I have not had a good track record with overhead pressing and those with back pain.
These were not with large loads, usually just a little more weight than the bar.
But twice, I have seen people with a history of back pain have setbacks due to overhead pressing.
As a result, it has caused me to make some changes when programming for adults.
Simply, it means no more barbell overhead work.
Both times a barbell press was used and I think the closed nature of the exercise creates issues. Having both hands on the bar allows less mobility in the movement.
A barbell also requires maneuvering around the head.
Starting in the front rack position is usually where overhead pressing starts from. The only problem is that you cannot press the bar through the jaw and skull into the air.
This requires the neck to flex in order for the bar to travel straight up.
The main compensation from this pattern is for the ribs to flare, putting the low back into extension.
When the back is in extension, pressure is put on the structures of the vertebral column.
Also, any misalignment of the spine or pelvis is going to be exacerbated in extension. Loading an extended spine can be very painful.
Getting overhead also requires adequate lat length. Very few people have the range of motion in their lats that would allow for safe overhead pressing.
Bad posture is a third risk factor for overhead pressing issues.
When the scapulae start to tilt towards the front and protract, the rib cage cannot move freely.
In order to avoid lumbar extension, the t- spine must be able to extend. There is much more range of motion in the thoracic spine compared to the low back.
The t spine cannot extend when the shoulders are rounded over. The next area down the chain to achieve this range of motion becomes the low back.
The ability to squeeze the shoulder blades together can help with function of the rib cage and t spine.
This retraction would allow for easier overhead pressing.
Some of the solutions for this issue involve ditching the barbell.
Dumbbells, kettlebells, and single arm options have all worked with great success.
I am all about finding ways to get the same results, in a safer fashion. I find it quite dangerous to
become married to particular exercises or methods.
I have seen problems with both the Barbell Push Press as well as a regular Barbell Overhead Press.
Some of my favorite alternatives are as follows.
Dumbbell Push Press
Tall Kneeling Kettlebell Press
Single Arm Dumbbell Push Press
These three alternatives are much more open chain exercises. They also require stability to come from the torso.
The goal is to create the same benefits without putting the back at risk.
For those without any back issues use whichever exercises you want at your discretion. Just be aware of the positives and negatives of all options.