If your patients are working hard in the gym, they will experience pain and injury from time to time. This seems to be especially true for shoulder pain during the bench press.
As more and more people train hard in the gym, it’s important for us to understand how to recover from injuries in these fitness athletes.
Injuries are horrendous and they can literally disrupt our patients’ training routines. However, this is part of the game and it happens from time to time.
Having said that, just because our patients have some pain, doesn’t mean they should stop training. Ideally, we could work through these injuries with the patient and learn how to continue training (albeit in a smarter way) when these issues arise. How to get them back in the gym when a big injury does pop up.
For someone with shoulder pain, the bench press can be a huge source of frustration. It can both limit training performance and sometimes even make your bench press day miserable.
If our patient has persistent pain during the bench press, the following may occur:
- the pain will eventually go away
- pain stays the same
- Pain that gets worse over time
I think most of us have had this experience as weightlifters. Sometimes you can train through the pain, which will gradually get better over time. On the flip side of the coin, the opposite often happens and we are in more trouble than when the pain first began.
Really, it’s a roll of the dice. Every time our patients play this game, they are essentially gambling. Maybe everything goes well, maybe it doesn’t. If we were genuinely interested in the long-term performance and health of patients, we shouldn’t bet on their shoulder injuries.
For this reason, it is important that we learn how to modify their training so they can continue working toward their training goals while ensuring their pain improves over time. What’s great is that exercising can actually help with injury recovery while, under the right circumstances, continuing to work towards your training goals.
The way we do this is by learning how to perform movement appropriately.
Think of the difference between taking two aspirin pills for a headache and taking a whole bottle of aspirin. The whole bottle can kill you, but two aspirins work well.
The same goes for exercise. If we are injured, we have to find the right dose to help our patients heal. Imagine, with a shoulder injury, bench pressing 90% of your 1 rep max for 15 sets to failure. It’s a bit like taking a whole bottle of aspirin. We don’t want that. However, if we do 3 sets of 12 dumbbell bench presses in tempo, this may be just the medicine we need to keep training and recovering patients at the same time.
So how can we find the right dose of bench press for shoulder pain relief?
The goal is to find bench press variations and/or set/rep schemes most similar It is also very well tolerated by the shoulders following the training plan for the day.
This usually means pain < 5/10, feels tolerable, and pain levels return to baseline by the next day. Use the following guidelines to help find the right dose for your patient:
How to Reduce Shoulder Pain While Bench Pressing
When I work with someone who has shoulder pain during bench pressing, I focus on modifying the exercise before immediately advising someone to stop bench pressing.
Not only does this help with recovery from shoulder pain, it also helps increase patient acceptance and compliance.
I like to focus on 6 things.
How to Reduce Shoulder Pain While Bench Pressing
- Reduce the total load or slow down the movement speed – Reducing the total load can reduce the stress on the shoulders.
Increase the number of repetitions – increasing the number of repetitions in a set will reduce the total load you can lift during the bench press. Think max 5 vs max 12.
Slow down the lifts or add a “pause” at the bottom of the bench press — Tempo or pause lifts reduce the total weight on the bar, potentially allowing for a therapeutic dose of bench press.
- Reduce the number of compressions over the course of the week to reduce the number of repetitions—reducing total compressions is often enough to get rid of shoulder pain.
Decrease the total number of bench press sets in a given session.Substitute 1-2 presses for rowing exercises in your program
- Varying your pressing exercise – Changing the angle, grip, or implement is often enough to get rid of pain when you press
Try changing to incline or decline presses.
Try varying the grip width or switching to a neutral grip.
Try using dumbbells. - Closer grip and limited range of motion – narrower grip and less depth reduce stress on the AC joint
Try switching to a tight grip.
Try floor presses, plank presses, or single-point presses. - Try some crawls as a modification – crawls are often good for shoulder pain relief and work similar muscle groups (pecs, deltoids, triceps)
Bear crawls, sideways crawls, and inchworms fit the bill here.
- Use Presses Instead of Rows – If all else fails, try presses instead of rows.
Try the seal row, chest row, one-arm dumbbell row, or any other rowing style.
As you read through, you’ll find that the first step to help reduce pain is to slow down your reps or slightly increase your rep range for the day. It would be great if this solved the problem. That’s all the modifications you need.
If this doesn’t work for you, then you need to modify it. I’ve made a handy dandy infographic below to help you figure out the process below:
You’ll try the leftmost column first and see if you can find any modifications that are well tolerated. If not, you’ll move on to the exercises in between. If none of the exercises are working, replace the lifting workout for the day with a rowing workout at the end. Now you have a working plan.
My general advice for recovery is to initially avoid exercises that are not well tolerated, and once the pain feels better, slowly return to the initially painful exercise.
For our example athlete above, they might just be in pain on a particular day, and the next week the bench press is pain-free and he can go back to his normal program. If this is the case, great, you’ve got your patient back in action.
However, this is not always the case. You may end up having to modify your bench press for a few weeks (or months) and slowly go back to steps until you can now bench press pain-free again. Everyone is different when it comes to pain and injury.
So you’ve got a simple plan for helping your patients with shoulder pain during the bench press.
Want to work with fitness athletes?
If you’re looking to work with more bodybuilders, those who want to get out of pain and get back into the gym, then you’ll want to check out our online courses on bodybuilding recovery.
In this comprehensive class, we’ll show you everything you need to know to master basic moves like the squat, deadlift, and press so you can fully understand why you get injured and how you can help people avoid injuries in the future. Plus, it’s worth 10.75 CEUs.
