Bench Press: Technique and Injury Risk
The bench press is the most popular exercise in the gym and at the same time one of the main sources of shoulder pain among strength-training enthusiasts. Most problems are related not to the exercise itself but to technique, excessive weight and a lack of spotting. The editorial team explains how a safe bench press works, which injuries occur most often and how to avoid them.
Which structures work and are at risk in the bench press
The main movers in the bench press are the pectoralis major, the anterior deltoid and the triceps. Stabilization is provided by the muscles of the rotator cuff, the muscles that fix the shoulder blades, and also the legs and back extensors, which create a stable support on the bench. Both the result and safety depend on how well-coordinated this system works.
The shoulder joint is the most mobile in the human body, and that is precisely why it is the least stable. The head of the humerus lies in a shallow glenoid cavity and is held mainly by muscles and ligaments. When pressing heavy weight, especially at the lowest point of the movement, the anterior joint capsule and tendons take on a significant load.
Another vulnerable link is the acromioclavicular joint, where the collarbone connects to the shoulder blade. Repeated heavy presses transmit compressive loads to it, which in some athletes leads to specific changes in bone tissue.
Finally, the pectoral muscle itself and its tendon at the point of attachment to the humerus undergo maximum stretching under load at the lowest point. It is here that one of the most serious injuries of strength sports occurs — a rupture of the pectoralis major.
Typical injuries: shoulder, chest, collarbone
The review by Kolber and colleagues (2010) on shoulder injuries associated with strength training names among the most common problems anterior instability, subacromial impingement syndrome, rotator cuff damage and osteolysis of the distal end of the collarbone. The authors link many of these to excessive range of motion, a wide grip and heavy weights.
Osteolysis of the distal clavicle was first described in detail by Cahill (1982) in athletes who engaged in strength training. It is a condition in which the end of the collarbone gradually breaks down due to repeated microtraumas. A person feels an aching pain in the upper part of the shoulder that intensifies during presses and dips on parallel bars.
A rupture of the pectoralis major is a rare but severe injury. A meta-analysis by Bak, Cameron and Henderson (2000), covering 112 cases, showed: most ruptures occurred during the bench press, predominantly in men, and surgical treatment gave better results than conservative treatment. The typical mechanism is the eccentric phase with heavy weight, when the muscle is maximally stretched.
The narrative review by Bengtsson, Berglund and Aasa (2018) on injuries in powerlifting confirms that the shoulder is one of the most frequently affected areas precisely in connection with the bench press. At the same time, the overall injury rate in strength sports is low, and most problems develop gradually, as overload, rather than as a sudden catastrophe.
| Injury | Typical signs | Risk factors |
|---|---|---|
| Subacromial pain, rotator cuff damage | Pain when raising the arm, especially above shoulder level | Wide grip, flared elbows, 'floating' shoulder blades |
| Osteolysis of the collarbone | Aching pain in the upper part of the shoulder | Frequent heavy presses, dips on parallel bars |
| Rupture of the pectoral muscle | Sudden pain, a click, bruising, deformation | Maximum weights, fast lowering, fatigue |
| Pain in the elbows and wrists | Pain when extending the arms | Excessive volume, backward extension of the wrist |
Technique: grip, shoulder blades, bar path
Grip width is the first parameter worth adjusting. A very wide grip increases the horizontal abduction of the shoulder and the load on the anterior capsule, as well as on the acromioclavicular joint. Reviews on exercise modifications for injured athletes, in particular the work of Fees and colleagues (1998), recommend for sensitive shoulders a grip no wider than about one and a half shoulder widths.
The position of the shoulder blades determines the stability of the whole structure. Before lifting the bar off the racks, the shoulder blades are drawn together and pulled down, creating a stable 'platform' on the bench. A moderate arch in the thoracic spine, in which the pelvis stays on the bench, reduces the range of motion and unloads the front of the shoulder.
The elbows should not be flared at a right angle to the torso — this is the position in which the shoulder is most vulnerable. For most people a comfortable angle between the upper arm and the torso at the lowest point is about 45–70 degrees. The bar is lowered to the lower part of the chest, not to the neck or upper chest.
The lowering of the bar should be controlled. A 'bounce' off the chest from a fast drop of the bar is a common way to lift more, but it is precisely in this phase that the risk to the pectoral muscle and shoulder joint is highest. A short controlled pause on the chest is both safer and better for technique.
The legs are an underrated element of the press. The feet stand firmly on the floor, creating support for the body. Lifting the legs onto the bench or holding them in the air means depriving yourself of stability and shifting more load onto the shoulder girdle.
Spotting and safe work with weight
The bench press is one of the few exercises in the gym where a mistake can be fatal. A bar that cannot be pushed up ends up on the chest or neck of the person lying down. There are known cases of death from asphyxiation when an athlete trained alone. That is why spotting rules here are not a formality.
- A spotteris mandatory when working with weights close to the maximum.
- Safety pinsin a power rack, set slightly below chest level, allow safe training alone.
- An open grip(without wrapping the thumb around the bar) sharply increases the risk of the bar slipping — it should be avoided.
- Collars on the barare not used when training with safety pins, so that in an emergency the plates can be dropped by tilting the bar.
- Dumbbellsare safer than a barbell for working to failure alone.
Attempts at a maximum are not needed for most amateurs. Strength grows even when working in the range of 3–8 reps with a reserve, and the risk of injury is lower with this. If you want to check your progress, you can estimate a calculated maximum from the number of reps with a submaximal weight.
The warm-up before pressing should include not only general warming up but also several sets with a gradual increase in weight, as well as rotator cuff exercises with a resistance band. A cold shoulder under heavy weight is a common injury scenario.
The volume of pressing movements in the weekly plan also matters. If a program has many presses — bench, overhead, incline, dips on parallel bars — and few pulls, an imbalance of the shoulder girdle muscles develops. A ratio of pressing to pulling sets of at least one to one is a sensible preventive measure.
Modifications for pain and prevention
If the press causes discomfort in the shoulder, it is not always necessary to abandon the exercise. Often narrowing the grip, reducing the range of motion, replacing the barbell with dumbbells with a neutral grip (palms facing each other), or pressing on a slightly inclined bench helps. These changes reduce the load on vulnerable structures.
A press with a limited range of motion, for example with a board on the chest or from pins in a power rack, allows training to continue while avoiding the riskiest lowest point. This approach is often used during recovery after minor shoulder problems.
Prevention lies in a balanced program: regular pulls in the horizontal plane, exercises for the rear delts and rotator cuff, gradual progression and sufficient recovery. Pain that persists for more than a few days, intensifies or is accompanied by weakness is a reason to see an orthopedist or sports physician.
Sudden pain in the chest or armpit during the press, a sensation of a 'click', the appearance of a bruise and a change in the contour of the pectoral muscle are signs of a possible rupture. In that case an immediate consultation with a doctor is needed: for the best result, surgical treatment of a rupture is preferably performed as early as possible.
Editorial conclusions
The bench press is an effective exercise for the upper body, but the shoulder joint, collarbone and pectoral muscle are indeed vulnerable in it. Most problems are related to technique, excessive weight and program imbalance.
A moderate grip width, drawn-together shoulder blades, elbows at an angle to the torso, controlled lowering and stable support with the legs are the basis of a safe press.
Spotting or safety pins when working with a heavy barbell are mandatory: this is a matter not only of injuries but of life.
The editorial team also recommends reading our materials on back safety in the deadlift, on typical mistakes in squats, and on the cool-down and stretching after training.
References
- Kolber MJ, Beekhuizen KS, Cheng MS, Hellman MA. Shoulder injuries attributed to resistance training: a brief review. J Strength Cond Res. 2010;24(6):1696–1704.
- Fees M, Decker T, Snyder-Mackler L, Axe MJ. Upper extremity weight-training modifications for the injured athlete: a clinical perspective. Am J Sports Med. 1998;26(5):732–742.
- Bak K, Cameron EA, Henderson IJ. Rupture of the pectoralis major: a meta-analysis of 112 cases. Knee Surg Sports Traumatol Arthrosc. 2000;8(2):113–119.
- Cahill BR. Osteolysis of the distal part of the clavicle in male athletes. J Bone Joint Surg Am. 1982;64(7):1053–1058.
- Bengtsson V, Berglund L, Aasa U. Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift. BMJ Open Sport Exerc Med. 2018;4(1):e000382.
- Aasa U, Svartholm I, Andersson F, Berglund L. Injuries among weightlifters and powerlifters: a systematic review. Br J Sports Med. 2017;51(4):211–219.
Andriy Melnyk
A strength-sports coach and author of programs for beginner and intermediate levels. Writes about training planning.
