Shoulder pain from bench press or overhead press: why it happens and how to keep training

The rotator cuff is a group of small muscles that keep the ball of the shoulder centred in its socket. Heavy pressing trains the big chest and shoulder muscles quickly, but the rotator cuff and the muscles around the shoulder blade often lag behind. When they cannot keep up, the tendons at the front and top of the shoulder get irritated.

The typical pattern is an ache at the front or side of the shoulder during pressing, pain lifting the arm sideways past shoulder height, and sometimes pain lying on that side at night. Strength is usually normal or only a little reduced.

Less often, pain sits at the top of the shoulder over the small joint where the collarbone meets the shoulder blade. This is common in people who bench very heavy or do a lot of dips.

Elbows flared straight out at 90 degrees to the body on the bench. Tucking them to roughly 45 to 70 degrees from the body shares the load more evenly and is easier on the front of the shoulder.

A very wide grip. It shortens the range for the chest but puts the shoulder in a more vulnerable position at the bottom. Bringing the grip in a little often eases pain straight away.

Shoulder blades that are not set. On the bench, pulling the shoulder blades back and down before unracking gives the shoulder a stable base. Overhead, letting the shoulder blades move up and around with the arm is normal and needed.

Bringing the bar down too fast or too low, or bouncing it off the chest. Controlled lowering to the lower chest protects the front of the shoulder.

Lots of pressing and very little pulling. A week of bench press, incline press, shoulder press and dips with one set of rows is a common recipe for shoulder pain. Aim for at least as many pulling sets as pressing sets.

Pain up to about 3 out of 10 during an exercise, which settles within a day, is usually fine. Pain that goes higher, or a shoulder that is worse the next morning, means the load needs to come down.

Swap the barbell for dumbbells, which let the shoulder find a more comfortable path, or try a neutral grip with palms facing each other. Reduce the range for now, for example a floor press, and drop the weight to a level where the last reps are clean.

Keep training the legs, back and pain-free upper body movements. Stopping the gym altogether tends to make people deconditioned and the shoulder no better.

Rotator cuff and shoulder blade exercises are the core of recovery: rows, face pulls, external rotation with a band, and exercises that train the shoulder blade to move well. Two or three sessions a week for six to twelve weeks is a typical course.

Build pressing back gradually once these feel strong, starting light and adding weight only when the shoulder stays quiet the next day.

A sudden pop or tearing feeling at the front of the chest or armpit during bench press, followed by bruising and weakness, can mean a torn chest muscle (pectoral tendon). This needs a doctor within days, because some are repaired surgically.

Also see a doctor for a shoulder that suddenly cannot lift the arm after an injury, a shoulder that looks out of place, or pain with numbness or weakness down the arm.