Without doubt, the bench press is the most popular weight-training exercise in North America. Anyone who asks, “How much do you lift?” is inevitably referring to the bench press. It’s almost a rite-of-passage exercise among boys in high school. Most learn to bench when preparing for football. In the past, many high school coaches didn’t know much about squats, power cleans, snatches and push presses, so they couldn’t teach them. Today, more schools have access to strength and conditioning coaches, and that makes for better-developed athletes. High school girls are also exposed to strength training for their sports.
Some young athletes begin to have shoulder pain in high school, and some develop it in college or in recreational weight rooms and commercial gyms. The bench press is a lift they know, and they know what constitutes a “good lift” or a “good weight.” We have all heard the milestone numbers of a 300- or 400-pound bench press. If you ask them what would be a good power-clean weight, they wouldn’t know. So the bench press training continues into the trainees’ 20s and 30s. Very often by the age of 40, most weight trainees have dropped the bench press altogether due to shoulder pain. Why does a shoulder hurt on and off for years? There are multiple reasons.
The bench press uses prime and secondary movers, depending on the type of bench press performed, including the pectoralis major, deltoid, triceps, serratus anterior and a number of muscles that stabilize the shoulder or the body. The rotator cuff muscles stabilize the shoulder joint so that big movements like the bench press can occur. If the rotator cuff muscles are weak, fatigued or injured, they cannot stabilize the shoulder very well, and the stress and load from the bench press can become too much for those muscles. Either they become further injured, or the cycle of pain and inflammation is perpetuated. If other exercises that contribute to rotator cuff tendinitis are performed, the pain becomes even worse. I’ve addressed those exercises multiple times in this column, but they include upright rows, lateral raises with the fronts of the dumbbells turned downward and full front-delt raises.
Another source of shoulder pain is from the glenoid labrum, a cartilage ring that surrounds the shoulder socket. One of the biceps tendons attaches to the ring as well as the rim of the socket, or glenoid. When the shoulder is stressed sufficiently by either a throwing motion or a bench press motion, the cartilage ring can be torn. The tear occurs at predictable locations. If you think of the shoulder socket as the face of a clock, a tear of the labrum occurs at one, two and 10 o’clock, or it can be torn all the way from 10 o’clock to two. The acronym for the injury is a SLAP tear, which stands for superior labrum anterior posterior. That means the top of the cartilage ring is torn at the front and back.
SLAP tears often cause clicking in the shoulder, which may or may not cause pain. When the shoulder is stressed, as in throwing a baseball or javelin or hitting a tennis ball or volleyball or performing heavy bench presses or flyes, the labrum is stressed and the torn biceps tendon attachment on the labrum can also cause pain.
If the ligaments, which attach bone to bone, at the back of the shoulder joint are too tight, the movement of the ball in the socket is shifted upward and backward, which can cause the labrum to tear. It can also partially tear the rotator cuff and cause tendinitis. Stretching the ligaments in the back of the shoulder can prevent SLAP tears.
If you have a SLAP tear, it doesn’t mean you must have surgery. Many athletes can rehabilitate their way out of the problem. The tear is still there, but the shoulder is strong and functional, and it can overcome the problem. The rehab would include improving your posture and strengthening the rotator cuff and shoulder blade muscles and stretching the ligaments in the back of the shoulder. Modifying your bench press technique is important as well. I’ll have more on this topic in the future. Until then, train smart, then train hard.
Editor’s note: Visit www.SoftTissueCenter.com for reprints of Horrigan’s past Sportsmedicine columns that have appeared in IRON MAN. You can order the books, Strength, Conditioning and Injury Prevention for Hockey by Joseph Horrigan, D.C., and E.J. “Doc” Kreis, D.A., and the 7-Minute Rotator Cuff Solution by Horrigan and Jerry Robinson from Home Gym Warehouse, (800) 447-0008, or at www.Home-Gym.com.