Ren and Stimpy are getting ready for bed…

Stimpy: “And please bless Grandma, and Grandpa…”

Ren: “And please give me a million dollars, and, oh yeah, huge pectoral muscles.”

Both: “Amen!”

For many FTMs, having well-developed pecs is one thing which marks a successful transition. While an excessive focus on chest work is, to some degree, misguided (see my article on gaining visual mass), chest training should nevertheless be an important part of a well-balanced program for two reasons: beginning pec work prior to upper surgery not only provides a foundation for post-surgery mass, but anecdotal evidence suggests that it also may improve recovery from the surgery itself.

“Chest focused weight lifting can enhance the contour of your chest and improve your final results over time.” – Dr. Scott Mosser, FTM Top Surgery and Getting Back to Exercise

However, there are common mistakes which even experienced trainees, in their zeal to have big beach muscles, make when working chest. All of these are discussed further below.

  1. Working chest too much.
  2. Using too much weight and poor form.
  3. Not being watchful for signs of shoulder impingement.

Let’s examine each of these in greater detail.

Mistake #1. Working chest too much.

I recently heard of a trainer who gave his client six days of chest work in a week, and this was to a client with pre-existing injury from benching too much. I assume that this trainer’s cure for the common cold would be to give the client bubonic plague. The chest is a relatively simple muscle group compared to something like the back. It doesn’t need ridiculous amounts of work.

First, a little anatomy. The chest is composed primarily of the pectoralis major muscle, which has two heads, the sternal and clavicular head. You can preferentially recruit upper and lower pecs by performing different exercises, although the real-world effect in mass gaining and appearance terms is, at best, speculative. The main function of the pectorals is to assist in movement of the upper arm, moving it across the body and rotating it internally (downward and towards the midline of the body). The pec major is assisted by smaller muscles such as the pectoralis minor, a small muscle which runs along the outer edge of the pec major, and the serratus anterior, ridges of muscle which sit along the lateral (outer) side of the ribcage. A tiny muscle called the subclavius runs along the collarbone and stabilizes it during pec movement. In pressing-type exercises, the chest is also assisted by the shoulders, particularly the anterior deltoid (front of shoulders) and triceps.

So, what does this mean in training terms? It means that when training the chest with significant resistance, you don’t need to go overboard. Once to twice a week for chest training is sufficient. At the end of this article, I suggest some ideas for a chest training program.

Mistake #2. Using too much weight or poor form.

If I had to pick one image which epitomized macho gym stupidity, it would be the sight of two guys working bench press, with one guy bouncing the bar off his ribcage, while the other guy hangs on to the bar, essentially pulling it off the bencher, and screaming, “It’s all you, man!” Unless there’s some secret high-impact ribcage training protocol I’m unaware of, this isn’t going to do much.

Quality, not quantity, is your objective. To begin with, on all exercises, use a weight that you can handle in good form and with control. Do not increase your weight by cheating. Cheating on the bench press includes bouncing the bar off your chest, having your spotter haul it off you, putting your feet on the bench and wiggling your body in various ways to push the bar, etc. You’re not cheating anyone but yourself, as my third grade teacher used to say. If you aren’t doing the movement properly, you’re not going to see results.

To perform the basic bench press properly, first make sure the pins which hold the bar are set at the proper height. Begin with back flat on bench, feet on floor. If you have short legs, put some plates or a small platform (like one of those steps used for step aerobics) under your feet. Putting your feet on the bench increases bodily instability, and trust me, when you’re under a bench press bar, you don’t want to sacrifice any control.

Grip the bar with a grip that is comfortable. A wider grip increases pec involvement, but increases the risk of shoulder injury significantly. Aim for moderation here. Unrack the bar from the pins, keeping arms straight, and make sure the bar feels comfortable and balanced. Slowly bring the bar down to your chest, at about the level of your nipples. Bodybuilders argue that the best way to target pecs is to flare elbows out from body as much as possible during the press, but this greatly increases the risk of shoulder injury. It’s better to keep upper arms about 45 degrees to the side of the body. Pause the bar at your chest for a moment, keeping muscles tight. Then press upwards. At the top, don’t lock elbows. The keys to good form here are the slow descent, the pause on the chest, and then the controlled ascent without locking the elbows. These form tips also apply to dumbbell presses.

Mistake #3. Not being watchful for signs of shoulder impingement.

Chest work, especially particular exercises, can cause chronic shoulder injuries ranging from mild tendonitis to frozen shoulder, tearing of the biceps tendon, and cartilage degeneration. You must always be alert for shoulder pain, and stop training immediately if this occurs. Take it from someone who spent months recovering from a shoulder injury caused by bench pressing: you don’t want to do this. Look around your gym and notice the guys with the hunched posture, shoulders pulled forward. They probably bench way more than they do back work, and they probably complain about shoulder problems. After reading this you can sit and laugh smugly, superior in your preventive knowledge.

Here is why chest work can cause shoulder problems. Along your shoulder blade (scapula) sit four muscles that comprise the rotator cuff. These muscles are responsible for moving the scapula, stabilizing the shoulder, and assisting in the rotation of the upper arm. The shoulder joint itself is a very unstable joint. Think of a golf ball sitting on a tee. The golf ball is the top of the upper arm bone (humerus), and the tee is the shoulder joint. While this allows lots of movement, the inherent instability can cause problems. When the pecs move the upper arm across the body, or rotate it, the top of the humerus gets pulled in its socket. If there is nothing to resist that pull, the top of the humerus tries to make a break for it. That’s where the rotator cuff comes in: it counterbalances that pull and makes sure the humerus stays where it belongs.

Too much chest work, too much reliance on problematic exercises, and/or too little back work can result in a rotator cuff weakness and resulting shoulder impingement. There are many symptoms of this: tendonitis, lack of motion in the shoulder, pain in the front or sides of the shoulder, or where the biceps attaches to the front of the shoulder. In the worst-case scenario, the biceps or supraspinatus tendon can tear completely because of being ground in the joint. These symptoms are not diagnoses in and of themselves; the shoulder instability and/or impingement is the underlying cause. Some people, because of the structure of their shoulder, are simply unable to perform high-risk exercises long-term without injury.

To avoid these problems, train back in about a 1.5-2 to 1 ratio to chest. Avoid high-risk exercises such as those specified below if you experience ANY pain. Try some of the lower-risk substitutes. And try some preventive rotator cuff work.

High risk exercises.

Any exercise which abducts the humerus (in other words, which brings the upper arm out from the body), particularly when combined with internal/external rotation and loading (weight) can cause shoulder damage. However, some exercises are worse than others.

Here are the high-risk exercises, with substitutes listed in parentheses.

  • Bench press with bar (incline bench press, bench press with dumbbells)
  • Overhead press, especially where arms are twisted on the ascent and/or where bar is pressed starting behind the head (try overhead press with dumbbells, lying side press, and/or pressing with upper arms more towards the front and/or palms facing one another)
  • Dips (experiment with upper arm positions or use a limited range of motion)
  • Upright rows (these are generally a shoulder exercise, not a chest exercise, but I thought I’d throw them in anyway since they are known shoulder wreckers and should not be performed at all; a good substitute is a shrug or hang clean)
  • Lat pulldowns pulled behind the neck (again, not a chest exercise, but what the hell. Pull to the front, always; it just works better formwise, anyway)

Suggestions for Chest Training Program

On the subject of chest training, I’m going to defer to the expertise of powerlifters. These folks know from benching, and they have the chest mass to prove it.

Deepsquatter’s site should be your first stop on the road to good chest training. Lots of routines and technique suggestions for both newbie and experienced lifters.

Westside Barbell is famed for coach Louie Simmons’ conjugate method, and the videos illustrate the techniques.

Hardgainer has several articles on bench training, many derived from the excellent text Insider’s Tell-All Handbook on Weight-Training Technique by Stuart McRobert (by the way, if you can get your hands on this book, definitely do so).