Q: Hi Denis,
Is the bench press a safe exercise? I am told that it can really hurt the shoulders. Sometimes when I do it, I feel pain. What do you think?
. . . Todd Riley
A: Hi Todd,
That’s an interesting topic, one that exposes the unfortunate fact that a lot of trainers don’t possess a comprehensive understanding of the basic principles of anatomical functions, and have no idea of what’s going on during any specific exercise. And if you think I’m being a little harsh, I challenge you to find a training article that explains what I’m about to tell you! I’ll take the time to give you some valuable information, and I’ll explain it the way I do with my university students. I must warn you, though, it will become a little complex at times, but I have to go through the details to make you understand what’s going on when your shoulder hurts while bench pressing. I’ve also made drawings so that you can visualize the basic concepts, just like I do in class.
For the bodybuilder, the bench press is an exercise that should target the pectoralis major muscle (commonly called: chest). Reaching that goal has a lot to do with range of motion (ROM). In order to efficiently stimulate hypertrophy in a specific muscle, you must be able to bring it into its stretch position. For the pectorals, that means you need functional ROM in all the joints of the shoulder girdle. Few know that the shoulder is actually composed of five mutual “joints” that all work in synergy to ensure proper motion of the upper limb. Unfortunately, a lot of trainers and therapists focus on the gleno-humeral joint and forget about the importance of the others, which all play a crucial role in proper function of the upper extremity. That’s one of the reasons you’ll see people who have been treated for a recurrent shoulder problem and tried a lot of things to get over it, but who still have something wrong and experience pain now and then. For the purpose of the present article I will only focus on two potential problems.
The bench press is a horizontal abduction motion. The mobility of the gleno-humeral joint (what people refer to as the shoulder) is limited to around 20-30 degrees in extension, depending on your flexibility. The thing is that even these are considered “normal” standards, but most people's muscle are so tense that they are prevented from going even this far! So the limited ROM prevents you from being able to bring the bar to the chest, unless you use another joint: the scapulo-thoracic (the motion the shoulder blade does while moving on the rib cage). The scapulo-thoracic joint is the one that will give your upper extremity that additional ROM you need to bring the bar closer to the chest. Then you need to literally open the ribcage to further widen the anterior area and finally be able to bring the bar to the chest without compromising any structure.
The mobility of the scapulae (shoulder blade) is the most overlooked and compromised. That’s a big issue because, as you now know, the mobility of the humeral bone (arm) is quite restricted and you must use the shoulder blade to perform any wide-range motion. If there’s an inappropriate positioning of the shoulder blade you are automatically compromising shoulder integrity and thus exposing your body to injuries.
Postural assessment crash course
The two most common inappropriate positions of the shoulder blade are the forward tilt (what people call a winged shoulder) and the rolling of the shoulder girdle. The first one is characterized by a noticeable inclination of the shoulder blade, seen from the side view. It is mainly maintained by muscular retraction of the pectoralis minor (1) and the levator scapulae (2) and some of the arm flexors like the short head of the biceps brachii (3) and the coracobrachialis (4) muscles. It is also often accompanied with adduction and inward rotation of the scapula. Forward head positioning is an example of a postural attitude that leads to a forward tilt of the shoulder blade as it pulls the levator scapulae muscle (attached to the neck). It is, in fact, one of the reasons why you should keep your head straight and in a neutral position at all times in most upper body exercises.
The second movement is characterized by a rolling pattern (abduction and outward rotation) of the shoulder blade around the torso, mainly maintained by accumulated tension in the pectoralis major (5) and serratus anterior (6).
You need (to first carefully assess your posture because you can have either one or a combination of the two. For example, a lot of people will have a forward tilt on their dominant arm, but a rolling one on the other (as a matter of compensation that I don’t want to explain now as it exceeds the extent of the present article). That’s why a lot of trainees will experience more pain in one shoulder than the other on some movements like the bench press. The arm that’s held behind in adduction and inward rotation by the rhomboideus is thus prevented from rolling properly forward. People will often get the funny feeling that one pectoral does get stretched at the bottom and that the other arm is kind of a step behind the other or gets to the top a little late. In order to correct these postural problems you need to stretch each specific muscle related to that postural pattern. And, please, don’t do those exercises you see in the magazines, as they are always full of mistakes; do seek professional help. (I get headaches every time I see an article on that!) If that doesn’t work, it simply means that you maintained those tensions over such a period of time that the body tissues adapted to that scheme and lost their mobility. At that point you will need the help of a qualified therapist that works ROM and chronic musculoskeletal problems with massage or mobilization techniques.
You also have to look for other correlated postural attitudes that could be present and cause that kind of problem. I already pointed out that forward head positioning will mechanically encourage the forward tilt of the scapulae. A rounded back postural attitude will also compromise proper ROM by maintaining retractions in the pectoralis major and serratus anterior. Of course, the problem could also come from other muscular retractions like the rotator cuff muscles (e.g., subscapularis), but, once again, most of the time the problem lies more in a lack of mobility than an actual lack of strength.
How to bench press properly
As you lie on the bench, you take the bar with a neutral position of the wrist (no hyperextension) and place it directly over your chest. The hands should be as wide as your elbows will be at the bottom of the movement so that the forearm is in a vertical line to push up. A lot of people just think about letting the bar and the elbows go down and rapidly bounce back up. First thing, you should be in complete control of the weight at all times and be able to make a stop at the top and the bottom of the movement. I don’t care that much about tempo, but my rule is that you should have the ability to stop the bar anywhere during the movement if wanted. Shoulders should be held back and you should feel your shoulder blades flat on the bench. Right there, if you can’t do this, you need stretching exercises! When going down, try to think about opening the chest and bringing it up to the bar as you take a deep breath. Also try to visualize the motion of widening the elbows to the side rather than letting them go downward. Once the bar is just about chest level (without touching), make a one-second stop while you hold your breath to ensure thoracic stabilization. You should feel the stretch in your pectorals right there! Then push the bar using your chest and exhale only at the top, going to a controlled full extension at the elbow (again without going into hyperextension). A lot of trainees never complete their range of motion and thus lose their functional ROM and end up injured.
On the picture above you have an example of the limited ROM you have at the gleno-humeral joint with a forward positioning of the shoulder on the left. On the right is the greater ROM (and pectoral stretch) you’ll get with proper positioning of the shoulder blade. Not only will you get better chest recruitment that way, but you’ll also avoid joint damage and your chances of getting injured. Free-weight bench pressing shouldn’t hurt your shoulders if done properly, as you have complete control of the movement that’s being done; on the other hand, it might in a guided pattern like a smith machine, where you have to follow a restrictive path (vector) that might not fit your structure.
Understanding the pain mechanism
The gleno-humeral joint is the most mobile part of the shoulder, thus more unstable and prone to injury. The body always tries to find the most effective way to produce a movement and will use the most movable joints available. What happens when you have a posture issue in the shoulder girdle (e.g., scapula-thoracic area) is that your body won’t be able to let you use the part of the movement that should be done with the shoulder blade, and the rib cage and will try to do it with what’s left, pushing the gleno-humeral joint to the limit! The result is quite simple: pain in the front area of the shoulder. Instead of feeling the stretch in the pectoralis major muscle, you will experience pain in the front deltoid, coracobrachialis, or even the short head of the biceps brachii. As soon as you are able to properly open your shoulder blades and your rib cage, you’ll notice that the pain is no longer there.
Where to start
1) Have someone examine you while doing the movement to carefully assess shoulder positioning and movement during the exercise.
2) According to what’s going on, try to correct your posture during the set (with barely any weight on the bar) just so that you can concentrate on the movement.
3) If you can’t position yourself correctly, start to do some stretching for the muscles that keep you from doing the motion properly. I notice that a lot of trainees have rolled shoulders, so a good start is pectoralis major and serratus anterior. For the first weeks, you will need to do them 1-3 times every day and hold the position for about 30-60 sec. each (no bouncing!).
4) Drop some weight for now on your bench press and focus on getting that perfect control of the motion. As soon as you get better at it, start to increase the weight again.
5) Apply that principle to all your upper body exercises to develop your ROM and control. You’ll notice that not only will you feel less and less pain, but you’ll actually get even stronger with time as you will become more efficient mechanically.
I hope I didn’t lose you in all that technical stuff. I also hope that the drawings helped you visualize what actually happens. You may not realize it but you now know more about the shoulder biomechanics than most trainers out there. This is a mere example of what I teach in my kinesiology classes. Those basic principles can be applied to all your other upper body exercises, so use that information and try to become more and more aware of your posture and exercise form.
By the way, you might hear that some studies have shown that stretching decreases force output and performance. That is true, but applies only if you’re an athlete looking for performance (e.g., power lifter) and if you stretch prior to the lift. It’s different if you have posture problems, don’t even have functional range of motion, and are looking for muscle development. To enjoy the power to sculpt your body, you first need a healthy and efficient one to work with. Therein lies the foundation of good health and a long life.
. . . Denis Pedneault, Canadian Champion 2005, 2006 and 2009