yogabook / pathology / bench press shoulder

Definition of

Bench-press shoulder is an insertion stenopathy of the insertion tendon of the pectoralis minor and is most common in men aged around 30 who do sports such as weight training or bodybuilding. The coracoid process then tends to be painful on the medial side. Both the bench press and other exercises that demand strength from the muscle trigger the familiar pain. Bench presses target a variety of muscles, especially the frontal adductor and transverse adductor muscles:

1. Pectoralis major
2. Deltoid pars clavicularis
3. Coracobrachialis
4. Biceps brachii
5. Muscles of the rotator cuff
6. Muscles in the kinetic chain such as the triceps

If the bench press is performed intensively with high loads over a long period of time, several disorders can occur that are relevant to the differential diagnosis:

1. Tear of the rotator cuff
2. Subacromial impingement
3. AC-joint distortion (sprain: overstretching of the capsule/ligaments)
4. Distal clavicle osteolysis
5. Biceps tendinitis
6. Strain of the pectoralis major
7. Strain of the coracobrachialis
8. Labral tear (SLAP lesion)

In one study, tearing of the pectoralis major was the most common injury. Cases of triceps tears were mostly associated with previous use of anabolic steroids.

The actual bench press shoulder described above can be caused by technical errors when performing the bench press, for example if the force required to move the barbell back up is generated proportionally from the protraction of the shoulder blade, in which the pectoralis minor is involved. This is not least due to an insufficiently retracted shoulder blade, which would normally be held in position by the weight applied. As there are two other muscles attached to the coracoid process, the coracobrachialis and the biceps with its short head, these must be excluded as causes of pain by clinical testing, i.e. tests must be carried out for pain on extension in retroversion of the arm with(coracobrachialis) and without(biceps) a flexed arm and for pain on exertion in frontal abduction (biceps and coracobrachialis) and flexion of the elbow joint (biceps).

Tests for pain on extension during elevation of the scapula and pain on exertion during forceful depression of the scapula confirm the suspicion of an insertional tendinopathy of the pectoralis minor attachment tendon.

Cause

1. Overuse and technical faults: rudimentary protraction of the shoulder blade, swinging movements, especially lower swing reversal

Predisposing

– Musculoskeletal system

1. Scapular dyskinesia

Diagnosis

1. clinically with the above symptoms
2. Sono/MRI

Symptoms

1. Pain in the coracoid process during bench presses and other transverse adductions of the arm
2. Stretching pain on elevation of the shoulder blade
3. Strain pain with powerful depression of the shoulder blade
4. Pressure pain of the coracoid process

Complications

1. Chronification
2. Tendon rupture

Therapie

1. Elimination of the above-mentioned faults in technique, Omitting the reverse bounce
2. If necessary: reduce the training intensity