Todd Sabol, MS, AT
Monday is the day dreaded by many, the start to a long work week, the weekend seemingly so far away. But for much of the weight lifting community there is a silver lining to Mondays, and that is their chest work out, or international chest day. In our society, the question of “how much can you bench bro” is synonymous to how much wealth do you have or how successful you are, but at what cost are we trying to sky-rocket our bench. Many avid bench pressers will develop shoulder pain over time, whether that is from the frequency of benching being way too high, attempting to rep a load that the tissue cannot adequately tolerate, or technique that is less than desirable.
When someone begins to have shoulder pain specifically from bench pressing, we need to think about the structures involved. The bench press obviously involves the pec major and minor, the main muscles targeted during the press. But when we think about the stress on other musculature surrounding the shoulder joint that assists in the bench press, we can easily see why pain can begin to occur after excessive benching or benching without ideal form. Some of the other main movers in the bench (in no particular order) are: latissimus dorsi, anterior deltoid, middle deltoid, teres major, subscapularis, triceps. A few others worth mentioning are the serratus anterior, biceps brachii, coracobrachialis, infraspinatus, supraspinatus and teres minor. All of these muscles, plus many other “secondary” bench muscles play a role in a successful bench.
Where would I have pain if I have ‘bencher’s shoulder”? Well, it can originate in multiple areas. I listed out the muscles involved in bench to give you an idea of how many muscles are actively contracting and concurrently working with each other. If injury to one of these multiple tissues occurs, especially the specific ones that attach in the shoulder, inflammation can occur in that specific muscle and being classified as tendinitis (inflammation of the tendon). Additionally, that inflammation can cause a narrowing of the space in the shoulder where many of those tendons navigate and cause them to “rub” on each other, which classifies as an impingement issue. My initial recommendation would be to seek out a qualified medical professional that specializes in injury evaluation and diagnosis to get a specific idea of what your ailment is, because with so many structures potentially being involved, you want to make sure you identify the correct one and get on a rehabilitation program specifically designed for you. But in any case let’s talk about the specific structures most commonly injured during the bench press.
The anterior deltoid and pec major are most commonly injured during the bench press. If they are injured you will have pain along those two muscle bellies. To test if you have an anterior deltoid strain, you simply raise the arm out to the side of your body against some type of resistance and have a “break test” at the very top. If there is pain during this test, you may be suffering from an anterior deltoid strain. If you want to test for a pec strain you can lay on the ground with your arm straight up in the air and have someone resist your arm from that position and you actively try to move it towards your other shoulder while keeping your elbow straight. One important point to note is if you have pain while doing this in the medial part of your upper arm, towards your armpit, you will also want to consider the coracobrachialis, which is a small muscle that acts on the shoulder and sits in between the bicep and tricep.
Another structure that is commonly injured during the bench press is the subscapularis, which is one of the four rotator cuff muscles, and the only one that sits on the anterior side of the scapula. The subscapularis is a tricky muscle to identify because of where the muscle sits deep in the shoulder girdle, but it can cause a substantial amount of pain because of its internal rotation responsibility and its responsibility with the other rotator cuff muscles to stabilize the humeral head in its proper place in the joint throughout movement. If this muscle is injured, it won’t be able to stabilize as effectively and your shoulder may begin to come forward during the movement and cause more anterior shoulder pain.
The last issue I would like to talk about is bicep pain. Your bicep contracts eccentrically during the downward portion of the bench press, and helps keep the weight controlled. If the load is too heavy, the bicep can also be strained and cause shoulder and arm pain. The short head of the bicep attaches up on the coracoid process of the scapula, while the long head attaches on the supraglenoid tubercle of the scapula, so this can cause pain in multiple areas of the shoulder.
Like I said earlier in this article, I would highly recommend to seek an evaluation from someone highly trained in orthopedic evaluation to assess your specific pain. But in the meantime I will give a few recommendations. 1) Make sure your lats and posterior scapular musculature is engaged during your bench press, this will help your shoulders to be in a better position during the movement and keep your elbows from flaring out. 2) If you are having pain, attempt to reduce the frequency and load of what you are benching because you may just be over doing it. 3) Finally, work on the eccentric portion of the lift. If you cannot control the weight, you are putting yourself at a high risk of injury, so don’t let your ego get in the way and be smart! If you have any other questions about pain with benching or shoulder pain in general please feel free to reach out and always remember to #HealByMoving.