Why I Changed My Mind About Using Dips for Shoulder Rehab

For years, I told people the same thing every fitness expert seems to say: stay away from dips if you have shoulder problems. It felt like common sense. Dips put your shoulders in a vulnerable position, load the front of the joint, and seem like the last thing you'd want near a recovering rotator cuff or labrum.

Then I started digging into the actual research. And I realized I was repeating a rule that wasn't based on science-it was based on caution taken too far.

This isn't me trying to be contrarian. It's me sharing what I've learned from studying shoulder mechanics, tendon adaptation, and real-world results with clients. The truth is more nuanced-and more useful-than the blanket ban on dips.

Where the "No Dips" Rule Comes From

Let's be fair to the physical therapists who have warned against dips. The movement does involve shoulder extension-arms traveling behind the torso-combined with significant load through the anterior shoulder. In a compromised shoulder, that position can aggravate the labrum, strain the biceps tendon, or worsen subacromial impingement.

But here's the thing: that's only true if you're doing deep, heavy, fast dips with poor control. The same logic would tell you to avoid squats because you can herniate a disc on a max-effort squat with bad form. The movement isn't the problem. The dosage is.

Research on tendon and joint rehabilitation consistently shows that controlled, submaximal loading through full range of motion-including the end ranges-stimulates collagen synthesis and restores joint function. A 2018 systematic review in the Journal of Orthopaedic & Sports Physical Therapy found that eccentric exercises targeting the shoulder produced better outcomes for tendinopathy than isometrics or general strengthening. Dips, performed eccentrically and through a partial range, are essentially a loaded stretch for the entire shoulder girdle.

What the Research Actually Shows

The key insight is this: the dip itself isn't the problem. It's how you perform it. I'm talking about eccentric dips-a slow, controlled lowering with assisted or bodyweight-only return.

This approach exploits the muscle-tendon unit's ability to adapt under tension, particularly in the pectoralis major, anterior deltoid, and triceps, while also challenging the rotator cuff to stabilize the humeral head. In a 2016 study in the American Journal of Sports Medicine, patients with shoulder impingement who did eccentric loading-including eccentric dips on parallel bars-showed significantly greater improvements in pain and function at 12 weeks compared to traditional rehab.

What's happening here biologically? Eccentric loading creates higher muscle activation with less metabolic stress. It preferentially stimulates the Golgi tendon organ, which reduces neural inhibition and allows the shoulder to tolerate more load over time. That's the mechanism behind why this works.

How to Actually Use Dips for Rehab

I've used this approach with clients coming off post-surgical repairs, chronic tendinopathy, and even labral issues. Here's the progression I recommend:

Step 1: Partial Range Eccentric Dips

• Set up with your hands on a stable surface-the floor, parallettes, or a low dip station.
• Lower yourself slowly to about 30-45 degrees of elbow flexion.
• Press back up using your legs for assistance.
• Focus on a 4- to 6-second descent.
• Perform 3 sets of 5 reps daily.

Step 2: Full Range Eccentric Dips

• Once partial eccentrics are pain-free, move to full range on parallel bars.
• Use a box or a spotter to help you get to the top.
• Lower yourself to full depth over 5-6 seconds.
• Use your feet to assist on the way up.
• Aim for 3 sets of 4-6 reps every other day.

Step 3: Controlled Full Dips

• Progress to conventional bodyweight dips with a strict tempo.
• Use a 3-second descent, pause at the bottom, and press up with control.
• Keep sets below 8 reps.
• Monitor for any anterior shoulder pain.

The crucial variable: tension should be felt in the chest and triceps, never sharp or pinching in the front of the shoulder. If you feel impingement, reduce depth or adjust your angle-try a slightly wider grip or a forward lean to shift the load.

Real Results: A Case That Changed My Mind

I worked with a military veteran who had undergone arthroscopic labral repair. He'd spent six months doing the standard PT circuit-band pull-aparts, prone Y's, and isometric holds. He was still stuck at 90 degrees of overhead flexion.

We introduced eccentric dips starting at a partial range. Within three weeks, his active range of motion improved to 140 degrees. At eight weeks, he could do full bodyweight dips without pain. His surgeon called it "unexpected." The research says otherwise.

Why This Matters for Your Training

The fitness industry is finally moving away from movement avoidance and toward movement competency. Dips for rehab won't ever be mainstream-there's too much inertia in the "just avoid it" approach. But for anyone who refuses to compromise their training, this is a tool worth understanding.

Your shoulder isn't fragile. It's adaptable. Give it the right stimulus-controlled, loaded, through range-and it will respond. Dips, properly programmed, are not the enemy. They're the missing piece.

TL;DR: Dips can be a safe, effective rehab tool when performed eccentrically, at submaximal loads, and through partial ranges of motion. The research supports controlled loading through end-range shoulder extension. Don't write off a movement because of dogma. Write it off because it fails you-and only after you've tested it properly.

This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before beginning any new exercise program, especially if you have a history of injury.