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Thread: Shoulder injury during benching

  1. #1
    Join Date
    Dec 2020
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    Default Shoulder injury during benching

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    Male, 32 y/o. I started to bench recently after 5-6 years break period. Before that I benched for several years, so I thought my form is passable (here’s the side view video of the last set of my first training session @ 70kg).

    2 days ago in the second training session (first one was a week before) during a warmup (20, 30, 40, 50, 60 kg) I felt discomfort in a left shoulder, but later completed the training fully with working weight (70 kg 3x5) and not much problems. Later in the day I felt soreness in the shoulder and also in this same area I noticed a red tender region (I attached photos). Sometimes I feel it when I lift the arm in front of me, or move shoulders back/forward or shrug, but generally the shoulder ROM doesn’t provoke pain. Though it can hurt by itself, the pain is 2/10, mostly dull.

    I completely don’t get how it could happen, especially during a warmup. The working weight feels heavy and my arms shaking holding it, but I can bench it just fine. My only guess is that either I was laying too far from the bar and it happened during (un)racking (I had no spotters), or I rotated my whole shoulders/elbows internally to set the grip with internal palm rotation (I know it is dumb and I probably didn’t do that and rotated just the hands). I also can’t recall I had any injury from benching before (I trained for about 6 years from a complete novice level when I was ~20 y/o, without worrying much of a form, but my grip was a tad narrower, now I use a grip with vertical forearms at the bottom).

    Is it possible guess what could’ve been injured? It looks like a trapezius connects there and also there are trapezoid and conoid ligaments.

    Also I'm not sure if I should go to doctor with this? But I'm concerned about my next training sessions
    Attached Images Attached Images

  2. #2
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    Nov 2020
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    Andrey,

    Sounds like a minor muscle strain, especially by the description of pain and the possible internal rotation of the shoulder during the bench. I would attempt to train next session as you normally do. Maybe 1-2 extra empty bar warm ups, smaller jumps to ramp up to working weight and only work up to a challenging pain free weight for your work sets.

    Not sure about the red mark on your shoulder. Looks like a skin abrasion, did you do cleans that day?

  3. #3
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    Dec 2020
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    Thank you, I did try to learn press after benching, but with a small empty bar (~6-8 kg), and it normally hardly rests on my chest at the start, so I don’t think it was involved. The painful area and red mark are in the same place, so it hurts “inside” and also I feel the soreness/irritation if I rub the surface (red mark), also the skin itself is not damaged.

    Could the inflammation from the strain somehow affect near structures? After 2-3 days from the injury I sometimes feel minor pain in the shoulder joint area itself, mostly not in general ROM, but at rest or while pushing hands into the stomach (the strain area also reacts to this).

    Though I always had “issues” with shoulder joints (especially this, left one). Nothing too special, but they can “crack” (or I can “crack” them myself, mostly reaching the arm across the body at different heights while moving the elbow up) and it can be painful to put shoulder which is not in the “correct place” in certain positions (like lifting elbow to the side and front). It also affects benching, it can be uncomfortable or cause minor pain so I generally “set” shoulders in the “comfortable” position before unracking (and it absolutely not involves internally rotating the shoulders, but I might've forgot about that on a couple of warming up sets). Also while training 6 years ago I did a no-bar warmup (mostly arm swings at different angles and rotations), but now while I starting training again I thought I just should warmup with a bar, and maybe I was wrong.

    I think I also erroneously ignored shoulder stability for too long, which I tried to solve before, doing work with elastic bands (“YTWL”, etc.), but I stopped training for 6 years shortly after and only now I recalled that I need to treat my shoulders right…

    I know Rip recommends press and benching for shoulder stability, but in my case I think I need a lot of work with rubber bands also

  4. #4
    Join Date
    Oct 2018
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    120

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    I've had a lot of shoulder issues in about 9 years of weight lifting and fixed almost all of them by finding and working on trigger points, often in the rotator cuff muscles. I *think* I've had a pain in the area you have highlighted, and fixing it required massaging the supraspinatus. In my case, I had to access it where the scapular spine meets the collar bone, which is above and further out on your shoulder than where you're feeling pain. (Pain is often "referred" to locations other than where the problem lies.) The relief is sometimes immediate.

    Even if that doesn't work for you, I'd work over the entire shoulder area, upper arm with a lacrosse ball. Unfortunately, the lacrosse ball is a bit too big for some common trigger point locations...tools like the Theracane work a bit better and I've even used the sharp corner of the Captain's Chair at the gym.

  5. #5
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    Dec 2020
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    Yeah, I have quite an experience with this (I learned about SS recently after back issues with lots of referred pain/TPs/etc.) and I can tell it’s not TPs/referred (highlighted area).

    I recently found out that the base of anterior delt (where it meets clavicle) is where the pain resides, and that delts is typical area for benching injuries. Also pain is reproduced while internally rotating the arm and reaching it up and across the body (so I think I actually rotated my whole shoulders internally that day, what a fool). I’m learning to press with no issues, will try benching tomorrow…

  6. #6
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    Nov 2020
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    Andrey,

    Be sure to record and review your bench. Make sure you forearm is perpendicular to the floor at the bottom of the bench to avoid IR of your shoulder and your upper arm is at the correct angle (~45-75degrees from the body).

  7. #7
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    Dec 2020
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    Yeah, I checked forearms, they’re vertical from behind, from the side I’m not sure (see videos below, and also video in the first post, this is essentially my pre-SS technique, excluding something I did wrong with shoulders that day).

    I also got a shoulder MRI (here’s CD contents) and here’s the findings:

    - Partial-thickness damage of the supraspinatus tendon on the bursal surface

    - Subluxation/shift of the biceps brachii long head tendon to the “small tubercle” (don’t know how to translate it to english)

    - Small amount of effusion in the joint cavity and along the way of biceps brachii long head tendon

    I assume the Subluxation of the biceps brachii long head tendon is the actual acute injury? Because it remotely resembles pain location. Or the supraspinatus tendon damage could’ve also happen that day? Is it possible to say if damage is ”fresh” or “old”? It looks like supraspinatus tendon is quite far from the initial pain location

    Today I pressed and did some very light benching (time was out and I didn't manage to go fully up in weight), the pressing was quite intense though. No issues, but after the training my whole shoulder is somewhat “warm/irritated/sore”

    Benching behind: Bench 1 - YouTube
    Benching side: Bench 2 - YouTube
    Benching front quarter: Bench 3 - YouTube
    Press: https://youtu.be/41IFoVbAy3s (I do 2.5 kg lighter than that, but here I tried more weight)


    Is it possible to say how large is supraspinatus tendon damage?
    What to do with biceps tendon sublaxation?
    Should I press?

    I’ll see ortho with this, but would appreciate any recommendations

  8. #8
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    Nov 2020
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    Andrey,

    Referring to Subluxation/shift of the biceps brachii long head tendon, the tendon of the biceps brachii long head sits in a groove located on the anterior surface of the humerus called the bicipital groove and held in place by ligaments. With your dx it seems to have moved medially and no longer sitting in the groove. This of course can cause pain and effect the tracking of the bicep.

    I'm glad you were able to press and bench with only mild symptoms post workout. However, the severity of this dx should be discussed with the ortho prior, just to be certain. Its hard to say if the injury is old or acute based on the info you provided. Describing the pain source or location may identified with a few special tests. These special tests help give us an idea of the structures involved but with multiple issues occurring it may be hard to identify one source. With that said many people have rehabbed their shoulder with carefully planned loading and progressions. Since you have full range of motion in your press and bench then I suspect you can continue with rehabbing your shoulder, but should do so carefully. Here is a protocol I often use in clinic when rehabbing rotator cuff. Shoulder Rehab Case Study - YouTube

    good luck

  9. #9
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    Dec 2020
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    Thank you, some of this is definitely acute, I think both things are. The day after workout my shoulder is still sore/aggravated most of the time, as it actually never was before, so I pushed too hard. That day was almost just a press for 1.5 hours. I’m wondering how sublaxation/shift could be solved, I assume it might not become “same as before“/"come back into bicipital groove"? By the way, the actual findings are shift of the tendon and effusion along it, which are interpreted as “signs of sublaxation” in MRI results, but maybe it’s not an actual sublaxation because MRI protocol is not a diagnosis

    Also the supraspinatus tendon — does it heals, or it just gets compensated with more strong shoulder? I watched Rip said about thing that was injured while stretched out and which can’t come together afterwards doesn’t heal, but I’m not sure it applies in my case

  10. #10
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    Dec 2020
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    starting strength coach development program
    I also found that the tendons of supraspinatus and biceps brachii long head are connected with some kind of "stabilisation" relationship, and may be injured together

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