Kinesiology Thursday - Bicep tendonitis and the bench press

Anterior (front) shoulder pain is one of the most common complaints of pain with the bench press. It’s easy to toss this off as pain due to lifting too much weight or performing too many repetitions. But if you ask most people who suffer from this ailment, they will most likely tell you it is affecting just one shoulder even though both arms seem to be going through the same motion.

The answer lies in the position of the scapula. When you stand in your natural position, your shoulder should line up with your ear.

This is easy to see if you stand in front of a mirror and look at your hands. Do you see knuckles? If your scapulas are in the right position, you should only be able to see the thumb and side of your index finger.

If you can see more knuckles on one hand than the other, most likely one of your scapulas is sitting more forward, or protracted.

So what does this have to do with the bench press? As you lower the weight with a bench press, the following should occur:

Scapular retraction – your shoulder blades should move closer together
Shoulder extension or horizontal abduction – your arms should move behind you. This is also the position of stretch for the biceps long head tendon. Clinically speaking, the humeral head glides anteriorly during these motions due to the convex humeral head moving on concave glenoid fossa.

The biceps long head tendon attaches to the superior glenoid fossa. By looking at the picture above, you can appreciate the tension and strain that would would occur if the scapula remains protracted while the humerus is extended or horizontally abducted.

Here is a list of things that would protract the scapula:

Trigger points in pec minor or serratus anterior
Decreased thoracic rotation to that side (check this in side lying)
An anteriorly displaced medial clavicle (easily fixable)

This information isn’t just for bench pressers. If you (or your patients) have shoulder pain with reaching behind to grab something out of the back seat of your car, or if you have a hard time sleeping on your back due to shoulder pain, this may pertain to you as well.

Conventional thinking says: My shoulder hurts when I bench press because I’m lifting too much weight.

Real World Thinking says: Reaching behind (or lowering a weight) requires coordinated movement of scapular retraction with humeral extension (or horizontal abduction). Loss of scapular retraction due to tight muscles or thoracic hypomobility will place the bicep tendon at risk for strain. So take a look in the mirror. It just might hold the answer to your bench press.

Because nobody has time to be in pain.

Until next time…