Welcome to the first ever edition of ‘A FISIO journal’. Here, we will try our best to translate the evidence, or professional opinions (where evidence lacks) on commonly discussed, often confusing, and always interesting topics.
This week, we will discuss the curious case of shoulder pain, particular, that associated with bench press. What could be causing it? What can you do? Do you need to see someone for it?
Firstly, lets talk about the muscles that are used during the bench press. It is much more than a simple ‘pec exercise’. The main muscles used for a flat barbell bench press include; pecs, deltoids, traps, lat dorsi, triceps the coracobrachilas, and of course, the muscles of the rotator cuff.
The 2 most common complaints I see when it comes to bench press and shoulder pain are:
1) Anterior shoulder pain ( at the front of your shoulder)
2) Posterior shoulder pain; particularly along the spine of the scapula/ shoulder blade.
Usually, the pain is described as being sharp when trying to bench press, and then is associated with a dull ache following the workout.Often, the biggest fear people have when it comes to shoulder pain is that of the rotator cuff. “I’ve done my cuff”. Thankfully, this isn’t always the case.
Common mistakes contributing to pain during bench press:
– Too much shoulder abduction (elbows sticking out); increases pressure on deltoids and exposes shoulder joint ^.
– Not engaging legs during the lift; drive through the legs!
– Trying to lift too heavy, too soon; slow down and build yourself up!
– Not addressing underlying issues; eg too neck pain, bicep injury, posture.
– Not keeping shoulder retracted: this helps to create a stable base of support, and helps to recruit pec major optimally (length tension relationships)
– Hand position: full grip of the bar. Wrap your thumb around to close your fist. It is safer, and also helps with muscle recruitment.
– Width: 1.5x bi-acromial width (just wider than shoulder width) is the sweet spot. Can go up to 2 x as wide, though after this point, injury risk increases without justifiable benefit in recruitment.
– Avoid bounding weight off chest; big change in momentum on shoulder, potential for sternal fracture.
Below you will see a info that summarises common causes of shoulder pain associated with bench press + some ideas for you to try if you think you fall under this category. It is awesome to be able to try and rehab yourself, however, it is also really important to remember when to ask for help. Physiotherapists are highly trained professionals, and often, seeing a physio early can stop a small issue becoming a big one. The shoulders are a particularly tricky joint because of the amount of tendons in a small space. They are one of the most commonly injured body parts, so you are not alone with your symptoms.
FInally, I’d like to list a few ways you can progress or regress your bench press, These should be matched to your goals!
– Heavier weights (strength)
– Higher volume (hypertrophy)
– Higher reps (endurance)
– Challenged environment: eg one leg lifted
– Slower reps (TIME UNDER TENSION)
– Lighter weight, less reps
– Less challenged environment; eg ‘standing bench press’ using cable machine
– Band assisted reps aid with recoil
Overall, the bench press is a fantastic exercise for the pecs and shoulders, however, shoulder pain is not uncommon. The shoulder is a complex joint, with lots of muscles in a small area. It has the most range of motion out of all joints in the body, and therefore, requires lots of control. Shoulder pain can come from ligaments, joint movement dysfunction, or muscles. It can sometimes even be referred from the neck (office workers!!).
It is cool to be able to try and ‘fix yourself’, but sometimes you need a helping hand. If you have a niggling shoulder, we can help you by assessing the painful movements, testing the relevant structures and providing you with a program to address the issue, and help you get back on your way to smashing your goals
If you would like a review of your shoulder pain, get in contact with us today; have a chat when you see the physio’s around the gym, or message us on 0426 422 224