Shoulder pain during bench press is one of the most common issues in the gym.

If you feel a sharp or aching pain at the front of your shoulder when pressing, you’re not alone. The good news? Most cases aren’t serious – and you don’t need to stop bench pressing completely.

The classic example is someone feels a sharp pain at the front of the shoulder – worst at the bottom of the press. Other movements like rows feel fine.

It often feels like and labelled as an impingement, rotator cuff tear or bursitis.

It sounds mental, but impingement actually happens in everyone! Every time you elevate your arm there is some form of impingement happening in the shoulder. Whether or not it is painful often depends on how sensitive the structures in the shoulder are. Therefore a better way to look at it: Load > Capacity causing sensitivity.

Load = what you’re doing/have been doing

Capacity = what your shoulder can tolerate.

The goal in rehab – slowly build up load so slowly build up your capacity.

So does this mean stop bench pressing? Not necessarily. The beauty of the bench press is we can change so many factors to make it more comfortable again.

• Lighter weights

• Limited range of motion

• Isometrics

• Smith machine instead of dumbbells/barbells

• Reduced sets/reps/frequency.

• Elbows more narrow vs elbows more wide.

• Wide grip vs narrow grip.

Any variation that is tolerable will do. Your goal is to just gradually progress the above towards the type of bench press you are wanting to get back to.

If even just the movement unweighted hurts, then maybe we need to give the bench press a small break temporarily.

In this time, we make every other movement around the shoulder strong. Particularly internal and external rotation, as well as shoulder flexion and abduction. What does this mean?

Apply the above factors to a:

• Cable shoulder external and internal rotation
• Front raise
• Lateral raise

Now we have a complete shoulder program keeping you generally strong. As you improve, we inch closer and closer to that 100kg bench press you have been working on!

I see a lot of players from our local soccer/football/netball leagues coming in with a vast array of injuries. What’s common between them is the same question – “How long until I am back?”

From experience, it is a tricky question to answer. There are many variables that come into play, therefore accurate estimates of a return to sport time are difficult. Someone may have a higher baseline in strength or plyometric ability. Another may not. Someone may have a very positive outlook with returning. Another may not. The variables are endless.

We can use our assessments and what the research says to estimate the time frame and it may give us a guide. But the most important factor is not time alone – it’s probably your rehab.

A scenario:

A senior football player, lets call him Jack, comes to see me with a hamstring strain from last weekend. It’s a decent one – grade 2. We do our assessment and see a severe reduction in his strength, endurance and range of motion. We give him some initial exercises to get started with – perhaps the Askling exercises.

Jack is eager to get back – the pressures of performing for himself and the team, the loss of income due to not playing and of course the mental side of things, missing out on the sport he loves.

Jack asks me – “so how long until I’m back”

I respond with – “based off your measures and the research for grade 2 strains, you are likely 6 weeks away from returning”

Now that all sounds good, but this can go two ways in Jack’s mind.

1. “Okay, so in these 6 weeks I need to rebuild my capacity through progressive exercise and loading, then I might be ready to return to sport pending what my assessment measures are like” – the correct option.
2. “Sweet, if I just do these same exercises for 6 weeks I will be all good to return to playing at exactly 6 weeks” – the incorrect option

Time alone is not a rehab plan. This mindset will likely result in reoccurrence of the injury due to not rebuilding capacity then resulting in more time lost due to injury.

There are steps to a rehab plan that bridge the gap from the injury to performing at your top level.

From basic exercises to desensitise the area and increase range of motion, to starting some strength training progressing to very heavy loads, and lastly returning to plyometric and power drills such as hopping, sprinting and jumping. NOT – do these 3 exercises for the entirety of a 6 week period to return saying “she’ll be right”.

Ankle sprains are the most common injury in the world of sports. We all know someone that has experienced an ankle sprain. The common advice – “you’ll be right, it’s just an ankle sprain”.

The primary reason we can’t call it “just an ankle sprain” is due to the incredibly high recurrence of them. After your first ankle sprain, 40% of people go on to develop chronic ankle instability (CAI) – a condition that results in more time away from sport and impairs performance significantly.

Upon testing we often see severe reductions in balance, proprioception and often reliance on vision and attention to compensate for an impaired ankle. This is why resting until it “feels better” does not cut it.

Early rehab focusing on strength, balance, and movement retraining is key. The goal isn’t just to get rid of pain – it’s to rebuild confidence and control in the ankle so it can handle the unpredictable nature of sport.

So, next time you or someone you know rolls an ankle, don’t brush it off. Treat it with the same intent you’d give any other injury. Because if you don’t rehab it right the first time, you’ll likely be dealing with it again… and again.

At Goulburn Valley Physiotherapy Centre, ankle sprain management is one of our bread-and-butter conditions. All our physiotherapists are experienced in assessing and treating ankle injuries. Using our AxIT system, we objectively measure strength, hopping ability, and compensations to identify every contributing factor.

Our goal is simple – to get you back to your sport stronger, more stable, and with a reduced risk of re-injury.

After working with people with sports injuries in Shepparton and Numurkah for nearly twenty years, I have seen a lot of different approaches to rehabilitation and recovery. The way an injury is managed can have profound implications on the rate of recovery, the level of recovery, and the rate of reinjury. Some people make full and sustained recoveries, while others seem to have a permanent spot on the injury list. Some may even never return to sport. Here is an outline of “the good,” “the bad” and “the ugly” approaches I have seen.

The Good

The best approach to managing sports injuries has three main components:

1. Good early management.

This may involve withdrawal from play to protect the area from further injury, pain relieving modalities such as ice, and professional assessment to determine the nature of the injury.

2. Specific rehabilitation.

A specific rehabilitation plan should be developed for each person. This takes into consideration the person’s injury, any impairments and the person’s return to sport goals. For example, despite both players having a hamstring strain, a tennis player’s rehabilitation would look very different to that of a football player as the sports have different physical demands. Obviously, to develop an appropriate rehabilitation plan, thorough and ongoing assessment is required.

3. Addressing of injury risk factors

Unfortunately, pre-existing injury is a risk factor for future injury. Each player should be assessed for physical, behavioural and environmental factors that may predispose to future injury. Was there a sudden change in physical load? Are there any strength or balance deficits that need addressing? Are there any lifestyle factors that need to be considered?

Good physiotherapists try to do themselves out of a job. If rehabilitation is done well, recovery is sustained and players minimise visits to the clinic.

The Bad

Many myths have evolved in the space of injury management. People have described many questionable practices either self-inflicted or inflicted on them by others. I’ve heard of:

• rubbing methylated spirits into an injury, 
• drinking vinegar, 
• having muscles “put into place,” and even 
• having ligaments “untwisted.”

At best, these practices are ineffective. At worst they can increase the inflammatory response to an acute injury or delay appropriate treatment and recovery. If a person suggests any of these practices, use your judgment to form your own opinion as to whether they are appropriately trained in injury management.

The Ugly

Now to the worst approaches. Here are a couple of examples that I have seen in the clinic.

1. Ignoring an injury

Ignoring something doesn’t necessarily make it go away. I’ve seen examples of sports people attempting play on after knee injury, only to discover ACL and cartilage damage in later assessments. If the area was protected at an earlier stage, the severity of the injury could have been limited, reducing the long-term negative consequences.

2. Alcohol

Unfortunately, alcohol and early recovery do not mix. Alcohol may affect the inflammatory process that occurs following an injury. Numerous people have presented to me with swollen and sore joints after a night on the town whilst they were injured.

3. Premature return to sport

Recovery takes time. As I have mentioned, injury is the biggest predictor of re-injury, and a premature return to sport elevates the risk further. Often, we are working against deadlines for events, or players are missing out on payments whilst they are on the injury list. People that do well take the view that their body is their priority. A patient approach to rehabilitation will often mean less time away from the sport, or an improvement in performance upon return.

Being injured can be a frustrating and long journey. Making sure that you follow a good approach to your recovery can pay dividends. Goulburn Valley Physiotherapy have highly trained physiotherapists, ready to guide you to a successful return to sport.

There are many physiotherapists out there, but not all are the right one for you.

Finding the right one for you is a difficult challenge, so here are 3 things to look out for when selecting a good sports physio.

They express their clinical reasoning.

• Find a physiotherapist that asks detailed questions about load, training history and context. Not just the location of the pain.
• They connect the dots through all aspects rather than just “weak muscles”. They refer to aspects such as physical, mental, technical and lifestyle attributes that influence injuries, performance and recovery.
• They give you a plan with a rationale, not just “come in twice a week and we’ll see
• RED FLAG: “Your hip flexors are tight, your glutes aren’t firing, and your posture is bad.” That’s lazy, outdated, and meaningless

They integrate performance.

• A good sports physio wants you to return even better than where you once were.
• This means your physiotherapist must bridge the gap between rehab and strength and conditioning, addressing aspects such as strength, power, speed and endurance rather than 3×10 of a simple exercise for 8 weeks.
• Rule of thumb: A good physio doesn’t stop when pain is gone – they stop when you can compete at your old level (or higher)

They assess, and don’t guess.

• A good sports physiotherapist reviews aspects such as strength, power, speed and endurance, as well as assesses your tolerance to sports specific movements constantly.
• Exercise progressions are based on data and assessments, not just time.
• There should be no guess work, you should be able to see HOW you are getting better.
• Rule of thumb: If you are not being tested with a wide range of physical tests, your physio is guessing.

We at Goulburn Valley Physiotherapy Centre are committed to the above three points to provide the best sports care available. If you have any sporting injuries and need a physiotherapist, trust that you are in good hands when you see us!