Shoulder Tendonitis Exercises to Avoid — and What to Do Instead (Including Tendonosis)

By Marcus Cole, Certified Personal Trainer

You’ve got shoulder pain. You’ve done some research. Now you’re seeing conflicting advice: “Push through it,” “Rest completely,” “Just do these stretches,” and “You probably need surgery.”

Here’s what I know: Most people who think they have shoulder tendinitis actually have shoulder tendinosis — and the treatment for each is completely different. And that distinction changes everything about what exercises you should avoid and what you should do instead.

In this post, I’m going to walk you through the difference, give you a specific list of exercises to drop, show you what to replace them with, and provide a protocol you can follow right now — whether you’re in the acute inflammatory phase or dealing with chronic shoulder degeneration.

The Critical Distinction: Tendinitis vs. Tendinosis

This is the most important thing to understand, so I’m putting it first.

Tendinitis (the “-itis” suffix means inflammation) is the acute phase. It typically lasts 0-3 weeks. Your shoulder is warm, swollen, painful during activity AND at rest. You probably remember when it started — a sudden overload, a new exercise, or direct trauma. Your tendon is inflamed and you need to stop provoking it immediately.

Tendinosis (the “-osis” suffix means degeneration) is the chronic phase. There’s no active inflammation anymore. Instead, your tendon tissue has undergone degenerative changes at the microscopic level. It feels stiff in the morning, warms up as you move throughout the day, and hurts specifically when you load it in certain positions. It’s been going on for months — or even years.

Here’s the thing: Most people who say they have tendinitis actually have tendinosis. They’ve had the shoulder pain for 6 months, or 2 years, or 5 years. That’s not inflammation. That’s degeneration.

Why does this matter?

Because the treatment is opposite.

With true tendinitis, you need relative rest and provocation avoidance. Stop doing the thing that triggered the inflammation. Apply ice. Give it 2-3 weeks.

With tendinosis, complete rest makes it worse. A degenerating tendon needs graded loading to stimulate collagen repair and remodel the tissue. Sitting in a sling for three months will not fix a tendinosis problem — it will decondition the tendon further.

This is why generic advice to “rest and stretch” fails so many people.

Can You Push Through Shoulder Tendinosis Pain?

Let me answer this directly: No, you cannot push THROUGH it. But you can absolutely train AROUND it.

There’s a critical difference.

Pushing through means continuing to do the exact exercise that provokes your symptoms, with the same load and range of motion, and just accepting the pain. This is how partial tears and complete ruptures happen. It’s also how acute tendinitis becomes chronic tendinosis in the first place. Don’t do this.

Training around it means modifying the exercise — changing the range of motion, reducing the load, altering the angle, or swapping it for a variation that doesn’t provoke your symptoms — while continuing to train everything else. This is how you maintain strength, continue progressing, and allow the tendon to heal. Do this.

To know which category you’re in, I use the traffic light system for tendon pain:

GREEN (0-3/10 pain): Pain during exercise disappears within 24 hours. You can train. This is the sweet spot for loading a tendinosis.

YELLOW (4-5/10 pain): Pain during exercise lingers for 24-48 hours. Reduce the load, modify the range of motion, or swap the exercise entirely.

RED (6+/10 pain): Pain that worsens during sets, or pain lasting more than 48 hours. Stop that exercise. You’re in the acute phase or the modification wasn’t enough.

The Exercises to Avoid (And Why)

If you have shoulder tendinitis or tendinosis, these exercises should be removed from your program immediately:

1. Behind-the-Neck Press

This movement places your shoulder in extreme internal rotation at end range while under load. It’s one of the most impingement-prone positions possible. If you have any shoulder tendon irritation, this is the first thing to cut.

Replace with: Neutral-grip dumbbell overhead press. The neutral hand position (palms facing each other) reduces internal rotation demand and is far less impingement-prone.

2. Upright Rows

At the top of the movement, your shoulder is in a position of high impingement risk. The narrow grip and high elbow position compress the supraspinatus tendon between the humerus and acromion.

Replace with: Band pull-aparts and face pulls. These build your rear delts and mid-traps (which actually help prevent impingement) without any risk to the shoulder joint.

3. Wide-Grip Barbell Bench Press (Elbows Flared >75 Degrees)

A wide grip with flared elbows increases anterior shoulder stress and impingement risk. The problem isn’t benching — it’s the grip width and elbow angle.

Replace with: Close-grip bench press or dumbbell floor press. A tighter elbow tuck (elbows at 45 degrees, not 90 degrees away from your body) dramatically reduces shoulder stress while maintaining chest activation.

4. Heavy Overhead Pressing (Through Pain)

If overhead pressing is the specific movement that provokes your symptoms, you can’t just power through with heavy weight. You need to reduce the load or ROM significantly until the tendon adapts.

Replace with: Landmine press. The diagonal force vector (pressing at roughly 45 degrees instead of straight overhead) reduces impingement risk while still training the pressing pattern. Or use neutral-grip dumbbells with a reduced range of motion.

5. Dips (Especially With Forward Lean)

Dips place extremely high anterior shoulder stress. A forward lean makes it worse. If your shoulder is already irritated, this is a high-risk movement.

Replace with: Tricep pushdowns or close-grip bench press for triceps strength. You’re not losing out — you’re just choosing a safer variation.

6. Lateral Raises With Thumb-Down Grip (Empty Can Position)

While the empty can test is useful for diagnosis, doing lateral raises in this position — thumb pointing down, shoulder internally rotated — is provocative for supraspinatus tendinopathy. It’s the worst position to load if you have rotator cuff tendon irritation.

Replace with: Lateral raises with neutral or thumb-up grip. Or do band pull-aparts instead. You get the shoulder abduction without the problematic internal rotation.

7. Sleeping on the Affected Shoulder

This isn’t an exercise, but it matters just as much. Sleeping on an irritated shoulder compresses the tendon all night, significantly delaying healing. If you have right shoulder pain, sleep on your left side for the next 4-6 weeks. This one habit alone can speed up recovery by weeks.

The Rehabilitation Protocol for Shoulder Tendinosis

If you have tendinosis (chronic pain, not acute inflammation), here’s a protocol that actually works. It progresses through three phases: isometric, isotonic, and integration.

Phase 1: Isometric Holds (Weeks 1-2) — Pain Reduction

The goal here is to settle down the pain and begin loading the tendon without provoking symptoms. Isometric contractions (where the muscle contracts but doesn’t move) have an immediate analgesic effect on tendons — they reduce pain without aggravating the tissue.

Isometric External Rotation Hold:

Stand next to a wall or doorframe.
Your arm is at your side, elbow bent to 90 degrees.
Press the back of your hand against the wall, resisting outward rotation.
Hold with about 40-50% effort (not maximal).
5 reps × 45-second holds, 3x per week.

Do this for the first 2 weeks. Pain should drop noticeably.

Phase 2: Isotonic Loading (Weeks 2-6) — Building Tolerance

Now you’re introducing movement while maintaining light load. The goal is to stimulate collagen remodeling in the tendon without re-provoking symptoms.

Side-Lying Dumbbell External Rotation:

Lie on your unaffected side.
Arm at your side, elbow bent 90 degrees, holding a light dumbbell (2-5 lbs).
Rotate the forearm upward, taking 3 seconds to lower it back down.
3 sets × 15 reps, every other day.

Band Pull-Aparts:

Hold a resistance band at shoulder height, arms straight.
Pull the band apart, squeezing your shoulder blades together.
3 sets × 20 reps, daily.

Face Pulls:

Use a rope attachment on a cable machine or resistance band.
Pull toward your face, elbows high, separating the rope as you pull.
3 sets × 15 reps, daily.

Stay in green (0-3/10 pain) for all of these. If you hit yellow or red, the load is too high.

Phase 3: Integration (Weeks 6-12) — Returning to Normal Training

You’ve built tolerance. Now you’re gradually reintroducing the movements and loads you actually care about — pressing, pulling, and loaded work.

Week 6-8: Start with landmine pressing. 3 sets × 8-10 reps, 2x per week. Keep load moderate (green pain zone).

Week 8-10: Progress to neutral-grip dumbbell overhead press. 3 sets × 8-10 reps, 2x per week.

Week 10-12: Gradually return to barbell pressing if desired, but with a closer grip and controlled tempo. Avoid wide grip and heavy weights for at least 12 weeks total.

Throughout all phases: Band pull-aparts and face pulls are permanent additions to your upper body days. Not optional. These movements build rear delt and mid-trap strength, which stabilizes the shoulder and prevents future tendinopathy.

When to See a Doctor

Most shoulder tendinosis responds well to this approach within 6-8 weeks. But see a doctor if:

You have night pain that wakes you up. This can indicate a rotator cuff tear, not simple tendinopathy.
Sudden weakness or inability to raise your arm. This suggests acute damage and needs imaging.
No improvement after 4-6 weeks of conservative management. You might need a different diagnosis or approach.
A history of acute injury. If you remember a pop or sudden sharp pain during an exercise, you need imaging to rule out a tear.

The Bottom Line

You don’t have to choose between training and healing your shoulder. You just have to train smart: avoid the provocative movements, replace them with safer variations, and follow a graded loading protocol. Most shoulder tendinosis responds well within 8-12 weeks if you’re consistent.

The key is understanding whether you have acute tendinitis (rare, true inflammation) or chronic tendinosis (common, degeneration). That distinction determines whether you rest or load. Get it right, and recovery is fast. Get it wrong, and you’ll be dealing with this for years.

Start with the traffic light system. Stay in green. Replace your problem exercises. Add face pulls and band work permanently. Trust the process.

Your shoulder will thank you.