Introduction
A very common complaint we see at our physical therapy clinic, Ironphysio Sports Physical Therapy and Performance, is shoulder pain while bench pressing. This seems to be an experience most lifters deal with at some point during their weightlifting journeys. Even as a physical therapist myself, this is something that I have dealt with and have had to rehab through. Being on social media, there are numerous videos that suggest that the pain is coming from one certain structure and that one certain exercise can fix your pain. Although I wish it were this easy, it is not. If I am going to be real I can tell you that there are a multitude of factors which could be leading to your shoulder pain while bench pressing, therefore it is important to see a physical therapist who can assess your deficits and provide you with an individualized treatment plan.
In my experience as a physical therapist, here are some of the most common reasons that the patients I have treated have shoulder pain with bench pressing
· Form/mechanics
· Rotator cuff and periscapular musculature deficiencies
· Pain referred from the cervical spine
Form/Mechanics
In all, bench press is a great exercise to help build muscle when performed correctly. However, it is a relatively complex motion which can lead to form breakdown while performing your sets. Variance in form/mechanics is expected from person to person due to differences in body compositions, but there are some common form mistakes that may be leading to your shoulder pain while bench pressing. Starting from the bench to the bar, you want to ensure that your shoulder blades are retracted and depressed, in other words, “back and down.” This helps create a stable base of support for your shoulders and can reduce the stress passing through the shoulder joint thereby reducing pain. Another factor to look out for is grip width and elbow positioning. Gripping the bar roughly shoulder width apart helps prevent flaring the elbows out and putting excessive stress on the shoulders. Lastly, ensure your wrists are not excessively extended or “rolling back” when you are bench pressing. This puts you had a great biomechanical disadvantage and can lead to compensatory strategies which can increase stress on your shoulders.
Rotator cuff and periscapular deficiencies
The rotator cuff is usually the first thing that lifters think about when they are having shoulder pain with bench pressing. I often see lifters performing “rotator cuff” exercises the wrong way when they are prepping for benching. The most common mistake I see is when lifters stand upright and use a dumbbell or plate and perform external rotation. This is not an optimal way to challenge the rotator cuff because there is minimal resistance in this position while performing external rotation. Instead, using a cable column or band that is anchored provides a greater challenge for the external rotators because the line of pull is resisting the external rotation movement. While this is a good exercise, it may not be the most optimal for specifically targeting the pain reproduced by benching. It is important to think about the position that we are in and that the shoulder joint is in while benching. Perhaps a better variant of this exercise is in the 90-90 shoulder position. This is why it is important to see a physical therapist when you are having pain while lifting because we can make it specific to your deficiencies and the movement that is reproducing the pain. Another thing to keep in mind is that the rotator cuff is not only an external rotator, but it also works to stabilize the shoulder joint while we are performing overhead motions. Using exercises that dynamically challenge the rotator cuff muscles will help better prime them for bench press. Check out our Instagram page to see some of the exercises we use to dynamically challenge the rotator cuff. Last, but not least, working the periscapular muscles is of utmost importance. Consider adding exercises that work to challenge the lower trapezius, middle trapezius, and serratus anterior into your workout routine.
Pain referred from the cervical spine
The cervical spine, or neck, often refers pain to the shoulder. Although you are feeling the pain in the shoulder, it does not necessarily mean that is the location for the root cause of your pain. There are many neural structures that originate in your neck and travel down your arm that could possibly be a component of your shoulder pain while bench pressing.
Bottom line
There are a variety of reasons that can cause shoulder pain while bench pressing. It is unlikely that one exercise or form change is going to work to correct all your problems. Visit a physical therapist who is adept to treating athletes and lifters to get a treatment plan that is individualized to your deficiencies and needs and that can help you get back on the right track of your lifting journey!
Local to the Bucks County, PA area? Schedule a free discovery call with Ironphysio Sports Physical Therapy and Performance and let’s come up with an individualized plan for you!
*Disclaimer: This article is not intended to be used as medical advice. It is intended to provide the reader with education on the given topic. I highly advise contacting a healthcare provider to help guide your treatment program.