Q: When I bench press, my shoulders hurt like hell. Should I work around the pain, or should I just take up stamp collecting?
A: Most likely, one of three different shoulder problems is responsible for your pain:
Improper Muscle Balance
If the strength ratio between two muscle groups is off-kilter, you can actually experience faulty alignment. For example, if the strength of your pecs is far greater than that of the external rotators of the humerus (teres minor and infraspinatus), you'll likely feel a sharp pain in the superior anterior portion of the upper arm (this problem is often misdiagnosed as bicipital tendonitis). There are lots of other examples of off-set muscle/strength ratios, but explaining them all is beyond the scope of this column.
One of the regrettable side effects of years and years of weight training is the build-up of adhesions in soft tissues and structures. Adhesions are a result of the load used and the total volume of repetitions. In other words, the more sets and reps you perform and the stronger you've become, the more adhesions you've developed. These connective tissue buildups can take place within the muscle, between muscle groups, or between the nerve and the muscle. Adhesions can occur in any muscle structure but the one most often responsible for bench-press induced shoulder pain is the subscapularis muscle. The good news is that they can be found and "cured" quickly through a soft-tissue management technique called Active Release Techniques®.
Lack of Flexibility
Failure to stretch the muscles on a regular basis can precipitate the onset of injuries. You don't need to become the Grand Master of Yoga, though. Regular P.N.F. stretching of the shoulder girdle before your upper body workouts will do wonders for keeping your shoulders healthy and functional. I'll be doing an article about stretching on this website soon.
Recently, my good friend and IFBB professional bodybuilder Milos Sarcev called me out of the blue. He mentioned that he was scheduled to have arthroscopic surgery the following week for both of his shoulders. He was understandably upset. For one thing, the surgery would cost him about $18,000. Additionally, he'd have to undergo an extensive rehab program, and this would keep him from competing and earning an income for a long time. I told him to get his ass over to my office right away and see my colleague and ART? specialist Dr. Mike Leahy before letting a surgeon anywhere near his shoulders. (Incidentally, the orthopedic surgeon who made the initial diagnosis told Milos that he had an impingement syndrome and surgery was the ONLY option. The surgeon actually wanted to cut away some of the bone above the shoulder to make room for the muscle.)
When Milos came to the office, he hadn't trained in over 4 months because of the excruciating pain. Even lowering an unloaded Olympic bar (45 pounds) caused him to recoil in pain. However, after working on him for just 45 minutes, Dr. Leahy told Milos to go to the gym and give his shoulders a trial run. Somewhat reluctantly, Milos allowed me to take him to the local World Gym. In total disbelief, he bench pressed 315 pounds for two reps. Five days later, he did 6 reps with 315 pounds, without feeling any pain!
A month later, he saw Dr. Leahy again for a follow-up. Milos was already back in near-contest shape and he was training full-force for some upcoming IFBB shows. Dr. Leahy made a few minor, additional "probes," but all-in-all, Milos was cured.
The important point to realize is that you don't have to suffer or quit training because you have shoulder problems. Depending on your particular problem, either get a certified strength coach to help you design a proper routine, or locate a credentialed Active Release Techniques Provider. You can phone the National Strength and Conditioning Association at 888-746-CERT to find a qualified strength coach in your area. To find a credentialed Active Release Techniques Provider, call 719-473-7000. (Remember, use only credentialed ART providers?there are far too many doctors who are more than willing to experiment with your body).