Last year, I injured my left shoulder. This year, I have been gradually rebuilding my bench press. Unfortunately, my left shoulder started aching again during flat benching. Incline variations feel better. To prevent this from becoming a long-lasting injury, I reduced the weight and switched to tempo benching with lower weights.
When flat benching, the pain increases with more weight, especially at the bottom of the lift. Recently, I’ve been using 75-90 kg for tempo benching, with pain levels around 4/10. For example, yesterday, I tempo benched 80 kg with a pain level of 3/10. The day after training, my shoulder feels okay or just slightly stiff.
How can I track if my symptoms are truly improving and how should I progress? For instance, benching 60 kg still causes a slight pain (2/10), similar to two weeks ago. Should the pain threshold be increasing over time?
It sounds like you’ve made some reasonable initial changes to manage this. Fortunately we have some resource that should be useful:
Start here, with the section titled "Step 2: Progression and Expectation management"
We suggest that initial loading increments be conservative. If symptoms remain constant (i.e., neither exacerbated nor improved), we may even keep the absolute load constant for a few of the initial sessions to begin observing a de-sensitization effect. Once we observe this effect, we can begin incrementing loads across non-consecutive sessions. There is no “optimal” increment to use in terms of absolute weight (e.g., 2.5-5 lbs. at a time), or relative increases (e.g., 5-10% of load) from session to session, but we may give individuals who are looking for specific guidance these sorts of arbitrary suggestions. However, we qualify this advice since we do not want to imply that the process will be linear. Neither strength acquisition nor injury rehabilitation are straight-line, predictable affairs. Rather, we should maintain flexibility in our approach to allow for the “up” days where we may be able to increment a bit more, as well as the “down” days where we may need to adjust loading down or hold it constant depending on the nature of symptoms during and between sessions.
The most common errors made in this process involve overly aggressive increments of loading despite worsening symptoms, which often results in the process taking longer than necessary. This may be due to inappropriate expectations about a reasonable timeline for recovery. For example, full recovery from a tendinopathy or acute radiculopathy may take several months, whereas other non-specific aches and pains may resolve in a matter of a few days. Patience, acceptance, and psychological buy-in to the process are at least as important as the physical training — these are discussed in further detail in Charlie Dickson’s article.
As loads gradually trend upwards with stable or decreasing symptoms, the target repetition ranges will naturally need to decrease (e.g., from sets of 12, to sets of 10, 8, 6, etc.) and tempo will accelerate towards normal speed (e.g., from 3-0-3 to 3-0-0 to regular or paused movements). With an improvement in symptoms we can begin to consider increasing the volume of training to continue building capacity. This may involve starting by adding one back-off set to the regular programming, assessing tolerability and symptoms in the subsequent 24-48 hours, and continuing on from there until the individual has progressed back to their baseline level of function and training.