Author: Brian Schiff PT, DPT OCS, CSCS
It’s no secret that most guys love to bench press in the gym. Some pick it up through sports directed training programs, while others simply want to get buff and strong on their own. The amount of weight one can bench press can be seen as a badge of honor and show of strength.
With that said, heavy repetitive bench pressing may also pose a risk to shoulder health. Like any repetitive loading activity, the joint must adapt and respond to stress. Often times, the goal of strength programs is to continue building hypertrophy and max strength, thereby leading to progressive loading regimens.
Over time, the shoulder must adapt to this pattern of loading. Positive adaptations include muscle hypertrophy (increased mass) in the chest, deltoids and triceps, increased strength and ultimately increased confidence. In some sports, improved horizontal pressing strength may lead to improved performance (e.g. blocking in football, wrestling or shot put).
However, there are some anatomical concerns and potential injuries associated with heavy and repetitive bench pressing. They include:
- Poor posture via rounded shoulders and increased internal rotation caused by pec tightness
- Repetitive friction between the rotator cuff and/or labrum particularly in deeper range of motion
- Acquired capsular laxity in the anterior shoulder joint over time
- Arthritis in the acromioclavicular joint (known as weightlifter’s shoulder)
- Risk of pectorals major rupture
A person’s own anatomy (the shape of the acromion) may further contribute to shoulder impingement. X-rays often reveal whether the acromion is normal, flat or hook-shaped, as well as if any bone spurs are present that may compromise the rotator cuff. If pain occurs in the shoulder with pressing, this should be viewed as a red flag.
Modifying range of motion by limiting the depth of the barbell or dumbbell path can be helpful in reducing strain on the shoulder. Preventing the elbows from traveling below the midline of the upper body will help safeguard the shoulder, and this is especially important for overhead athletes such as throwers, swimmers, tennis players, etc. Performing dumbbell or barbell pressing from the floor ensures the elbows do not pass this point.
In the end, too much of any one movement or loading pattern can create overuse pathology. Some may be able to lift for years without an issue, while others may suffer acute injuries early on in life. It is important to weigh out risk versus reward and how bench pressing applies to the demands one one’s sport or vocational activity. Keep in mind that the exercise itself is not bad; more importantly, it is the application of it over time that will determine its impact on the body.
Both Raleigh Orthopaedic Performance Center locations offer free injury screens for acute or ongoing concerns.
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