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40 million Americans in 1998 (18), with spacing <1.5 biacromial width main-
summary an increase in the number of athletes tains shoulder abduction below 45° (8).
and coaches using resistance training to However, the level of external rotation
Bodybuilders, athletes, and recre- supplement their sport-specific training is minimal during the flat bench press,
regime and regular gym users training but increases in proportion to the angle
ational lifters select a grip width for aesthetic purposes. The bench press of inclination during the incline bench
during the bench press that they be- is a very popular exercise, especially for press.
individuals seeking aesthetic improve-
lieve will produce a greater force ments. However, due to incorrect tech- Acute injuries (rupture of pectorialis
nique, individuals are at risk from acute major) and chronic over-use injuries
output. Research has demonstrated shoulder injuries involving a sudden (anterior instability and atraumatic os-
that a wide grip (>1.5 biacromial traumatic episode, such as a rupture of teolysis of the distal clavicle) are com-
the pectoralis major, during the bench mon. The risk of both acute and chronic
width) may increase the risk of press (4, 20). shoulder injury may be increased by
repetitive movements performed with
shoulder injury, including anterior The musculoskeletal system of the the shoulder close to the 90° of abduc-
shoulder instability, atraumatic os- glenohumeral joint has to provide a tion, as seen during the bench press
base of support for the motion of the when performed with a grip >1.5 times
teolysis of distal clavicle, and pec- barbell during the bench press. The bi-acromial width (10, 19, 20). This risk
performance of the bench press may may be increased with a greater level of
toralis major rupture. Reducing grip place the glenohumeral joint in a posi- external rotation, leading to the at-risk
width to ≤1.5 biacromial width ap- tion approaching 90° of abduction, and position.
the position may include some external
pears to reduce this risk and does rotation. Ninety degrees of abduction Mechanism of Injury
combined with end-range external ro- During the bench press extension of
not affect muscle recruitment pat- tation (Figure 1) has been defined as the shoulder on the descent phase caus-
terns, only resulting in a ±5% differ- the “at-risk position” that may increase es increased traction to the acromio-
the risk of shoulder injuries (10). It has clavicular. Technique performance er-
ence in one repetition maximum. been reported that a hand spacing of ≥2 rors (10, 16, 18) increase the risk of
biacromial width (shoulder width as anterior instability, atraumatic osteoly-
eight training, as an increas- defined by the distance between sis of distal clavicle, and pectoralis
100% and 200% biacromial width, (3, els of proprioception and perfection of FORMES, AND J.J. SONZOGNI. Anterior
12). Electromyographic results showed the new technique (10), especially if re- shoulder instability in weight lifters.
that grip width did not significantly af- habilitating postinjury, as this can result Am. J. Sports Med. 21:599–603.
X1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 01/17/2024
fect activity of the sternocostal head of in reduced proprioception, and the coac- 1993.
the pectorialis major (p > 0.05). Howev- tivation of rotator cuff muscles can be al- 11. HAUPT, H.A. Upper extremity injuries
er, the narrow grip significantly in- tered greatly, leading to an increased risk associated with strength training. Clin
creased the activity of the clavicular head of recurrent instability (15). ♦ Sports Med. 20:481–491. 2001.
(p < 0.01) and the activity of the triceps 12. LEHMAN, G.J. The influence of grip
brachii (p < 0.05) compared to the wide References width and forearm pronation/supina-
grip (3, 12). Therefore, this demonstrat- 1. AARIMAA, V., J. RANTANEN, J. HEIKKI- tion on upper-body myoelectrical ac-
ed that force is not dramatically reduced LA, L. HELTTULA, AND S. ORAVA. Rup- tivity during the flat bench press. J.
and neither is there a reduction in the ture of the pectoralis major muscle. Strength Cond. Res. 19:587–591. 2005.
contribution of the pectoral muscles Am. J. Sports Med. 32:1256–1262. 13. MADSEN, N., AND T. MCLAUGHLIN.
when grip width is reduced. 2004. Kinematic factors influencing perfor-
2. A UGE , W.K., AND R.A. F ISCHER . mance and injury risk in the bench
It may also be advisable to avoid incline Arthroscopic distal clavicle resection press exercise. Med. Sci. Sports Exer.
variations of the bench press, unless the for isolated atraumatic osteolysis in 16:376–381. 1984.
angle is specific for sports performance, weight lifters. Am. J. Sports Med. 14. M C C ANN , P.D., M.E. W OOTTEN ,
as this will lead to a greater level of exter- 26:189–192. 1998. M.P. KADABA, AND L.U. BIGLIANI. A
nal rotation and possibly an increase in 3. B ARNETT, C., V. K IPPERS , AND P. kinematic and electromyographic
the risk of injury. Research has also TURNER. Effects of variations of the study of shoulder rehabilitation exer-
demonstrated that the level of inclina- bench press exercise on EMG activity cises. Clin. Orthop. Related. Res.
tion does not alter activation of the clav- of five shoulder muscles. J. Strength 288:179–188. 1993.
icular (upper) portion of the pectorals, Cond. Res. 9:222–227. 1995. 15. MYERS, J.B., Y.Y. JU, J.H. HWANG, P.J.
but does decrease activation of the ster- 4. BUTCHER, J.D., A. SIEKANOWICZ, AND M C M AHON , M.W. RODOSKY, AND
nal portion, resulting in a reduction in F. PETTRONE. Pectoralis major rupture: S.M. LEPHART. Reflective muscle acti-
force (9). Ensuring accurate diagnosis and effec- vation alterations in shoulders with an-
tive rehabilitation. Phys. Sportsmed. terior glenohumeral instability. Am. J.
Recommendations 24(3):37–42. 1996. Sports Med. 32:1013–1021. 2004.
To potentially minimize the risk of in- 5. CAREK, P.J., AND A. HAWKINS. Rup- 16. NEVIASER, T.J. Weight lifting: Risks
jury, the bench press should be per- ture of pectoralis major during parallel and injuries to the shoulder. Clin.
formed with a grip ≤1.5 biacromial bar dips: Case report and review. Med. Sports. Med. 10:615–621. 1991.
width to maintain shoulder abduction Sci. Sports Exer. 30:335–338. 1998. 17. RASKE, %., AND R. NORLIN. Injury in-
within 45° (8, 10). It has been suggested 6. CLEMENS, J.M., AND C. AARON. Effect cidence and prevalence amoung elite
that the descent phase should finish 4–6 of grip width on myoelectric activity of weight and power lifters. Am. J. Sports
cm above the chest (11), and the nar- the prime movers in the bench press. J. Med. 30:248–256. 2002.
rower grip width could potentially re- Strength Cond. Res. 11:82–87. 1997. 18. REEVES, R.K., E.R. LAWKOWSKI, AND
duce the risk of injury by reducing the 7. E SENKAYA , I., H. T UYGUN , AND M. J. SMITH. Weight training injuries: Part
level of stretch on the inferior pectorialis ToRKMEN. Bilateral anterior shoulder 2: Diagnosing and managing chronic
fibers. However, this would only be ap- dislocation in a weight lifter. Phys. conditions. Phys. Sportsmed. 26(3):55–
plicable to the recreational lifter, as Sportsmed. 28(3):93–100. 2000. 63. 1998.
competitive power lifters must lower the 8. F EES , M., T. D ECKER , L. S NYDER - 19. SPEER, K.P. Anatomy and pathome-
bar and touch the chest prior to the lift- MACKLER, AND M.J. AXE. Upper ex- chanics of shoulder instability. Clin
ing phase. The adjustments to the grip tremity weight-training modifications Sports Med. 14:751–760. 1995.
width will decrease the angle of abduc- for the injured athlete: A clinical per- 20. STEPHENS, M., P.M. WOLIN, J.A. TAR-
tion and possibly external rotation at the spective. Am. J. Sports. Med. 26:732– BET, AND M. ALKHAYARIN. Osteolysis
shoulder, in turn potentially reducing 742. 1998. of the distal clavicle; readily detected
20:587–93. 1992.
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