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The Affect of Grip Width on Bench Press Performance and Risk of Injury

October 2007
Strength & Conditioning Journal 29(5)

DOI:10.1519/00126548-200710000-00001

Authors:

University of Salford

summary: Bodybuilders, athletes, and recreational lifters select a grip width during the bench press that they believe will produce a greater force output. Research has demonstrated that a wide grip (> 1.5 biacromial width) may increase the risk of shoulder injury, including anterior shoulder instability, atraumatic osteolysis of distal clavicle, and pectoralis major rupture. Reducing grip width to <=1.5 biacromial width appears to reduce this risk and does not affect muscle recruitment patterns, only resulting in a +/-5% difference in one repetition maximum. (C) 2007 National Strength and Conditioning Association

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The Affect of Grip Width on Bench Press

Performance and Risk of Injury

Carly M.Green,CSCS

Sports Injury Specialist Clinic, Gidea Park,Romford, United Kingdom

Paul Comfort,MSc,CSCS

London Sports Institute,Middlesex University,Queensway, Enﬁeld, London, United Kingdom

Volume 29,Number 5, pages 10–14

Keywords: bench press; injury; performance; glenohumeral joint;

pectorialis major

Weight training, as an increas-

ingly popular culture, was es-

timated to attract more than

40 million Americans in 1998 (18), with

an increase in the number of athletes

and coaches using resistance training to

supplement their sport-specific training

regime and regular gym users training

for aesthetic purposes. The bench press

is a very popular exercise, especially for

individuals seeking aesthetic improve-

ments. However, due to incorrect tech-

nique, individuals are at risk from acute

shoulder injuries involving a sudden

traumatic episode, such as a rupture of

the pectoralis major, during the bench

press (4, 20).

The musculoskeletal system of the

glenohumeral joint has to provide a

base of support for the motion of the

barbell during the bench press. The

performance of the bench press may

place the glenohumeral joint in a posi-

tion approaching 90° of abduction, and

the position may include some external

rotation. Ninety degrees of abduction

combined with end-range external ro-

tation (Figure 1) has been defined as

the “at-risk position” that may increase

the risk of shoulder injuries (10). It has

been reported that a hand spacing of ≥2

biacromial width (shoulder width as

defined by the distance between

acromion processes) increases shoulder

abduction above 75°, whereas hand

spacing <1.5 biacromial width main-

tains shoulder abduction below 45° (8).

However, the level of external rotation

is minimal during the flat bench press,

but increases in proportion to the angle

of inclination during the incline bench

press.

Acute injuries (rupture of pectorialis

major) and chronic over-use injuries

(anterior instability and atraumatic os-

teolysis of the distal clavicle) are com-

mon. The risk of both acute and chronic

shoulder injury may be increased by

repetitive movements performed with

the shoulder close to the 90° of abduc-

tion, as seen during the bench press

when performed with a grip >1.5 times

bi-acromial width (10, 19, 20). This risk

may be increased with a greater level of

external rotation, leading to the at-risk

position.

Mechanism of Injury

During the bench press extension of

the shoulder on the descent phase caus-

es increased traction to the acromio-

clavicular. Technique performance er-

rors (10, 16, 18) increase the risk of

anterior instability, atraumatic osteoly-

sis of distal clavicle, and pectoralis

major rupture (10, 19, 20). Exercises

reported to produce pain include wide-

summary

Bodybuilders, athletes, and recre-

ational lifters select a grip width

during the bench press that they be-

lieve will produce a greater force

output. Research has demonstrated

that a wide grip (>1.5 biacromial

width) may increase the risk of

shoulder injury, including anterior

shoulder instability, atraumatic os-

teolysis of distal clavicle, and pec-

toralis major rupture. Reducing grip

width to ≤1.5 biacromial width ap-

pears to reduce this risk and does

not affect muscle recruitment pat-

terns, only resulting in a ±5% differ-

ence in one repetition maximum.

10 October 2007 •Strength and Conditioning Journal

grip bench press, incline flys, and be-

hind-the-neck military press, all of

which position the humerus into ab-

duction and external rotation (10, 16,

18).

The loads, repetitions, and sets per-

formed in weight lifting encourage

over-use, chronic-type injuries as ath-

letes will perform 1–12 repetitions

with loads of 80–100% of the one-rep-

etition maximum (17). A variety of

techniques, such as super sets and com-

pound sets, eccentric contractions, and

forced repetitions to muscle failure, are

used by athletes (7, 18) combined with

a number of different exercises (varia-

tions of shoulder press, pec-dec, pec-

toral flys), leading to muscular fatigue

(10). The use of forced repetitions and

eccentric repetitions increase the load-

ing on the skeletal and musculo-tendi-

nous structures and further increase

the risk of injury, especially if used reg-

ularly. Case studies have indicated that

ruptures of the pectoralis major may

occur during the eccentric loading

phase when the musculo-tendinous

junction is at its highest point of

stretch; therefore, regular use of eccen-

tric repetitions may increase the risk of

this injury (4).

The repetitive nature and use of heavy

loads in weight training may provide a

fertile environment for chronic injuries

(18), and it is normal for athletes to

push themselves to the highest weight

limit possible in spite of pain (16),

thereby increasing the risk of injury.

A grip of more than 1.5 biacromial

width increases shoulder torque by 1.5

times that of a narrow grip (8), thus

increasing the risk of injury. Research

has also demonstrated that altering

grip width from 100% biacromial

width up to 190% does not signifi-

cantly (p> 0.05) affect recruitment of

the pectorialis major or the anterior

deltoid; however, the narrower the

grip, the greater the activation of the

triceps brachii (6).

It is the general consensus that the use

of a narrow grip during the bench press

produces less stress for the acromio-

clavicular joint, the inferior gleno-

humeral ligament, and the pectoralis

major (8, 11). By adjusting hand spac-

ing to no more than 1.5 biacromial

width, the component angles of abduc-

tion can be decreased. This in turn will

decrease the peak torque and stress oc-

curring at the shoulder joint (8, 11),

thereby potentially decreasing the risk

of injuries to these structures. It is in-

teresting to note that one article de-

tailed that the narrow grip caused pain

for patients with osteolysis of the distal

clavicle (2); however, as this was not

noted in any other research and because

the exact distance of the grip was not

expressed, it is possible that the nar-

rower grip was still greater than 1.5 bi-

acromial width.

The major mechanisms of injury sug-

gested within the literature are:

• Hand spacing >1.5 ×biacromial

width (1, 8, 13).

• High or intolerable exercise dose or

repetitive strain (2, 5, 10, 18).

• Altered proprioception (postinjury)

(8, 15).

Common Injuries

Anterior Glenohumeral Instability

Anterior glenohumeral instability, de-

fined as the inability to maintain the

humeral head centred in the glenoid

fossa, appears to be the most common

shoulder injury experienced by competi-

tive weight lifters (19). Anterior shoul-

der stability is largely dependant on the

inferior glenohumeral ligament (IGHL).

The IGHL is found attached to the ante-

rior inferior aspect of the humeral head

and to the anterior glenoid and labrum.

The IGHL is responsible for restraining

anterior translation at 90° of abduction;

if the IGHL is damaged, the shoulder be-

comes more susceptible to anterior insta-

bility (19).

Anterior instability is considered a

chronic condition that may occur in

individuals who regularly perform

weight-training exercises with the

October 2007 •Strength and Conditioning Journal

Figure 1. At-risk position.

shoulder approaching 90° abduction

and may be increased with external ro-

tation (10). However, losing control of

a heavy load during a lifting exercise is

the most common mechanism for

acute subluxation or dislocation and

concurrent instability (16).

Atraumatic Osteolysis of the

Distal Clavicle

A stress-failure syndrome of the distal

clavicle is a pathologic process of bone

destruction to the subchondral bone

of the distal clavicle (2). The injury

appears to be a chronic condition

mostly caused by repetitive weight-

training exercises, as seen in body-

builders and powerlifters (20). The

weakness of the clavicles makes this

area of the shoulder girdle highly sus-

ceptible to trauma (11). The extension

mechanism of the shoulder during the

eccentric phase of the bench press ex-

cessively stresses the acromioclavicular

joint and is thought to contribute to

osteolysis of the distal clavicle (18)

caused by repetitive microtrauma dur-

ing weight lifting (20).

Atraumatic osteolysis of the distal clavi-

cle appears to be caused by repetitive

movements performed with the shoul-

der at 90° abduction, which is ap-

proached during the bench press when

performed with a grip >1.5 times biacro-

mial width (10, 20) and worsened if ex-

ternal rotation also occurs, as seen in the

inline bench press and behind neck

press.

The incidence of osteolysis mimics the

increase in the number of athletes using

strength training, although large num-

bers of weight-lifting subjects with oste-

olysis do not seem to exist (2).

Pectoralis Major Rupture

A rupture of the pectoralis muscle oc-

curs mainly during strength training

and especially during the bench press

(11). It is characterized by a sudden

acute injury often occurring during the

eccentric loading phase when the mus-

culo-tendinous junction is at its highest

point of stretch (4). Due to the twisting

orientation of the inferior pectorialis

fibers that converge onto the proximal

aspect of the humerus, the inferior fibers

of the pectoralis major are at a higher

risk of trauma (11). The injury occurs

during the concentric phase after the ec-

centric lowering that stresses the inferior

pectorialis fibers as the humerus con-

trols the barbell up to finish the press

(1). When the glenohumeral joint is in

extension during the descent phase

where the bar touches the chest, the pec-

toralis muscle is stretched and contract-

ed and it is the load in this position that

forces the inferior pectorialis fibers to

tear. The inferior fibers are lengthened

disproportionately during the final 30°

of humeral extension, creating a me-

chanical disadvantage during the eccen-

tric phase, resulting in an increased risk

of injury (21).

Ruptures occur commonly at the tendi-

nous insertion on the humerus after ex-

cessive weight is applied to a maximally

contracted muscle (5). Prior research

noted that 24 out of 33 subjects suffered

a pectoralis rupture during power lifting

and bodybuilding with a bench-pressing

mechanism (1).

Bench Press Performance

The bench press should be performed

with a grip <1.5 biacromial width,

lowering the bar in a slow, smooth,

controlled manner to the lower por-

tion of the pectorals (Figure 2) to re-

duce the level of abduction and rota-

tion at the shoulder. The bar should

move through the same plane of mo-

tion during the lifting phase, but

should be more rapid.

The action of the bench press has a var-

ied kinematics pattern (13). The more

experienced lifter will control the bar to

and from the chest following a path that

keeps the lever arm closer to its center of

gravity (using a narrow grip <1.5 biacro-

mial width, lowering the bar to the

lower portion of the pectorals), which is

created by the support base of the gleno-

humeral joint. The experienced lifter

will also take longer to complete the ex-

ercise, therefore resulting in a decrease

12 October 2007 •Strength and Conditioning Journal

Figure 2. Mid-range bar position.

in force exerted on the musculo-tendi-

nous junction (13).

Research has demonstrated a nonsignifi-

cant difference ±5% (p> 0.05) in one

repetition maximum with a grip width of

100% and 200% biacromial width, (3,

12). Electromyographic results showed

that grip width did not significantly af-

fect activity of the sternocostal head of

the pectorialis major (p> 0.05). Howev-

er, the narrow grip significantly in-

creased the activity of the clavicular head

(p< 0.01) and the activity of the triceps

brachii (p< 0.05) compared to the wide

grip (3, 12). Therefore, this demonstrat-

ed that force is not dramatically reduced

and neither is there a reduction in the

contribution of the pectoral muscles

when grip width is reduced.

It may also be advisable to avoid incline

variations of the bench press, unless the

angle is specific for sports performance,

as this will lead to a greater level of exter-

nal rotation and possibly an increase in

the risk of injury. Research has also

demonstrated that the level of inclina-

tion does not alter activation of the clav-

icular (upper) portion of the pectorals,

but does decrease activation of the ster-

nal portion, resulting in a reduction in

force (9).

Recommendations

To potentially minimize the risk of in-

jury, the bench press should be per-

formed with a grip ≤1.5 biacromial

width to maintain shoulder abduction

within 45° (8, 10). It has been suggested

that the descent phase should finish 4–6

cm above the chest (11), and the nar-

rower grip width could potentially re-

duce the risk of injury by reducing the

level of stretch on the inferior pectorialis

fibers. However, this would only be ap-

plicable to the recreational lifter, as

competitive power lifters must lower the

bar and touch the chest prior to the lift-

ing phase. The adjustments to the grip

width will decrease the angle of abduc-

tion and possibly external rotation at the

shoulder, in turn potentially reducing

the risk of shoulder injury without alter-

ing the benefits or performance of the

exercise (3, 6, 12).

It is also essential that altering technique

loads are reduced to allow increased lev-

els of proprioception and perfection of

the new technique (10), especially if re-

habilitating postinjury, as this can result

in reduced proprioception, and the coac-

tivation of rotator cuff muscles can be al-

tered greatly, leading to an increased risk

of recurrent instability (15). ♦

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Green

Comfort

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Sep 2023
INT J SPORTS MED

This research aimed to conduct a systematic review of para powerlifting strength performance. The searches were conducted in three electronic databases: PubMed, Scopus, and SPORTDiscus. Intervention studies related to para powerlifting performance were included. The main information was extracted systematically, based on criteria established by the authors. The data on study design, sample size, participant’s characteristics (e. g. type of disability, sex, age, body weight, and height), training experience, assessment tools, physical performance criteria, and force-related outcomes were extracted and analyzed. The studies (n=9) describe factors related to biomechanics and performance. Outcomes revealed that the one-repetition maximum test is used as load prescription and that para powerlifting should work at high speeds and higher loads. Regarding technique, grip width with 1.5 biacromial distance provides a good lift and partial amplitude training as an alternative to training. There are no differences in total load and movement quality in the lumbar arched technique compared with the flat technique. As a monitoring method, repetitions in reserve scale was used for submaximal loads. Finally, our outcomes and discussion indicated strategies and techniques that can be used by para powerlifting coaches.

Comparison of Muscle Activity between the Horizontal Bench Press and the Seated Chest Press Exercises Using Several Grips

Article

Full-text available

Apr 2023

This study aims to compare muscle activity in the pectoralis major, anterior deltoid, and triceps brachii in the horizontal bench press exercise with a prone grip at 150% and 50% of the biacromial width and the seated chest press exercise with two types of grips (a neutral grip at ~150% of the biacromial width and a prone grip at ~200% of the biacromial width). Twenty physically active adults performed a set of 8 repetitions at 60% of the one repetition maximum. The results showed that the clavicular portion of the pectoralis major had significantly greater muscle activity in the seated chest press exercise with a neutral grip (~30% of the maximal voluntary isometric contraction (MVIC)) than in the lying bench press exercise with a prone grip at 150% of the biacromial width (~25% MVIC). The muscle activity of the anterior deltoid was not significantly different across any exercise or grip evaluated (~24% MVIC). The muscle activity of the triceps brachii was significantly higher in the lying bench press exercise with a grip at 50% biacromial width (~16% MVIC) than at 150% of the biacromial width (~12% MVIC). In conclusion, all exercises and grips showed similar muscle activity, and the selection of these exercises should not be based exclusively on the grounds of muscle activation but rather on the load capacity lifted, the level of technique of the participant, and/or the transference to the specific sporting discipline or event.

A Comparison of Basic Training Variables in the Standard and Cambered Bar Bench Press Performed to Volitional Exhaustion

Article

Full-text available

Mar 2023
J HUM KINET

The objective of this study was to compare the impact of cambered and standard barbells used during the bench press exercise on the number of performed repetitions and mean velocity during a bench press training session that included 5 sets performed to volitional failure at 70% of one-repetition maximum (1RM) (for each barbell type). An additional objective was to determine whether there would be any difference in neuromuscular fatigue assessed by peak velocity changes during bench press throws performed 1 and 24 hours after the cessation of each session. The research participants included 12 healthy resistance-trained men. Participants performed 5 sets of the bench press exercise to volitional failure against 70% of 1RM with the cambered or standard barbell. The Friedman’s test showed an overall trend of a significant decrease in the mean velocity (p < 0.001) and a number of performed repetitions (p < 0.001) from the first to the fifth set (p < 0.006 and p < 0.02, respectively for all) under both conditions, yet neither bar showed significant differences between the corresponding sets. Two-way ANOVA indicated a significant main effect of time (p < 0.001) for peak velocity during the bench press throw. The post-hoc comparisons showed significantly lower peak velocity during the bench press throw one hour after the bench press compared to pre (p = 0.003) and 24-hour post intervention (p = 0.007). Both barbells caused a similar decrease in peak barbell velocity during the bench press throw performed one hour after the bench press training session, with values returning to baseline 24 hours later. This indicates that bench press workouts with either a standard or a cambered barbell present the same training demands.

Comparación de la actividad electromiográfica de los músculos implicados en el remo horizontal de polea baja con diferentes agarres y anchuras bilaterales (Comparison of the electromyographic activity of the muscles involved in low pulley horizontal rowing with different grips and bilateral widths)

Article

Full-text available

Sep 2024

Existen diferentes tipos de agarre que pueden utilizarse en el remo horizontal en máquina de polea baja. El objetivo de este estudio fue realizar un análisis electromiográfico de la activación muscular de los músculos dorsal ancho, bíceps braquial, deltoides posterior y parte transversa del trapecio, para diferentes agarres bilaterales y anchuras. La muestra estuvo formada por 12 participantes varones sanos. Se midió el nivel de activación muscular, expresado como porcentaje de una contracción voluntaria máxima. Los resultados mostraron una diferencia significativa (ρ≤0,05) en el bíceps braquial, siendo el agarre estrecho neutro el que más lo activaba. Por otro lado, el deltoides posterior se activó más con los agarres más anchos, siendo el agarre neutro ancho el que más lo activó. Hubo diferencias significativas en el trapecio, que se activó más con el agarre neutro de anchura media. En el caso del músculo dorsal ancho, aunque no de forma significativa, fue el agarre supino ancho. Concluimos que, aunque no se encontraron diferencias en el músculo dorsal ancho, el trapecio parece ser el músculo que más se activa con este ejercicio, siendo el agarre neutro estrecho el que muestra una mayor activación en el bíceps braquial. Palabras clave: Activación muscular, agarres, electromiografía, contracción máxima voluntaria, remo horizontal de polea baja Abstract. There are different types of grip that can be used in horizontal row on a low pulley machine. The aim of this study was to carry out an electromyographic analysis of the muscle activation of latissimus dorsi muscle, biceps brachii, posterior deltoid and transverse part of trapezius, for different bilateral grips and widths. The sample consisted of 12 healthy male participants. The level of muscle activation, expressed as a percentage of a maximum voluntary contraction, was measured. The results showed that a significant difference (ρ≤0.05) was obtained in the biceps brachii, with the narrow neutral grip activating it the most. On the other hand, the posterior deltoid was more activated with the wider grips, with the wide neutral grip activating it the most. There were significant differences in the trapezius, which was activated the most with the medium width neutral grip. In the case of the latissimus dorsi muscle, although not significantly, it was the wide supine grip. We concluded that, although no differences were found in the latissimus dorsi muscle, the trapezius seems to be the muscle that is most activated with this exercise, with the narrow neutral grip showing the highest activation in the biceps brachii. Keywords: muscle activation, grips, electromyography, voluntary maximum contraction, low pulley horizontal rowing

A Sports Medicine Clinician's Guide to the Diagnosis and Management of Distal Clavicular Osteolysis

Article

Jun 2023
Curr Sports Med Rep

Weightlifting associated shoulder injuries have seen a dramatic rise in the last 20 years. Distal clavicular osteolysis, coined weightlifter's shoulder, is one such condition caused by repetitive microtrauma to the distal clavicle with subsequent, painful development of bony erosions and resorption of the distal clavicle. Diagnosis, treatment, and prevention of this condition can be challenging. In this article, we highlight evidence-based clinical recommendations for the diagnosis and management of distal clavicular osteolysis, including specific considerations for atraumatic and posttraumatic etiologies, to help clinicians better care for their patients. Activity modification and rehabilitation are the mainstays of the initial treatment. Adjuvant treatments, such as injections or surgery, may be required in refractory cases or in certain patient populations. Early recognition and treatment of weightlifter's shoulder is essential to prevent progression to acromioclavicular joint pathology or instability and to allow for continued participation in sport-specific activities.

Effects of Variations of the Bench Press Exercise on the EMG Activity of Five Shoulder Muscles

Article

Full-text available

Nov 1995

This experiment investigated the effects of varying bench inclination and hand spacing on the EMG activity of five muscles acting at the shoulder joint. Six male weight trainers performed presses under four conditions of trunk inclination and two of hand spacing at 80% of their predetermined max. Preamplified surface EMG electrodes were placed over the five muscles in question. The EMG signals during the 2-sec lift indicated some significant effects of trunk inclination and hand spacing. The sternocostal head of the pectoralis major was more active during the press from a horizontal bench than from a decline bench. Also, the clavicular head of the pectoralis major was no more active during the incline bench press than during the horizontal one, but it was less active during the decline bench press. The clavicular head of the pectoralis major was more active with a narrow hand spacing. Anterior deltoid activity tended to increase as trunk inclination increased. The long head of the triceps brachii was more active during the decline and flat bench presses than the other two conditions, and was also more active with a narrow hand spacing. Latissimus dorsi exhibited low activity in all conditions. (C) 1995 National Strength and Conditioning Association

Effect of Grip Width on the Myoelectric Activity of the Prime Movers in the Bench Press

Article

Full-text available

May 1997

The purpose of this study was to determine the effect of grip width on myoelectric activity of the pectoralis major, anterior deltoid, triceps brachii, and biceps brachii during a 1-RM bench press. Grip widths of 100,130,165, and 190% (G1, 2, 3, 4, respectively) of biacromial breadth were used. Mean integrated myoelectric activity for each muscle and at each grip width was determined for the concentric portion of each 1-RM and normalized to percentages of max volitional isometric contractions (%MVIC). Data analysis employed a one-factor (grip width) univariate repeated measures ANOVA. Results indicated significant main effects for both grip width (p = 0.022) and muscles (p = 0.0001). Contrast analyses were conducted on both main effects. Significant differences (p <= 0.05) were found between grip widths G4 and both Gl and G2 relative to %MVIC. Significant %MVIC differences on the muscles main effect were also found. All prime movers registered significantly greater %MVICs than the biceps and, in addition, the triceps %MVIC was greater than the pectoralis major. (C) 1997 National Strength and Conditioning Association

Anatomy and pathomechanics of shoulder instability

Article

Jan 1993

K.P. Speer

Reflex muscle activation alterations in shoulders with anterior glenohumeral instability

Article

Jun 2004
AM J SPORT MED

Background: Patients with glenohumeral instability have proprioceptive deficits that are suggested to contribute to muscle activation alterations. Hypothesis: Muscle activation alterations will be present in shoulders with anterior glenohumeral instability. Study Design: Posttest-only control group design. Methods: Eleven patients diagnosed with anterior glenohumeral instability were matched with 11 control subjects. Each subject received an external humeral rotation apprehension perturbation while reflexive muscle activation characteristics were measured with indwelling electromyography and surface electromyography. Results: Patients with instability demonstrated suppressed pectoralis major and biceps brachii mean activation; increased peak activation of the subscapularis, supraspinatus, and infraspinatus; and a significantly slower biceps brachii reflex latency. Supraspinatus-subscapularis coactivation was significantly suppressed in the patients with instability as well. Conclusions and Clinical Relevance: In addition to the capsuloligamentous deficiency and proprioceptive deficits present in anterior glenohumeral instability, muscle activation alterations are also present. The suppressed rotator cuff coactivation, slower biceps brachii activation, and decreased pectoralis major and biceps brachii mean activation may contribute to the recurrent instability episodes seen in this patient group. Clinicians can implement therapeutic exercises that address the suppressed muscles in patients opting for conservative management or rehabilitation before and after capsulorraphy procedures.

Electromyographical Activity of the Pectoralis Muscle During Incline and Decline Bench Presses

Article

Aug 1997

The purpose of this study was to determine the relationship between motor unit recruitment within two areas of the pectoralis major and two forms of bench press exercise. Fifteen young men experienced in weight lifting completed 6 repetitions of the bench press at incline and decline angles of +30 and -15[degrees] from horizontal, respectively. Electrodes were placed over the pectoralis major at the 2nd and 5th intercostal spaces, midclavicular line. Surface electromyography was recorded and integrated during the concentric (Con) and eccentric (Ecc) phases of each repetition. Reliability of IEMG across repetitions was r = 0.87. Dependent means t-tests were used to examine motor unit activation for the lower (incline vs. decline) and upper pectoral muscles. Results showed significantly greater lower pectoral Con activation during decline bench press. The same result was seen during the Ecc phase. No significant differences were seen in upper pectoral activation between incline and decline bench press. It is concluded there are variations in the activation of the lower pectoralis major with regard to the angle of bench press, while the upper pectoral portion is unchanged. (C) 1997 National Strength and Conditioning Association

Arthroscopic Distal Clavicle Resection For Isolated Atraumatic Osteolysis in Weight Lifters

Article

Mar 1998
AM J SPORT MED

Ten consecutive patients with isolated atraumatic osteolysis of the distal clavicle who had failed results with conservative treatment were treated with arthroscopic resection of the involved distal clavicle (average, 4.5 mm). All patients were men with an average age of 30.4 years, had unilateral involvement, and were considered aggressive amateur to elite weight lifters or bodybuilders. Postoperative symptoms consisted of pain at the incision and discomfort from extravasation of the irrigation fluid. At an average followup of 18.7 months, all patients had returned to their sport (average, 3.2 days) and to their preoperative weight training program (average, 9.1 days). They continued to be asymptomatic throughout the follow-up period and were able to increase both their training volume and strength from preoperative levels. Limited arthroscopic resection of the distal clavicle for isolated atraumatic osteolysis is a viable alternative for the weight lifter or bodybuilder. The ability to continue training without significant interruption as well as a more acceptable cosmetic appearance are benefits for these patients. Limited arthroscopic resection of the distal clavicle may be sufficient for this entity in this patient population, rather than the 1 to 2 cm previously reported. A sport-specific functional outcome questionnaire has been developed for this patient population.

Rupture of pectoralis major during parallel bar dips: Case report and review

Article

Mar 1998

Rupture of the pectoralis major muscle is an uncommon athletic injury that can result in both functional and cosmetic deficiency. To date, most ruptures occurring in athletes have occurred while performing bench press or overhead lifting maneuvers. We describe a case of a pectoralis major rupture occurring while performing weighted parallel bar dips. Despite the popularity of this exercise, injuries associated with this exercise are infrequently reported. This injury can be easily detected by having the patient perform specific maneuvers on physical examination to accentuate any defect that may be present. In most cases, this injury is surgically repaired, although conservative treatment can be a successful option. Treatment options are discussed and recommendations given. A partial or complete tear of the pectoralis major muscle is a rare event and is often not easily detected on physical examination. Surgical repair is currently recommended to restore previous levels of strength and to correct the resulting cosmetic defect. Repair is rarely necessary to perform the normal activities of daily living.

Pectoralis Major Rupture: Ensuring Accurate Diagnosis and Effective Rehabilitation

Article

Mar 1996

Rupture of the pectoralis major muscle and tendon, which occurs most frequently among weight lifters but has been reported in many sports, can most often be diagnosed based on the history and physical exam. Surgical intervention for complete ruptures has a clear advantage over conservative therapy. Athletes of all levels can be expected to return to near preinjury levels of participation following surgery and a well-constructed, supervised rehabilitation program. This should involve immobilization followed by range-of-motion exercises and strength training of gradually increasing resistance.

Weight Training Injuries: Part 2: Diagnosing and Managing Chronic Conditions

Article

Mar 1998

The repetitive nature of weight training and the often heavy loads involved provide fertile ground for chronic injuries. Common chronic injuries include rotator cuff tendinopathy and stress injuries to the vertebrae, clavicles, and upper extremities. In addition, muscle hypertrophy, poor technique, or overuse can contribute to nerve injuries such as thoracic outlet syndrome or suprascapular neuropathy. Chronic medical conditions that are known to occur in weight trainers include vascular stenosis and weight lifter's cephalgia. Management of chronic problems will vary by condition, but relative rest and correction of poor technique are important for many.

Bilateral Anterior Shoulder Dislocation in a Weight Lifter

Article

Mar 2000

A young man experienced bilateral anterior dislocation of the shoulders while doing seated behind-the-neck military presses. When improperly performed, military presses can cause injury because the shoulder muscles may be unable to support the weight being lifted. To improve form, avoid injury, and maximize gain from workouts, beginning weight lifters and those with shoulder instability should be counseled to use safer alternative techniques such as frontal military presses that do not allow movement posterior to the plane of the body.