Pain-Free Bench Pressing
How to resolve the primary causes of shoulder pain during bench pressing
by Charles Poliquin
The squat is the most effective exercise for packing on muscle mass and improving body composition. It is the king of lifts, and deservedly so. But the fact is the most popular exercise in the weightroom is the bench press. It’s used by bodybuilders and strength athletes alike, but often it’s used too much or performed incorrectly, and the result is injury. If you’ve acquired an injury from bench pressing, or want to know how to avoid one, this article is for you.
One obvious reason for injuries in bench pressing is poor form. Dr. Richard Dominguez is an orthopedic surgeon who worked with top bodybuilder Bob Gajda, who won the 1966 AAU Mr. America and later earned a Ph.D. Dominguez and Gajda co-authored a fitness training book in 1982 that was ahead of its time entitled Total Body Training. In one interview with the editor of a popular strength training and general fitness magazine, Dominguez said that among the athletes he’s seen who needed shoulder surgery from lifting weights there were two major reasons they became injured performing bench presses: lowering the bar too quickly (and often as a result, bouncing the barbell off the chest) and using too wide of a grip. Further, it’s important to have a training partner help you lift the bar to the correct position, rather than lifting it off the supports yourself and placing excessive stress on the rotator cuff muscles, particularly the subscapularis.
It’s believed that the bench press places a lot of stress on the joints because the shoulder blades are not allowed to move freely during the exercise, as they are pinned against the bench. This would explain why Olympic lifters, despite the dynamic nature of their sport in which they basically throw weights overhead, usually are less likely to suffer from shoulder pain than powerlifters. As such, the higher the volume and frequency of training, the more at risk the athlete is of developing shoulder problems.
One of the highest-volume training programs is that used by many Russian powerlifters. The Russians, who have been dominating the sport of powerlifting for the past decade, often use programs that are characterized by lots of sets, high frequency, and very few assistance exercises – training that is modeled after Olympic lifting programs. One accomplished Russian powerlifting coach who promotes such training is Boris Ivanovich Sheiko.
Sheiko has published many sample workout programs. In one preparatory program I saw, he recommended up to 40 sets of bench presses per week, sometimes even performing the bench press twice in the same workout (a method I first heard about from Canadian weightlifting coach Pierre Roy, who called this method Doublé, which is a French word that means “done twice”). Because of the high volume, the load was generally low, focusing on weights that were about 70-80 percent of the 1-repetition maximum.
In American powerlifting, the most famous and successful powerlifting coach is Louie Simmons of the famous Westside Barbell Club. In contrast to the Russian system, Simmons would focus much of the training on assistance exercises that worked on the weakest part of the bench press. If a lifter had an especially hard time driving the barbell off the chest, then Simmons might suggest work with a cambered bar. However, because the newer bench press shirts assist so much with the start of a lift, the primary assistance exercises for the bench press have been on the lockout portion of the exercise, such as board presses. How much do shirts help the bench press? Well, one powerlifter who broke the absolute world record in this lift said that during the training cycle the barbell never touched his chest once and that the only time it did was during the competition!
Another popular system for the bench press, especially among high school athletes, is that recommended by a company called Bigger Faster Stronger. In this program the athletes bench press year-round, but only perform the classical exercise once a week. On the second pressing workout, a variation of the bench press is used. Their favorite exercise for this workout is a towel bench press, which involves placing a towel or pad on the chest to shorten the range of motion of the exercise. For football players, one of the most popular variations is a standing bench press machine, such as the Hammer Jammer or the BFS Unilateral Power Press. Because these machines have the athlete pressing from a standing position, the shoulder blades are allowed to move freely.
My approach is to simply incorporate more variety in the exercise selection and also change these exercises more frequently. A general guideline I use is to change the exercises every six workouts. As such, an athlete may do bench presses for two weeks, followed by incline presses for two weeks, then dips for two weeks, and then go back to the bench press. Such an approach prevents plateaus and also the variety reduces the risk of overuse injuries.
Training programs notwithstanding, there are four other common reasons for shoulder pain from bench pressing. Here are these causes and how they can be resolved.
1. Improper Muscle Balance. In my PICP certification programs, I discuss the concept of structural balance. What this means is that if the strength ratio between two muscle groups is off-kilter, you can actually experience faulty alignment. For example, if the strength of your pecs is far greater than that of the external rotators of the humerus (teres minor and infraspinatus), you’ll likely feel a sharp pain in the superior anterior portion of the upper arm (this problem is often misdiagnosed as bicipital tendonitis).
If you’re trying to improve your performance in the bench press, the weakness may not be only in the pressing muscles but also in the agonists and the synergists – if the antagonists are too weak, they actually send a message to the brain to shut down the agonists. So if your upper back is not as strong as your pecs and your triceps, your potential to improve in the bench press is compromised. It may seem odd to improve your bench press with rows and even chin-ups, but having worked with many elite athletes, I can tell you this is the case.
One reason many athletes don’t achieve their goals is that their approach to training is too simplistic, especially among stronger athletes. The basic rule is “The stronger an athlete is, the more complex the program should be.” Case in point: Most athletes with a big bench know that rotator cuff training is important to prevent injuries from bench pressing, so they may occasionally include a few light sets of rotator cuff work in their workouts. This approach is simply not good enough for serious athletes.
My research has found that rotator cuff strength should be about 9.8 percent of what you can lift in the bench press. Such a strength ratio is not going to be accomplished by tacking on a set of some external rotation exercise with a five-pound dumbbell. In fact, one of my pro hockey players, Jim McKenzie, improved his 14-inch, close-grip bench by 49 pounds in 9 weeks, from 281 to 330- pounds, by focusing on rotator cuff strength – in fact, we did no benching at all during this training program! I then switched McKenzie to a bench press specialization program, and three weeks later he did 380 pounds in this exercise.
One tool that will help determine structural balance is using radar graphs, which are so-named because they resemble a radar screen. A radar graph displays values that revolve around a central point. The central point is zero, and increasing values are represented farther out from the center. Unlike bar graphs or pie charts, radar graphs enable you to display values that are on different scales, and therefore they can easily illustrate symmetry.
Shown is a radar graph that shows how to determine upper body structural balance using the close-grip bench press as the core exercise. As you can see, the points around the graph are perfectly symmetrical, meaning this athlete has achieved structural balance in the close-grip bench press. The graph provides precise information on the lifts I would need in each of these seven exercises to achieve a 360- and a 400-pound close-grip bench press. To learn more about structural balance training, I highly recommend you take my PICP classes, as it is one of the major topics discussed in the Level 1 and Level 2 courses.
2. Adhesion Buildup. One of the regrettable side effects of years and years of weight training is the buildup of adhesions in soft tissues and surrounding structures. Adhesions are a result of the load used and the total volume of repetitions. In other words, the more sets and reps you perform and the stronger you’ve become, the more adhesions you’ll develop.
These connective tissue buildups can take place within the muscle, between muscle groups, or between the nerve and the muscle. Adhesions can occur in any muscle structure, but the one most often responsible for bench-press-induced shoulder pain is the subscapularis muscle. The good news is that adhesions can be found and “cured” quickly through a soft-tissue management technique called Active Release Techniques®, or ART.
Several years ago, my good friend and IFBB professional bodybuilder Milos Sarcev told me that he had not trained his shoulders in over four months because of excruciating pain – the pain was so great that he couldn’t lift even an empty 45-pound barbell without recoiling in pain. As a result, he was scheduled to have arthroscopic surgery the following week for both of his shoulders. Incidentally, the orthopedic surgeon who made the initial diagnosis told Milos that he had an impingement syndrome and surgery was the ONLY option. The surgeon actually wanted to cut away some of the bone above the shoulder to make room for the muscle.
Milos was understandably upset. For one thing, the surgery would cost him about $18,000. Additionally, he’d have to undergo an extensive rehab program, and this would prevent him from competing and earning an income for a long time. I told him to see Dr. Mike Leahy, the inventor of ART, before letting a surgeon anywhere near his shoulders. After working on him for just 45 minutes, Dr. Leahy told Milos to go to the gym and give his shoulders a trial run. Somewhat reluctantly, Milos tried to bench press, and in total disbelief was able to bench press 315 pounds for two reps without any pain. Five days later, he did six reps with 315 pounds, again without pain. A month later, Milos saw Dr. Leahy again for a follow-up and was already back in near-contest shape.
The lesson here is that you don’t have to suffer or quit training because you have shoulder problems. To find a credentialed Active Release Techniques provider, go to http://www.activerelease.com. And remember to use only credentialed ART providers, as there are far too many doctors who are more than willing to experiment with your body.
3. Poor Flexibility. Failure to stretch the upper body muscles on a regular basis can precipitate injuries. You don’t need to become a grand master of yoga, though. One of the most effective methods of stretching is Proprioceptive Neuromuscular Facilitation (PNF), which was developed about 70 years ago by Dr. Herman Kabat. PNF works by stimulating the proprioceptors in the muscles, which are nerve endings that react to changes in muscular tension. I will be writing an article about PNF stretching for this website soon, but what you need to understand is that stretching the shoulder girdle before your upper body workouts will do wonders for keeping your shoulders healthy and functional.
4. Poor Nutritional Support. A poor diet can increase the risk of inflammation and will not support the healthy maintenance of the muscles and connective tissues. And good food is not enough, as the soil quality has deteriorated so much by the use of inferior fertilizers that plants cannot provide the nourishment that they did in the past. According to Dr. Robert Rakowski, who recently gave an amazing nutrition seminar as part of our Special Consideration Training Series at the Poliquin Strength Institute in East Greenwich, Rhode Island, it takes 17 elements to make a healthy plant – and the common fertilizers used on crops replace only three of them. As a result, we consume malnourished plants or malnourished animals that are consuming malnourished plants.
The first part of the solution is to eat a clean, varied, multi-colored organic diet and to supplement with a high potency multivitamin/mineral supplement and ultra-purified fish oil. The multivitamin/mineral helps to replace the key nutrients no longer found in adequate amounts in our soil and food supply, like essential antioxidants that quench free radical damage. Fish oil contains EPA which is broken down into key metabolites (known as resolvins) which have been shown over and over in the research to reduce inflammation and to calm inflammatory signaling. Start with at least 10g of fish oil in divided doses each day. The easiest way to accomplish these two goals is to take Multi Intense and Omega 3 6:1.
In addition to basic nutrition, a more targeted nutritional approach can get you back to bench pressing more quickly and to help keep your joints healthier long term. Acute injury can result in two key reactions—inflammation and muscle spasm. Key herbs such as curcumin, cayenne, boswellia and ginger, as well as citrus bioflavonoids have been shown to therapeutically reduce inflammation. In addition to herbs, I have seen tremendous results using the active enzymes trypsin and chymotrypsin. These enzymes have been shown to both reduce inflammation better than NSAIDs as well as reduce healing time by more than 50%. Calming muscle spasm and tightness will also assist in proper alignment during the healing process. I recommend herbs like hops, valerian, passionflower and the minerals calcium and magnesium to have the greatest effect in reducing spasm and tightness. These nutrients should be supplemented during the first few days after an injury to accelerate healing. The easiest way to administer all these synergistic nutrients and herbs is to use our new Joint Task Force Px packets. I recommend using 3 packets per day for the 3 days immediately following any soft tissue injury or strain. In the past, you kept ibuprofen, aspirin, or acetaminophen in your medicine cabinet; now you should keep JTF Px on hand instead. One special note: JTF Px works especially well when combined with Active Release.
After the initial repair process, enzymes known as matrix metallo-proteinases (or MMPs) need to be kept in check. These enzymes can actually become overactivated after injury (and can stay elevated with chronic injuries). When these MMP enzymes are overactivated, they actually destroy the healthy new tissue that your body is trying to lay down to repair the injury. This results in weakened ligaments, tendons, and cartilage leading to chronic and overuse injuries. The specific combination of the nutrients niacinamide, tetrahydro-iso-alpha acids, berberine HCl, selenium and others has been shown to calm the MMP enzyme system both in vitro and clinically. This unique combination can be found in Sinew Plex and requires just 1 tablet 3 times per day. I also recommend 2 tabs before workouts to protect the soft-tissue and for a noticeable increase in power. The repaired tissues are stronger with healthy parallel strands of collagen and a noticeable reduction in both trigger points and pain. After the joint is back to full function, you can discontinue the Sinew Plex (it usually takes just 2 bottles) unless you want to continue the preworkout recommendation. Joint Task Force Px and Sinew Plex synergistically support the issues found in reasons 2 and 3 above by improving mobility and helping to clear adhesions after ART.
After your shoulders are healthy, I would recommend trying Flame Quench Px and Chondro Px. Flame Quench Px helps to slow any ongoing degradation of the joint while Chondro Px provides the raw materials the body needs to build and maintain healthy joints.
The bench press is the king of upper body lifts, but make certain you don’t fall off your throne in this exercise due to the pain of injury. My advice is to train smart and follow the practical suggestions in this article.