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Research indicates that shoulder problems are becoming more common during weightlifting. (1) Some of the injuries occurring most often are sprains, strains, and shoulder muscle tears.
One exercise that can lead to shoulder discomfort or pain is the bench press. Here’s why, as well as how to keep the shoulder healthy when doing the bench press exercise. We also talk about when to seek medical attention if you or your personal training client experience pain during a bench press.
The shoulders consist of many muscle groups, but three main muscles:
What many consider the shoulder is actually four different joints:
The main functions of the shoulder area are joint stability and eccentric and concentric muscle actions. Due to the large range of motion in this area, the shoulder ligaments are relatively slack compared to others in the body. Because of this, the rotator cuff muscles—infraspinatus, supraspinatus, subscapularis, and teres minor—and the deltoids take on the task of dynamic stabilization. However, the primary function of the rotator cuff muscle is to hold the head of the humerus in the glenoid cavity of the scapula during dynamic muscle actions.
Common causes of shoulder injuries during a bench press come from the following:
Extending beyond your range of motion
One of the most likely causes of bench press shoulder pain is not using proper form during this exercise. Rounded shoulders cause greater internal rotation of the shoulder joint, for instance. This places more stress on the rotator cuff muscles. In some cases, it can lead to rotator cuff impingement. If rounded shoulders are the issue, you’re likely to feel pain in the front of the shoulder.
Poor form can also appear via improper grip width. A wide grip places more stress on the shoulders. (Conversely, a narrow grip increases elbow stress.) This stress increases your risk of a cuff injury.
Extending beyond your range of motion can lead to pain in the shoulder area too. Push past this range far enough and it can even lead to a rotator cuff tear. Pain can also be a result of lifting too much too soon. This often presents as pain near the shoulder blade.
Another potential cause of shoulder pain during the bench press is muscle imbalance. If one shoulder is weaker than the other, you may develop pain in the weaker shoulder. Muscle tightness can lead to pain as well.
If your acromioclavicular or AC joint has a dysfunction, this can lead to pain. The AC joint is on the top of the shoulder. Injury to this area can occur as a result of trauma, such as by falling on it or being involved in an accident. You can also injure the AC joint with overuse, such as when lifting weights that are too heavy or performing repeated actions that involve lifting your arms overhead.
The bench press doesn’t have to be synonymous with shoulder pain. Your goal as a personal trainer is to help your clients get healthier and reach their fitness goals. Here’s how to avoid injury during the bench press exercise with nine simple actions:
Know your shoulder joint range of motion. When standing, pull your elbows back. How far back each elbow can go is dictated by shoulder range of motion. Don’t allow the elbow to go any further when doing the bench press. This helps protect the shoulder area.
Don’t flare your elbows. During the bench press, don’t allow either elbow to flare out to the side. If the elbow flares, it decreases space in the shoulder joint during the lift phase of the bench press. This opens you up to rotator cuff injury.
Pull your shoulders back and down. Try to pull one shoulder blade toward the other when doing the bench press. Also pull your shoulders down, as if moving them away from your ears. This helps you avoid rounded shoulders. It also reduces the stress on the rotator cuff.
Watch your grip. Too wide of a grip can lead to pain in the shoulder region. Ideally, your grip should not exceed one and a half times your shoulder width. Check your grip before beginning each bench press set. If it needs to be modified, adjust it immediately. While grip is a minor adjustment, it can have a major impact on injury risk.
Use dumbbells instead of a barbell. It can be easier to control shoulder movement when using dumbbells versus doing a barbell bench press. This alone can help prevent shoulder injury. Plus, you will likely be lifting less weight when using dumbbells. Less weight means less stress on the shoulder area. A third reason to choose dumbbells over barbells is if you have a muscle imbalance. Using barbells allows you to use the appropriate weight for each shoulder without risking injury.
Build your rotator cuff with different exercises. If you are worried that the bench press will lead to shoulder pain, strengthen it with other exercises first. Dumbbell front raises are reverse flys are good rotator cuff exercises to reduce injury risk. Other accessory exercises for the bench press are push-ups, pull-ups, and triceps extensions. Once you feel strong enough, transition to the bench press.
Master the basic bench press before doing variations. Some workout programs include a bench press variation (like an incline bench press) without focusing on the basic exercise first. If you’ve never done a bench press, let your trainer know. They can teach you proper bench press form and work with you to practice. After you are able to master this technique, a bench press variation can be included in your workout.
Increase the weight you lift slowly. Lift too much weight before your shoulder is strong enough and pain can result. Start with a weight that places tension on the shoulder but still allows you to do the bench press with proper form. After a week or two, take the weight up a notch. When that feels easy, take the weight up again.
Never compromise form to lift more. If you ever have to sacrifice your form to complete the bench press, this is a sign that you’re lifting too much weight. Bring the weight down to avoid injury and pain.
Discomfort during a bench press due to increased stress on the muscle is one thing. Pain is different and has no place in exercise.
Pain can be a symptom of many different shoulder injuries. It’s also possible to feel pain in the shoulder when the injury is actually in a different area of the body. For example, biceps tendonitis can lead to shoulder pain. You can also have shoulder pain if your thoracic spine is tight.
For these reasons, it’s important to encourage clients to seek medical attention if they have shoulder pain during the bench press exercise. Their healthcare provider can find the root cause of the pain, whether it is the rotator cuff muscles or in another area.
Also, pay attention to any other symptoms beyond pain as this can help a practitioner identify the potential problem. A grinding or popping in the shoulder, for instance, could be a sign of a torn labrum. The labrum is a thick piece of soft tissue that helps keep the shoulder joint in place.
If your personal training client has trouble raising their arms or can’t sleep because of the pain, it’s possible that their rotator cuff is to blame. Weakness in the arm is another sign of rotator cuff injury. Sharing additional symptoms can help their practitioner narrow down the problem.
As a personal trainer, your client may come to you with pre-existing shoulder pain. During these instances, they need to have authorization from their healthcare provider before doing a bench press or any other shoulder exercise. This authorization should address the movements they can and cannot safely do.
Adhering to these guidelines is important to avoid aggravating any existing shoulder injury. It also keeps them from increasing their levels of pain.
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Pirruccio, K., & Kelly, J. (2019). Weightlifting Shoulder Injuries Presenting to U.S. Emergency Departments: 2000–2030. International Journal Of Sports Medicine, 40(08), 528-534. https://doi.org/10.1055/a-0927-6818