Shoulder pain compromising bench presses

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atoz76 -> Shoulder pain compromising bench presses (October 12, 2004 10:21:00 PM)
Hello! I would just like to find out if anybody of you guys know what to do with shoulder pain which is very minimal but is of a chronic nature and tends to affect the performance of bench presses. I sustained a shoulder injury a long time ago from putting down dumbells while lying supine in the bench. These days I can rarely go heavy on bench presses. When I do start lifting heavy my shoulder seems to lock and I cannot move the arm affected. Any advice would be much appreciated. Thanks!!

Brian Smith, PT, CSCS -> Re: Shoulder pain compromising bench presses (October 13, 2004 2:36:00 PM)
First, I would reevaluate your form with the bench press and evaluate your lifting goals considering the heavy weight. Full evaluation of your shoulder is also recommended. After years of seeing multiple patients with tears in the rotator cuff and pec tears after bench pressing, I always have patients focus on form. I would start with the barbell versus dumbbell. As you lay down, I would concentrate stabilizing your shoulder blades with focus on retraction and increasing stability. Most of the shoulder injuries from the bench press have come from bouncing the heavy weight off their chest. The biggest thing is to concentrate on not bouncing the bar off your chest, controlling the weight lowering the upper arm to a parallel position to the ground. Start with a focus on correct form with a lighter weight and implement some form of RTC program, after shoulder evaluation, to ensure proper stabilization of the GH joint during this movement. Only increase the weight if no residual shoulder pain.

atoz76 -> Re: Shoulder pain compromising bench presses (October 14, 2004 2:56:00 AM)
Brian, Thanks for the advice. I have been lifting on and off and I just recently got back. I used to pyramid weights so these time I did the same thing on the incline bench. With a spotter it was OK. However it felt real frightening to have the shoulder lock and not be able to push the weight back up again when I was on a heavy set. I guess you are right about lifting heavy too early. I want to add mass you see. Sometimes you just need to impress too. Especially if you're a guy and you're with other guys. Very wrong indeed. So basically it's keeping the scapula retracted and the arms parallel to the floor when bringing the barbell down. That would be the right form right? Thanks again! Alex

Randy Dixon -> Re: Shoulder pain compromising bench presses (October 16, 2004 11:43:00 PM)
If you want some free advice from someone who isn't a PT, here goes. You may have some capsule damage from laying those dumbells down, you should probably get it checked but you probably won't, right? So, A. Check your flexibility on the bench press, although your friends may tell you otherwise it isn't necessary to touch your chest with the barbell. Use a light stick and go through the motion of a bench press, if it is uncomfortable to touch your chest then don't do it with a loaded bar. B. Do a good rotator cuff program along with your bench press. C. Make sure you are working the back, posterior deltoids and the whole posterior "pulling" muscles at least as hard, and probably harder than your pressing muscles. Not doing this is probably the most common mistake in the gym today. D. Check your arm angle during the press, are you trying to keep it at ninety degrees? Don't, find the most natural position for your arms and let them do what they want, and pretty much the same thing for where the bar hits your chest, if you try and force it to touch high on your chest you are placing more stress on the shoulder. E. If you don't like the advice or it's too simple, remember, it was free.

Dr.Wagner -> Re: Shoulder pain compromising bench presses (October 17, 2004 10:45:00 AM)
You may also wish to look at your question from another angle..."bench presses compromising your shoulder" I would avoid the movement restrictions found in the straight bar press and choose lighter weights dumbell presses or move directly to cable presses. Your shoulder joint is worth more than large pecs...look closely at your fitness priorities and choose your exercises very carfully.

atoz76 -> Re: Shoulder pain compromising bench presses (October 18, 2004 12:55:00 PM)
Very good advice from everyone. Much appreciated here. Now is the time to implement everything in the gym. Much thanks!!

PTupdate.com -> Re: Shoulder pain compromising bench presses (October 24, 2004 5:17:00 PM)
As Dr. Wagner suggests, ditch the flat bar (especially if over the age of 35 or so). Never the advice that people want to hear, but using Hammer Strength, dumbells and other equipment will still help you achieve your goals without destroying your shoulder. In 13 years of being a PT and avid lifter, I cannot think of how many people I have seen trash their cuff/biceps complex using a straight bar. John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]

atoz76 -> Re: Shoulder pain compromising bench presses (October 24, 2004 9:59:00 PM)
Thank you John. It is probably a big misconception then to use the bench press with a straight bar to build mass for the pectoralis major muscles. Most sports and fitness mags say that that's the only way to go for big pecs. At any rate it is no use i guess to grow big pecs and get a damaged shoulder in the process of building it. Much thanks again!

Randy Dixon -> Re: Shoulder pain compromising bench presses (October 25, 2004 10:43:00 PM)
Regarding using dumbbells or machines I have a question. Although using DB allows you to more easily change your arm and hand position it also allows you a greater range of motion, allowing the shoulder to be in an even more compromised position, it also requires more stabilization from the synergistic muscles, this is a plus from the training point of view but may be a minus in the injury prevention POV. Wouldn't a heavy lift using DB's pose more of a risk of injury? Some machines also are basically U shaped bars, that allow the "bar" to go beyond the chest in the down position, this too would seem to pose a greater risk. ( I noticed later that you seem to be with Dr. Wagner on recommending lighter weights, but I'll leave the question for discussion.) Hammer Strength are good machines but he is in the Philippines, so that is probably not available. My real question is to Atoz, why do you want to have big pecs? Wouldn't you rather concentrate on being strong?

atoz76 -> Re: Shoulder pain compromising bench presses (October 26, 2004 1:38:00 AM)
On the issue of strength and size if I quite remember right I was taught way back in college that strength is somehow related to the cross sectional area/thickness of a muscle. Correct me on this if I am wrong but a big pecs definitely means that I can bench press more weight.Therefore strength and size are directly related. Randy, are you pertaining to cardiovascular strenght/fitness? That is not entirely different but it requires a different approach. Of course my goal is to be strong and if I grow big in the process of growing strong I would be happy. The cosmetic aspect of weight lifting is only a bonus to me. What I usually look for in a work out is how I feel better after I finish the work out. So again I think strength and size are simply different sides of the same coin. As for Hammer Strength. Yes I don't have that in the gym where I work out but if somebody is interested to bring it here and build that gym next door to me i'd be happy and i'd be an instant member.Hehe! PS- As for those who advised that I shift to DB's. I have included that in my chest work out these days and it's cool.

Sebastian Asselbergs -> Re: Shoulder pain compromising bench presses (October 26, 2004 2:56:00 AM)
atoz, may I ask why you want to be stronger? "Of course my goal is to be strong" - for a sport? Or for work? This may be important to determine the type of exercise you need to focus on. Sebastian

atoz76 -> Re: Shoulder pain compromising bench presses (October 26, 2004 1:14:00 PM)
Sebastian, I am more of a recreational lifter. I'm not into any serious sports or competitions. I think the best answer to your question then would be I work out just for the health benefits of working out. If these helps in work (I teach), and in any of the sports I engage in (which I'm sure it does) then I am happy.I lift weights if time permits an average of 3 times per week making sure that my program includes exercises for the chest and arms, back and shoulder, and legs. This I do after a warm up of either stationary biking or treadmill. I stretch after I work out. I also try to include an aerobic circuit training work out once a week with my pals. So there it goes. I would welcome any recommendations and changes that would make this program better and would help me learn and help me prevent myself from injury as well. Thanks again.

pilatespt -> Re: Shoulder pain compromising bench presses (November 19, 2004 6:27:00 AM)
atoz, Seems to me you are using too much resistance. Try a Versa Tube in a standing position. You will better be able to control your range of motion, and get a greater improvement in overall upper body strength. Also, doing this is much more functional than what you are doing. The movement is achieved by several of the muscles working together. What you need to get away from is the concept of isolating the muscle ( ie., the pectoralis major) and think more in terms of the overall result you want. If you have absolutely no access to these exercise tubes, or you do not want to be in a standing position, you can use a bar or 'wand' in supine. With these you will better be able to do the exercises without pain, because the resistance is more evenly distributed.

Brian Schiff, PT, CSCS -> Re: Shoulder pain compromising bench presses (November 19, 2004 8:12:00 AM)
atoz, My 2 cents worth would be to simply use a variety of stimuli for strength gains, in so much that you can perform strict form in a safe range of motion without pain. Changing the reps, sets, resistance, concentric and eccentric lift times, rest intervals, etc. will serve to prevent training boredom and easy neural accomodation. I would not get hung up on one right way to target the chest, but instead understand how to use all of these suggestions to benefit your workout program. I would however, avoid maximal loads as the risk to your shoulder is not worth any benefits given that you do not compete in power lifting events. I would also add that using a bar would be easier due to a more evenly distributed resistance and given the fact that you are not required to rely on as much proprioceptive control as you need with dumbbells. You also avoid the strain of having to drop or sit down the dumbbells when your set is fininshed. Best of luck to you. --Brian Schiff, PT, CSCS [URL=http://www.thefitnessedge.cc]www.thefitnessedge.cc[/URL]

atoz76 -> Re: Shoulder pain compromising bench presses (November 29, 2004 11:34:00 AM)
My thanks to everyone for coming up with very good suggestions to get on with my chest workout in the presence of my shoulder pain. I should say I do not have much of the pain anymore and I have tried out the different suggestions I got from all of you. With regards to dumbells or barbells for presses these days I do both. I usually start with dumbell flat and incline bench presses doing it unilaterally so that I still have my other hand to support the dumbell for putting it down after the set. I found out I can safely increase weight this way. I then follow this with barbell presses. I usually get DOMS of the pecs after a workout meaning to say I got my pecs really pumped. Adding variation to the workout also is a good suggestion that I will take into consideration. Alex

treybien -> Re: Shoulder pain compromising bench presses (February 16, 2005 5:19:00 AM)
strength and size are not proportionally related necessarily. There are multiple kinds of muscle hypertrophy (sarcomere vs sarcoplasm in particular) not all of which lead to the greatest strength gains. Bodybuilders train for size. Strength trainers train differtly and often their muscle appearance is different.

JLS_PT_OCS -> Re: Shoulder pain compromising bench presses (February 16, 2005 7:50:00 AM)
Treybien is quite right. Look at the issue this way: Have you seen those 'Strongest Man in the World' type contests? Or Olympic weight lifting? If you have, you will note that the body types for those athletes are very different than those of a bodybuilder. The type of demand and the muscle physiology is COMPLETELY different between bodybuilding (emphasis hypertrophy) and strength training (emphasis strength). Note that bodybuilders are strong, and strength athletes do gain some size, but it is the goal and the relative contribution of each that are important. That's why Sebastian's question about your goals is key to determining what type of program you need.

JLS_PT_OCS -> Re: Shoulder pain compromising bench presses (February 16, 2005 8:01:00 AM)
I am unaware of any study showing incidence of shoulder pain greater in weightlifters vs nonweightlifters. Though I do see a lot of it in the clinic and the gym. (also some personal experience...) I do not think the bar is necessarily the culprit in a situation of shoulder pain, however. I have met many people who had some shoulder pain with certain exercises (SLAP lesions don't seem to like barbell bench presses, for example) but the pain abated when choosing other forms of exercise: DB presses, pushups, etc. As others have said, choose your exercises carefully. I would never recommend elastic resistance for general strength purposes, as it has some qualities that do not mesh well with the contraction/force curve of muscle. So stick with free weights...just you and the pain... :)

Shill -> Re: Shoulder pain compromising bench presses (February 17, 2005 2:26:00 AM)
Jason, Do a search on osteolysis of the distal clavicle, as I believe this is where some evidence lies, regarding weightlifters and shoulder injuries. Bench press is the purported culprit. I have access to full text stuff, so I can see what I can get too. Steve

PTupdate.com -> Re: Shoulder pain compromising bench presses (February 17, 2005 3:26:00 AM)
As Shill indicates, here is an article (one of the first I ever did on ptupdate) OSTEOLYSIS OF THE DISTAL CLAVICLE. The Physician and Sportsmedicine, Vol. 28, No. 12, December 2000. Melissa Stevens, MD Preston M. Wolin, MD Joyce A. Tarbet, MD Mohammed Alkhayarin, MD ABSTRACT Osteolysis of the distal clavicle occurs when resorption of the bone occurs, usually due to traumatic causes (a blow to the shoulder), or atraumatic causes (usually weightlifting in males, but also seen in air-hammer operators, judo artist, and handball player). Patients usually complain of a dull ache localized over the AC joint, but may radiate into the trapezius or deltoid. Night pain is rare, but sleeping on the involved side may cause pain. For weight lifters, pain usually occurs on bench pressing, dips, and push-ups. The AC joint is point tender, and cross body adduction will elicit pain. The patient may have full AROM, but may have pain on impingement tests. Differential diagnosis includes: AC joint pathology/arthritis/separation, rotator cuff problems, RA, instability, labral tears, and steroid arthropathy. Initial radiographs may not show a problem early on, but later, after months or years, show a loss of subchondral bone. Etiology may include vascular compromise, microfractures, and stress-induced osteoclastic resorption. Treatment consists of activity modification, or when that is not possible, distal resection of the clavicle. Injection may offer short-term relief, but no studies have been done to determine long-term effects. PT is not used unless there is a concomitant pathology in the shoulder. Symptoms usually return if the patient resumes the activities that cause pain.

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