While the bench press is one of the most popular exercises in the gym, shoulder pain and injuries are common problems. It’s no wonder that trainees turn to the incline-bench press as an alternative, and it’s also no wonder that there are so many variations of that exercise.

Adjustable-incline benches offer a number of variations and are especially popular for use with dumbbells. Some trainees find that, while they feel shoulder pain when they perform the standard 45 degree incline barbell press, they’re pain free when they do incline dumbbell presses at the same angle. “I can position my hands differently, and it doesn’t hurt that way,” is a typical comment. Others may still have shoulder pain at 45 degrees, but they can adjust the bench to 30 degrees and not experience pain. Others eliminate the pain when they increase the angle to around 80 degrees, and still others use a Smith machine on inclines to reduce shoulder pain.

Trainees are usually taught to get a full stretch or full range of motion—which frequently leads to their using exaggerated movements and excessive range of motion. The ball-and-socket shoulder joint has a layer of ligaments that blend to form the joint capsule, kind of like an organic Saran Wrap encasing the joint. If the ligaments become too stretched and loose, the ball, which is the head of the humerus, moves too much in the socket. Every time you perform a bench press motion, particularly the bottom half of the press, the force naturally pushes the ball forward in the socket. If the ligaments are tight, as they should be, they, along with the rotator cuff, prevent the ball from moving forward in the socket. If they’re loose or stretched, the ball moves forward and can cause pain and even numbness or tingling in the arm. If the posterior capsule is too tight, the ball is driven up and back, and that causes two effects: increased external rotation and damage to the cartilage ring around the socket. Many feel that injury here can damage the undersurface of the rotator cuff.

If numbness occurs, it’s because the bundle of nerves that supply the arm, which pass behind the collarbone and in front of the shoulder, are compressed, or impinged, when the head of the humerus moves too far forward in the loose shoulder. Performing an exaggerated incline- or flat-bench press causes the forward displacement, which causes the nerve compression. If you experience numbness in your arm when you do presses or afterward, see your physician and tell him or her about your symptoms. Try to find an orthopedic surgeon or chiropractor who specializes in sports medicine and handles weight-training patients or overhead-throwing athletes.

If you simply have shoulder instability, you may find that you feel pain in the back of your shoulders at the bottom position of a press. That may be a symptom of rotator cuff problems. You may also have a great deal of clicking or clunking in your shoulder as you move it. That’s usually not painful, but it does indicate a potential problem—it could be a sign of cartilage tears, arthritis or loose bodies in the joint (usually cartilage but sometimes bone fragments). Loose bodies usually cause pain with the clicking, however.

The placement of the bar may be a key component in avoiding shoulder pain. If you place the bar high on your chest or bring it to your neck, as some trainers advise, it maximizes the stretch on the capsule. Try placing the bar lower on your chest to avoid the excessive stretch. Also, if you have long arms, you’re already getting more stretch than most trainees, so don’t push for extra stretch.

Try not to swing your elbows out away from your body. A flared-elbow position is shoulder abduction, which further stretches the capsule and also places the shoulder in an awkward position for the rotator cuff to function strongly.

Again, try to avoid excessive and unnecessary movement while training. It’s easy to get a full range of motion on this exercise. Once you begin to try for that extra stretch, you’re setting yourself up for a problem that may catch up with you in a few months or a few years. If you stretch the shoulder capsule enough, your training will change forever—and not for the better.

Once the shoulder capsule is stretched, it doesn’t return to its original length naturally. You’ll have to modify your training. You’ll have to strengthen the rotator cuff to add dynamic stability to the shoulder, and, if all conservative efforts fail, you may end up requiring surgery.