The Contribution of Muscular Fatigue and Shoulder Biomechanics to Shoulder Injury Incidence During the Bench Press Exercise: A Narrative Review.

Motlagh, JG and Lipps, DB. The contribution of muscular fatigue and shoulder biomechanics to shoulder injury incidence during the bench press exercise: A narrative review. J Strength Cond Res 38(12): 2147-2163, 2024-Participation in competitive powerlifting has rapidly grown over the past two decades. As a result, powerlifting-related injury incidence has likely increased proportionally. Consistent high-load training places excess strain on the multiple joints involved during the squat, bench press, and deadlift. This literature review provides a comprehensive overview of all necessary considerations for evaluating the relationship between training methods, muscular fatigue, shoulder biomechanics, and shoulder injury risk in experienced powerlifters performing the bench press. Training methods such as velocity-based training, rate of perceived exertion/repetitions in reserve, and autoregulatory progressive resistance training should be prioritized over the repetitions until failure method to minimize the risk of overexertion. Despite the high risk of shoulder injury, these findings often lack robust insights into shoulder joint biomechanics during the bench press. Assessing shoulder joint angles and moments can provide valuable insight into an athlete's bench press form and technique to minimize injury risk. With a more robust methodology (e.g., motion capture, ultrasound imaging), alterations in shoulder biomechanics can be assessed during fatiguing training sessions, leading to more generalizable findings on the impact of sex, age, training experience, and bench press form on the shoulder injury risk. This research will improve individualized programming for peak powerlifting performance and optimal shoulder injury prevention.