What the bench press asks of the neck, and what no study has measuredEmerging evidence
You lie with your head, upper back and buttocks on the bench, eyes about under the bar and shoulder blades pulled back and down, as the site's bench press guide teaches. The neck isn't meant to push or lift, but its muscles hold your head still while your whole body braces, and many lifters press the back of the head into the bench or lift it to watch the bar.
Only one study has measured the neck muscles in a bench press. In 15 healthy people pressing 60% of their maximum, a neck support cut the activity of the muscles at the back of the neck by 37% and raised trapezius activity by 9.3%, with no change in the chest muscle. It didn't measure pain, injury or head position, and the support is a commercial product. No study compares a head pressed into the bench with one lifted or resting, and none counts neck pain caused by benching. A review of powerlifting injuries found chest, shoulder and arm injuries from the bench press, and no neck injuries. So the map on this page comes from that study, injury surveys, headache research and case reports.
Sources 1, 2
Who gets it: neck injuries are uncommon in lifting, and commoner in womenEmerging evidence
Across 17 reports of weightlifting and powerlifting injuries, the neck and upper back together made up between 1.7% and 14.7% of injuries, and women had more neck and upper back injuries. In 104 Swedish powerlifters, 70% had a current injury, women had more neck injuries, and current neck injuries weren't linked with any one lift. In 1,387 gym users, the shoulder was by far the commonest painful area and the neck came after the lower back, knee and elbow; 136 of the 432 who bench pressed (31%) linked it to their pain, without saying where it hurt.
In United States (US) emergency departments, 993 of 120,498 barbell injuries over 10 years were to the neck, under 1%; across weight training, the commonest diagnosis was a sprain or strain (46.1%) and the commonest cause a weight dropping on the person (65.5%). NHS inform lists muscle strain or tension, and repeating the same strained movements in sports and hobbies, among the causes of neck problems. It tends to bother people on heavy or maximal sets, with a big arch and the head driven back, a new programme, or a neck already sore from desk work, stress or poor sleep (our reading).
Sources 3, 4, 2, 5, 6, 7, 8
Headaches with heavy sets: usually harmless, but the first one needs checkingStrong evidence
The international headache classification describes a primary exercise headache as one brought on only by strenuous exercise and lasting under 48 hours, and recognises "weight-lifters headache" among them. It says the first one must be checked for a bleed on the brain, a torn neck artery and narrowing of the brain's arteries. Across 12 studies, about 4.9% of the general population had had one, but only about 0.5% of people seen in headache clinics, and it usually starts in the late 20s.
In 6,412 headache patients followed for 10 years, 97 (1.5%) had headaches brought on by coughing, exercise or sex, 11 of them by exercise; exertional headaches with another cause were rare, and the commonest cause was a bleed on the brain. A review says to suspect another cause after a single episode, with other symptoms or signs, over the age of 40, or with a headache lasting more than a day. The NHS asks for an urgent GP appointment or NHS 111 for a headache triggered or made worse by exercising.
Sources 9, 10, 11, 12, 13, 14
Straining, blood pressure and the rare serious causesEmerging evidence
A brief held breath can't be avoided once an effort goes above about 80% of your maximum (31 men), and in 5 bodybuilders blood pressure averaged 320/250 mmHg at the peak of a heavy double-leg press. In 250 people whose brain aneurysm burst, vigorous exercise roughly doubled the short-term risk (relative risk 2.4), alongside straining on the toilet and anything else that briefly raises blood pressure. The NHS says a bleed on the brain may be more likely when lifting something heavy.
A torn neck artery can start with neck pain and a headache: in 966 people with one, 40.5% had a minor knock or strain in the month before, and case reports describe tears after heavy lifting. A bar that lands on the neck can break the voice box: in two reported bench press accidents, both lifters needed hospital monitoring of their airway and recovered. All of these are rare, and none is a reason to fear benching, but they are why the warning signs come first.
Sources 15, 16, 17, 18, 19, 20, 21, 22, 23
When a scan or test mattersStrong evidence
Not for ordinary neck pain from benching. Bulging discs showed on magnetic resonance imaging (MRI) in 87.6% of 1,211 people without neck symptoms, including about three quarters of people in their 20s, so a scan report has to match your symptoms. NHS inform says X-rays and MRI scans are usually not needed to diagnose a trapped nerve, and a scan may be offered if symptoms aren't improving or greatly affect your life.
Tests matter for the first headache brought on by exercise or a sudden severe headache (hospital checks for a bleed, a torn artery or narrowed arteries), for weakness that is getting worse or signs of pressure on the spinal cord, after a bar has fallen on your neck, and for chest pain, which needs an electrocardiogram (ECG) and blood tests.
Sources 24, 25, 9, 26
How it usually goesStrong evidence
A neck that aches during the set settles soon after, and soreness after a new session fades within about a week. The NHS says most neck pain only lasts a few weeks, and NHS inform says you should see the biggest change in the first couple of weeks, with most problems improved within 8 weeks. Studies are less rosy: in pooled studies of new neck pain, pain fell from 64 to 35 out of 100 within about 6 weeks but was still 42 a year later.
A trapped nerve usually starts to improve within 12 weeks and can take up to a year, NHS inform says; substantial improvement usually comes within 4 to 6 months, and about 83% recover fully within 2 to 3 years. Exercise headaches last under 48 hours. Most injured powerlifters keep training with changes: only 16% had to stop completely. No one can promise a date.
Sources 27, 8, 28, 25, 29, 30, 4