Bench Press and Shoulder Pain
Along with the bicep curl the bench press is the most popular resistance exercise for men worldwide. A
snapshot of your local commercial gym usually reveals a horde of men hovering around the bench press station, all hoping to build big chest, or simply a big bench. It is quite telling that most gyms tend to have more space or equipment designated for the bench press than for a power rack or olympic lifting platform. And this is all for a piece of equipment which is pretty much good for only one thing; benching. The question I'm asking is, is all this bench pressing good for your shoulders?
Why bench press?
The average gym goer may have the sole ambition of looking good with his shirt off (which to be honest is a reasonable and healthy goal), and the shoulder pain he gets once per week when he benches isn't a big deal and wont affect him in the long run. But that is exactly the problem, longevity. It is very difficult to build an impressive physique if it hurts to put your shirt on.
Now many people will say; why bench press at all, why not just do isolation exercises for your chest, shoulders and triceps. That is certainly an option, but a properly performed bench press is a very effective stimulus in building significant muscle on your anterior shoulder girdle and arms. And is certainly more time economical than choosing a single exercise for your pecs, delts and triceps.
The bench press also gets a bad wrap from some health professionals; many strength and conditioning coaches scoff at the very thought of a bench press, citing that 'you don't play (insert your sport here) laying on your back'. Which is a ridiculous stance, and where a lot of coaches get mixed up on the idea of specificity and generality. You are never going to re-create exactly what you do on the pitch, court, track etc. in the gym, and for the most part nor should you. If the goal of your training is to stimulate hypertrophy, or strengthen the muscles acting on the shoulder and elbow then why not bench.
Unless you are a powerlifter, weightlifter or strongman you won't be picking up heavy bars off the floor or supporting them on your back during your sport. So, should you also not squat, deadlift or clean? Of course you should, like the bench press these are big multi-joint exercises with good potential to increase loading and stimulate muscle growth in large muscle groups paramount to fundamental athletic movements.
Why does the bench press hurt?
Not everyone suffers pain during the bench press, but it is common enough to be worth writing an article on (surprise surprise). Individual bone structure, mobility, and technique may influence whether you feel pain. The position at the bottom of a typical bench press is one of 90 degree shoulder abduction and horizontal abduction. Most people tend to combine this with a degree of scapular anterior tilt. This positition tends to create anterior humeral glide which causes trauma to the anterior shoulder capsule and long head of biceps, reduces the sub-acromial space which can lead to a whole host of problems, and can impart unwanted stress on the acromioclavicular joint. The long term effect of this repeated trauma includes shoulder instability, rotator cuff degeneration, osteophyte formation, muscular inhibition and worst of all a really weak bench! As you can see, this very bench specific position can prove injurious, which is why it is not uncommon to find people that struggle to bench but can decline press, close grip bench and dumbell bench pain free. Benching through pain should never be an option, the risks far outweigh the benefits, if bench pressing is hurting you (pre-established injury aside), it is almost certainly a technique issue.
So back to our regular Joe whose shoulders hurt when he benches, what should he do? Bench press hurts his shoulders. As with many exercises there are several correct (and incorrect) ways to bench press, poor bench press technique may be what is causing your shoulders to hurt. Choice of technique may be dictated by demands of your sport, individual anthropometry, the intention of the exercise and its position in your programme, previous injury, skill level, availability of equipment, or most worryingly...ignorance. Certainly the way that you bench press can impact on the chance of you suffering pain or injury. Researchers have investigated the impact of technique changes such as grip width, flat, decline and incline bench, and forearm pronation/supination. Finding variance between the different techniques on EMG muscle activity in the muscles involved in the bench press. These papers demonstrate that relatively subtle changes in technique can alter the contribution made by certain muscles. It is therefore not hard to see that technique changes can make a difference on the impact that the bench press has on your body. Effective technique involves limiting shoulder extension, avoiding anterior scapular tilting and protraction, and moderating shoulder abduction. There are certainly more technical aspects to reducing injury and improving performance, but these are my big three for reducing stress on the aforementioned shoulder structures, and reducing shoulder injury rate.
What else can go wrong?
Unfortunately even if you have proficient technique you can make yourself susceptible to injury via poor programming. You see it time and again; man enters gym and is immediately attracted like a magnet towards the the bench. Their weekly programme tends to look something like: Monday – bench, Wednesday – bench, Friday – bench and curls (to make sure his arms look big for his night on the town). Now with intelligent programming it is more than possible to bench three times a week, however, it is probably a rather large leap of faith to assume most people programme intelligently. Excess benching can cause chronic tightness of the anterior shoulder girdle musculature, it hurts to touch your chest, and you struggle to reach round to put on your seat belt. It can also irritate anterior intra-articular structures, and cause anterior shoulder instability, which is not ideal if you're a rugby or other contact sports player now with increased risk of dislocation. I'm not going to delve into what I deem intelligent programming because that is an article in itself (well, much more than one article) but suffice to say for 99% of people it isn't benching to a max or to failure three times a week (note I said 99% not 100%), and it will also likely involve exercises utilising shoulder extension and lateral rotation.
Another problem with this bench heavy approach is that it involves a lot of musculature on the front of the body which flexes, adducts and internally rotates, and not a lot on the back which extends and externally rotates. Of course you can't so readily see the musculature of the back and is often for this reason neglected, also no-one asks how much you bent over row, or single arm cable row. Including a little movement in the other direction can go a long way to correcting the muscle imbalances developed through years of bench induced tightness.
The bottom line on the bench press and shoulder pain
For those of you that just skipped to this part, here it is in summary. The bench press can cause shoulder pathology, especially when done too much and too wrong. Not benching as much, benching better and including exercises which work opposing muscle groups can reduce the chance of developing shoulder injuries. Future articles will discuss effective bench press technique, a quick and efficient bench press warm up, and exercises and management strategies which can reduce shoulder pain and fix movement impairment syndromes.
Sean Brindley MCSP
The information provided in these blog articles is the opinion of the author, based on best available evidence at the time. Is not intended as specific individual advice and should not be used as a substitute for professional advice from a healthcare professional.
1. Barnett C, Kippers V, Turner P. Effects of variations of the bench press exercise on EMG activity of the five shoulder muscles. Journal of Strength and Conditioning Research 1995;9(4): 222-227.
2. Clemons J, Chantelle A. Effect of grip width on the myoelectric activity of the prime movers in the bench press. Journal of Strength and Conditioning Research 1997;11(2): 82-87.
3. Lehman G. The influence of grip width and forearm pronation/supination on upper-body myoelectric activity during the flat bench press. Journal of Strength and Conditioning Research 2005; 19(3): 587-91.
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