• Stability before mobility
• Avoid end-range positions initially
• Focus on dynamic stability training
• May need to avoid certain movements long-term

Exercise modifications:

• Reduce range of motion in potentially unstable positions
• Use external support (rings closer together, parallettes instead of floor)
• Progress slowly through increasing ranges

When to Seek Professional Help

See a healthcare provider if:

• Pain persists beyond 2-3 weeks despite rest and modification
• You experience instability or catching/locking
• There's significant weakness that doesn't improve
• Night pain disrupts sleep regularly
• You've had a traumatic event (fall, dislocation)

What to expect:

• Physical examination and movement assessment
• Possible imaging (X-ray, ultrasound, MRI)
• Differential diagnosis (rule out referred pain from neck)
• Treatment plan (physical therapy, injection, or rarely surgery)

Key Takeaways

1. Prioritize stability—the shoulder's mobility is a gift and a liability
2. Train the rotator cuff—these small muscles do essential work
3. Master scapular control—it's often more important than cuff strength
4. Respect depth and range—pushing extreme positions risks injury
5. Technique matters—poor form accumulates stress
6. Address thoracic mobility—limitations here stress the shoulder
7. Don't train through significant shoulder pain—it rarely ends well
8. Build a maintenance routine—prevention is easier than rehabilitation