Why Does My Shoulder Hurt When I Bench? Understanding Anterior Shoulder Pain
For many lifters, few things are as frustrating as anterior shoulder pain when bench pressing. You finally build momentum with your training, only to be sidelined by discomfort at the front of your shoulder. Shoulder pain under the bar can arise from a range of different diagnoses, and understanding the “why” behind your pain is the first step to fixing it.
Common Diagnoses Behind Anterior Shoulder Pain
When the front of the shoulder hurts during pressing, several possible culprits should be considered:
Rotator cuff involvement - particularly the subscapularis or infraspinatus, which help stabilise the humeral head during pressing.
Long head of biceps tendon - often implicated in pain at the front of the shoulder, especially with deep pressing.
Pectoralis major strain - less common, but can occur with overload or poor technique.
Acromioclavicular (AC) joint irritation - aggravated by heavy or repeated horizontal pressing.
Deltoid strain - pain in the anterior deltoid region can mimic other causes, but sometimes it’s a red herring.
Patient Example: When a "Deltoid Strain" Wasn't the Real Problem
One of my patients, a dedicated gym-goer, presented with persistent pain during the dumbbell incline press. Initially, another physiotherapist had diagnosed the issue as a deltoid strain, and rehab was focused on the front of the shoulder. However, despite consistent work, his pain didn’t improve - because the true culprit wasn’t being addressed.
After reassessment, it became clear that the issue was with his infraspinatus, one of the rotator cuff muscles at the back of the shoulder. The pain was being felt at the front, but the underlying dysfunction was posterior.
With targeted strengthening of the infraspinatus through a variety of ranges of motion, plus gradual reloading, he made excellent progress. Over time, he was able to build back up to 35-40 kg dumbbell presses pain-free - a fantastic outcome after weeks of frustration.
This example highlights the importance of a thorough assessment. What feels like a “deltoid issue” may actually stem from deeper stabilisers around the shoulder.
What You Can Try if You’re Experiencing Shoulder Pain
If you’re experiencing shoulder pain with benching:
Deload – Temporarily reduce the load, volume, or pressing variation. Swap flat barbell bench for dumbbells or incline/neutral grip pressing.
Modify range – Sometimes reducing depth or adjusting grip width can significantly reduce pain.
Cuff strengthening – Incorporate external rotation and scaption exercises to keep the rotator cuff strong and balanced.
Scapular control – Rows, face pulls, and serratus-focused drills can support shoulder mechanics under load.
Acute pain management – Ice, relative rest, and anti-inflammatories (if tolerated/appropriate) can help settle symptoms early.
When to See a Physiotherapist
Shoulder pain that lingers more than 1-2 weeks, worsens with daily activity, or prevents progress in training is worth getting checked out. A physiotherapist can:
Identify the true source of your pain (it’s not always where you feel it).
Tailor a rehab program specific to your lifting and goals.
Help you modify training without losing progress.
Take-Home Message
Anterior shoulder pain with benching is common but not always straightforward. A “one-size-fits-all” approach doesn’t work, as shown in the case above where a misdiagnosis delayed recovery. With the right assessment and tailored rehab, most athletes return to pressing at full capacity.
If your shoulder pain is holding you back, book in with KINETIQ REHAB. An expert assessment could save you weeks of frustration and get you pressing pain-free again.
References
Lewis JS. Rotator cuff related shoulder pain: Assessment, management and uncertainties. Manual Therapy. 2016;23:57-68.
Cools AM, et al. (2015). Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. Br J Sports Med, 49(5): 327-334.
Escamilla RF, et al. (2009). Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med, 39(8): 663-685.
Lewis JS. (2016). Rotator cuff related shoulder pain: Assessment, management and uncertainties. Man Ther, 23: 57-68.
Seitz AL, et al. (2011). Clinical outcomes after exercise for rotator cuff tendinopathy: a meta-analysis. J Shoulder Elbow Surg, 20(12): 1912-1921.
Wilk KE, et al. (2020). Current concepts in the recognition and treatment of superior labral (SLAP) lesions. J Orthop Sports Phys Ther, 50(7): 361-379.