// Flat bench press: the good, the bad and the solution

by Ulrik Larsen

Among those who keep up with sports science research, the standard flat bench press is fast becoming the black sheep of gym exercises – and for good reason: it is widely reported as being the most common cause of shoulder injuries in the gym. Yet despite the growing recognition of this risk, the exercise remains very popular with personal trainers and strength and conditioning coaches. It is time for a serious reappraisal.

The flat bench press is an extremely good way to grow a big chest (pectoralis major), hence its abiding popularity with members and clients. The same levels of pectoral growth cannot be achieved with standing cable presses or single arm dumbbell presses on fitballs, even though biomechanically they are profoundly safer, as they spread the load across numerous body parts. So, rather than try to outlaw an exercise that is likely to remain extremely popular, it makes sense to learn how to overcome its dangers with some intelligent modification.

Poor biomechanics from the bench = poor results + pain

The high levels of injury associated with the flat bench press are primarily caused by the bench itself, and its effect on the movement of the shoulder joint. It is not uncommon to find that a client will experience shoulder pain when performing the flat bench press, but none if they are doing normal prone push-ups. This is because the effect of most benches is to severely restrict the movement of the scapula (also called the socket or the shoulder blade), thereby artificially exaggerating the movement of the glenohumeral (ball and socket) joint.

Alongside pain, muscular development will be inhibited and distorted. Pectoralis minor will begin to dominate the press movement over pectoralis major, preventing the chest from developing as it should. The excessive glenohumeral movement (sometimes termed ‘lurching’) will ensure that the pectoralis major does not have a strong base from which to operate, again preventing its normal development. Instead the shoulders become rounded, and the anterior deltoids and triceps sometimes become over-developed in relation to pectoralis major.

Personal trainers, therapists and strength coaches should know how to activate or enhance the protraction and retraction movements of the scapula in order to prevent rotator cuff overload and shoulder pain. Good push-pull biomechanics require synergistic movement of the scapula with the humerus. This notion is at odds with the school of thought which emphasises ‘locking back’ the scapula at all times as a sign of good scapular control. While there may be an argument for ‘locking back’ early in the training regime of a client with very poor muscular development and body awareness, research and anecdotal evidence strongly suggests that the scapulae should not be locked if one wants to protect the fragile structures of the glenohumeral joint and develop the muscles of the shoulder optimally. Rather, the scapula must move synergistically with the arm, so the rotator cuff is not over-worked. As soon as the client grows in their awareness, the trainer should teach them how to move the shoulder and the arm together in order to prevent injury. This is easily done with cable push machines, single arm dumbbell chest press or even the simple push-up.

It is my contention that the majority of rotator cuff problems that develop in the gym are due to poor scapular movement during push-pull exercise rather than because of a rotator cuff weakness. Standard ‘turn-out, turn-in’ exercises for the rotator cuff are of no real and immediate help for most of these situations, as the client will simply return to their poor technique and continue to overload the cuff tendon.

Two simple solutions

The following two approaches will allow you to start the process of correcting bad mechanics and enforcing good movement patterns without the need to ban the bench press from the client’s exercise repertoire. The first physically alters the bench to give the client a chance to use their scapula; the second gives movement feedback to challenge the client to isolate and activate key muscles.

1. Improve scapula retraction-protraction with the simple pool noodle

The client lies supine on the bench, with the noodle placed longitudinally under the length of the spine (including the head and pelvis). Get the client to perform a set or two using only the bar to get used to the sensation. Gradually add weight, taking care to not allow the bar to fall sideways – it will feel quite unstable.

During this simple modification of the bench press, the scapulae will be able to protract and retract, which you should encourage by using cues such as ‘Open your chest’ while the elbow travels beneath the level of the bench. As the scapulae retract to their limit, the elbows should not descend any further, thus preventing even the slightest ‘lurching’.
This should not be a temporary measure to ‘retrain’ patho-mechanics after which the client simply returns to the standard bench press: they should continue to perform the exercise with this modification, as the bench will always create a problem.

The noodle
This is a long cylindrical foam float, widely used in aqua fitness classes. You will need one that is 100mm or less in diameter and ideally has some ‘give’ in it. A half-circular foam roller will also work, but a full one is too high. The noodle needs to run the length of the client’s spine, so that head to pelvis can lie on it during the exercise. If the noodle sits too high off the bench, it makes it too unstable to perform the exercise safely; if it is too soft (e.g., a hollow-core pool noodle) it will not act as a stimulus to change the movement of the scapula.

2. Improve glenohumeral stability with rubber tubing (Iso-Integration technique)

The purpose of this technique is to activate (isolate and integrate together, hence ‘Iso-Integrate’) the subscapularis and serratus anterior muscles in order to improve the internal biomechanics of the shoulder during the movement.
Set up the client to perform the bench press (with the pool noodle as well), using a low weight on the bar. Ask the client to hold on to each end of the tubing at the loop handles, or alternatively fix the ends of the tubing to the ends of the bar outside the weight plates. Position yourself at the head-end of the bench, holding the middle of the tubing with tension.

As the client performs their bench press, gradually increase the pulling force on the tubing, creating additional ‘torque’ (rotary force) around the shoulder. Be careful not to pull the client’s line of push out of alignment (the forearms should remain vertical). It should be easy for the client to resist the force and continue their bench press. The more muscular the client, the more rotary torque is required to overcome any muscular imbalance, and the harder you need to apply tension. It is usually advisable to use red coloured tubing initially.

This activation mechanism is extremely effective at removing pain and creating a new sense of stability in clients who experience shoulder pain when pressing. Many people feel more safe and strong in the shoulder when it is under load, and many will achieve the pectoralis major gains that they strive for.


Rubber tubing
Acquire some low-resistance therapeutic rubber tubing. Be sure to use the round hollow core tubing; stretchy elastic bands sheets are not suitable for this purpose. Make a loop at either end for the client to hold onto.


‘Recruitment Patterns of the Scapular Rotator Muscles in Freestyle Swimmers with Subacromial Impingement’, D Wadsworth and J Bullock-Saxton, University of Queensland, Australia
‘Dynamic EMG Analysis of the shoulder muscles during rotational and scapular strengthening exercises’, Post M, Morrey BG, Hawkins RS (eds) Surgery of the Shoulder, St Louis CV Mosby; 1990
‘Intramuscular EMG of the subscapularis’, MP Kapada, A Cole, ME Wotten, P McCan, M Reid, G Mulford, E April, L Bigliani; Orthopaedic Engineering and Research Center, Helen Hayes Hosp, New York, USA
‘Subscapularis muscle activity during selected rehabilitation exercises’ Decker MJ, Tokish JM, Ellis HB, Torry MR, Hawkins RJ; Steadman-Hawkins Sports Medicine Foundation, Colorado, USA
‘Functional Stability of the Glenohumeral Joint’, Sally Hess; Dept of Physiotherapy, University of Queensland, Australia
‘Relative Balance of Serratus Anterior and Upper Trapezius Muscle activity During Push-up Exercises’; Ludewig PM, Hoff MS, Osowski EE, Meschke SA, Rundquist PJ; Program of Physical Therapy, Uni of Minnesota, USA


Ulrik Larsen
An Australian Sports Physiotherapist specialising in sports injury management, Ulrik has decades of experience working with personal trainers and their clients, including elite athletes and their coaches. His passion for giving fitness professionals competence to manage clients with injuries led him to develop the Rehab Trainer course which is now delivered internationally through his network of similarly-minded physiotherapists. For more information visit www.rehabtrainer.com.au or call 0423 861 342.

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