By: Rob Rowland DPT
To piggyback off of Dan’s post on building a bigger bench press, I wanted to share a few points on how to bench while decreasing risk of injury. Now it is hard to find good, quality evidence in the world of training, but there was a gem published in the American Journal of Sports Medicine back in 1998 discussing several weight-lifting modifications for the athlete with an upper extremity injury. One of the lifts analyzed was the bench press and how it can be modified for injuries like impingement, SLAP tears, instability, and rotator cuff tendinitis/tears. Using the research from that study, here are some considerations for preventing shoulder injury while keeping the bench press in your program:
1: Vary your grip
When using a straight barbell, your grip dictates what structure is positioned under the acromion during the press. With the classic overhand bench press, the supraspinatus is situated under the acromion. During an underhand, or supinated, bench press the long head of the biceps will be placed under the acromion. It may be best for your shoulders to swap in underhand presses every once in a while to give the supraspinatus a break. Pressing week to week with the classic overhand grip may increase the risk of bursal-sided rotator cuff fraying and/or impingement symptoms.
2: Vary your depth
One of the risks of shoulder injuries comes from loading the shoulder complex into extension at the bottom of the bench press. Extension past the plane of the body causes an anterior translation of the humeral head which can stress the anterior capsule/ligaments. This can lead to instability in those who are not injured, or cause injury in lifters who already have unstable shoulders. Now this isn’t an excuse to perform half-reps on bench press, but it may be wise to alternate floor presses and board presses into your workout to save your shoulders. I particularly like the floor press because it’s much easier to “feel” your scapulae in the retracted position when you’re on the ground versus a cushioned bench. The floor press also takes the elastic energy out of the press (if you do it right) forcing you to use tighter form.
3: Get away from the barbell
Now pressing with a barbell may be the “gold standard” for pressing strength, but getting away from the barbell in training may save your shoulders. One great tool is the multi-grip swiss bar. This bar allows the lifter to assume a neutral grip while pressing (again changing what structure rides under the acromion during a press). If you’re not fortunate enough to have access to a swiss bar, you can use dumbbells in your training as a break from straight bar pressing to alter your shoulder kinematics. Try neutral, underhand, and an underhand to overhand press with dumbbells to vary the stress on your shoulders.
4: Don’t go too wide (for most people)
The authors of this article recommend a grip no wider than 1.5 times the bi-acromial width when pressing to keep torque about the shoulder at a minimum. The only time they recommend going wider than a 1.5x bi-acromial width is if the athlete has posterior shoulder instability. The wider grip results in a compressive force at the gleno-humeral joint giving the joint some stability in the AP (anterior-posterior) plane.
5: Don’t forget about push-ups
I’m a firm believer that one should be proficient in bodyweight movements before adding external load. It’s good practice to keep push-ups as a regular part of your upper body workouts in an effort to maintain shoulder health as it is one of the best ways to integrate scapular stability with a press.
Take these tips into considering when programming your upper body training to decrease your risk of being sidelined by a shoulder injury. Pain-free shoulders = bigger lifts.
Fees et al. (1998) Upper Extremity Weight-Training Modification for the Injured Athlete: A Clinical Perspective. American Journal of Sports Medicine. 26 (5), 732-742
Rob earned his Doctorate in Physical Therapy from the University of Delaware and now practices in MD specializing in orthopedics and sports medicine. He is also a Certified Strength and Conditioning Specialist through the NSCA. He is a competitive strongman athlete and who has qualified for the NAS national championships several times. He can be contacted at firstname.lastname@example.org.
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