Shoulder pain in the bench press: Why it happens, and how to beat it to crush plateaus
One of the most classic gym exercises of all time- the bench press. The first question any gym goer will ask anyone is “how much do you bench?” It is widely known as the yardstick for pure, brute upper body strength, making its way out of the gym and into many sporting codes worldwide including the NFL, NBA and NRL for draft combine testing as well as pre-season training.
Although it has been around for a long time, it is still poorly executed and understood, which has led to countless shoulder injuries for many (including myself). Greg Nuckols and the team at Stronger by Science conducted an online survey in 2015 and found that shoulder and cuff related injuries made up almost 50% of all upper body injuries in powerlifters.
So what goes wrong? Why does it hurt when I Bench?
Understanding Bench-related shoulder pain (BRSP)
The two main reasons why we see the shoulders getting cooked in the bench press are:
1. Overloading beyond your body’s capacity
It’s one of the HEAVIEST of all upper body exercises in the gym. This means you can easily overload your shoulders beyond what they are prepared for.
Think about it this way. You have a cup, which is your capacity (what your body can handle currently) and you have a jug of water, which is your load (stressors to the body-training is one of them). If your cup isn’t big enough and you are overfilling it, this means that your body is redlining, and puts you at higher risk of injury.
You might now be rolling your eyes thinking “not another physio just telling me to rest and not do too much”. It’s true to an extent that higher weekly training volumes (weight x sets x rets) yields greater results. Does this mean you should bench more to get stronger? Yes, but do it the smart way- gradually and with room for recovery.
Allow adequate time between bench/upper body sessions sessions (48-72hrs), and throw in some lighter variations throughout the week to train the same muscle groups without risking overload (e.g. dumbbells, incline/declines, pauses, tempos).
But it’s not all about the program either. We also have to consider biomechanics and anatomy, as they can influence both load and capacity.
2. The shoulder joint is complex, as well as the execution of the bench press itself
The shoulder joint itself is complex, so in the bench-press everything from the shoulders all the way down to the feet need to work together like an orchestra for optimal performance.
Executing the bench in a more technically efficient manner allows for a reduction in load per rep. Capacity can be built by building the support structures of the shoulder, as well as through benching for a longer period of time without major setbacks. As you can see, they are both intertwined.
Let’s firstly consider the anatomy of the shoulder. It is a ball and socket joint, which allows for it to move free in space. Due to the high amount of mobility, it also requires a tonne of stability to support it in many different positions. These come from both active (muscular) and passive (joints-related) supports.
Active Support Structures
a) Rotator cuff:
A group of 4 muscles that start on the shoulder blade and wrap around to the top of the arm bone (Humerus) encapsulating the “ball”. Simple job – control the ball in the socket as the arm moves during the Bench Press.
b) Biceps tendon:
Inserts into the shoulder joint directly and runs on the front of it. Not only pretty for flexing at the beach, but also to help stabilise the shoulder.
c) Axioscapular muscles:
Yes, it’s a bit of a mouthful to say. These include your upward rotators: upper + lower trap, serratus and downward rotators: rhomboids, levator scapulae and pec minor. Their role is to help position the shoulder blade during the bench press.
Passive Support Structures
Fibrocartilage that deepens the shoulder socket for stability.
Designed to help the rotator cuff move is a sac of fluid called a bursa which is designed to reduce the friction as the tendons slide under the AC joint.
Breaking News – we all have bursae. Lots of them. Especially in the shoulder so when you’re told you have a bursae you are normal.
c) AC joint:
The AC joint consists of the collarbone acting as a strut and the outside part of the shoulder blade. The collarbone starts at the breastbone and is where the top part of the pec-major starts. It also serves as an anchor for other shoulder muscles, including your delts.
ANY of these structures can contribute to BRSP!
As you can see it is way too complex to consider each structure individually. We do have to consider the source of soreness once it does come around, but let’s try and avoid it coming to that. So instead, let’s delve into the movements that allow you to bench more AND painfree in the long run.
What makes the Bench Press work?
1. Adequate strength and recruitment of your pecs, delts, triceps and rotator cuff as you from the moment you unrack the bar and lower it, to the moment you press it out
2. Appropriately setting your shoulder blades #downandback with extension in the upper back to provide the base for your muscles to work from
3. Proper grip, with the bar in the heel of your hand for shoulder stability and efficient force transfer
4. The formation of a stable base with your hips and trunk, which allows force transfer from the ground up (literally)
5. Execution of a J-shaped bar path– the way that the pros do it to allow the least strain on the shoulders and to optimise force production
This will all be covered in detail in a 5 part series in the coming weeks, so stay tuned.