It can range from a constant, dull ache, to a sharp, agonizing, stabbing pain that stops you in your tracks. One thing is certain, no matter what the die-hard lifters say, the only way for a speedy and complete recovery is to rest it. And then apply rehabilitation techniques, such as lightweight strengthening exercises and soft tissue work.
Although acute, sudden injuries do occur, the vast majority of elbow problems experienced by lifters are due to: overuse, lifting too heavy, poor form, and poor grip strength, over a long period of time. It is this wear and tear from gradual overuse injuries that are most commonly manifested as some form of tendonitis, known as ‘lifter’s elbow’.
As you can see, the elbow is a fairly complex joint. Three major bones, the radius, ulnar, and humerus, converge into the joint complex. The complex is made up of three separate moving parts, and is capable of producing flexion, extension, and rotation. These moving parts are tightly bound together by strong ligaments and are surrounded by large muscles and their associated tendons.
The elbow is one of the strongest and most resilient joints in the human body, but under repeated, heavy load, can become damaged. This is mainly due to the amount of leverage placed on it. The muscles and their tendons insert very close to, or at the joint itself. So any weight at the end of the lever (in the hands) is massively magnified at the other side of the fulcrum (the joint).
Over time, these tendons and ligaments become strained, and due to their relatively poor blood flow, are unable to repair fully before they are battered again with another heavy bench press session. This leads to inflammation and small tears forming in these connective tissues. The pain is a warning sign of damage, and if ignored can lead to complete tears and permanent damage, the sorts of injuries that can take months and years for full recovery, if at all. So, rule number one when it comes to elbow pain, listen to your body!
Aches and pains in any joint are a common symptom of overtraining. If you have recurring aches, feel tired a lot, have dark urine, are stuck on a plateau at the gym, and maybe are even getting weaker, you’ve probably seriously overtrained.
Take a week or two off NOW. That might sound hard, you might see your gains wasting away just thinking about it, but you need it. In fact, there’s a good chance you’re losing gains right now, your body simply can’t recover between workouts, and the only way to put that straight is to rest. Some of the greatest bodybuilders ever have been great supporters of time out from the gym. Dorian Yates used to regularly take a week out before storming back into the gym and smashing PB’s. Training is hard when you’re passing the test. Supercharge with Sheer Strength Labs Pre-Workout Powder and kick off from that plateau.
So, if overtraining is the most common cause of lifters elbow, poor grip strength is a close second. Having a weak grip places extra strain on the neuromuscular system of the entire arm, especially the forearm. This strain is amplified at the elbow.
You should work on your grip as you would any other attribute in the gym. Relying on lifting straps, or using a false grip (with your thumb on the same side of the bar as your fingers), might help you to reach new PB’s on your big lifts. But it is placing huge strain on your elbows. Farmers walks, as in the picture, are a great way to improve grip strength, as well as overall strength and balance. If you don’t have this equipment in your gym, you can use dumbbells if they are heavy enough.
Ideally, a male should be able to walk at least 10 meters with the equivalent of their bodyweight in each hand. Another way to improve grip strength is holding an ultra heavy barbell for as long as possible. The best way to do this is to use a squat rack and set the stoppers high, so you only have to straighten up a few inches. You should be expecting to hold more than your deadlift PB. Use a belt. Secure a better grip by using Sheer Strength Labs NO2 Nitric Oxide Boosters. The ingredients in this great supplement increase blood flow to the muscles, giving you a huge pump and helping you to lift heavier.
Here are some other top tips for avoiding lifters elbow, especially if it is a recurring problem:
A neutral grip is where your palms are facing each other. Pull-ups are a common aggravator of elbow injuries, so consider doing them with a neutral grip, or using straps (pictured).
If you are experiencing niggles, you should also consider doing bench presses with a neutral grip. This can be achieved using a special neutral grip bar, or by using dumbbells. The added advantages with dumbbells are that the elbows are free to find their natural position, and you can get more of a squeeze on the pecs at the top of the movement.
Try to use a neutral grip on all other heavy pushing and pulling exercises, such as bent rows and shoulder press, by either using dumbbells or an appropriate bar.
Straight bar curls do engage the biceps like no other exercise, but sadly they are not a natural movement for the elbows. If you can do them, fine, but avoid using ultra heavy weights, or cheating them too much.
Try using an EZ-curl bar, it takes a little tension away from the brachialis but is still an effective bicep builder. Another great alternative is to use dumbbells, which allow you to rotate the forearm naturally.
If you have lifters elbow, avoid skullcrushers like the plague, the leverage placed on the tendons is incredible. When you feel ready to give them another go, stay away from the straight bar. Instead use an EZ-curl bar, which puts your wrists, forearms and elbows in a natural position. The best way to do skullcrushers is with two dumbbells or using a neutral grip bar if you have one.
Avoid going super heavy with bicep and tricep isolation exercises. To be honest, this is pretty much all of them. Keep the rep range high and concentrate instead on form. It’s just not worth risking the elbow leverage you get with big weights.
In fact, lower the amount of work you give to bicep and tricep exercises altogether. Really concentrate on form and blow them out with as few sets as possible, in the 12-20 rep range.
Thick bars and fat grip attachments are great for pumping the forearms and improving grip strength…. but they torture your elbows if you use them too much, use excessive weight or have a weak grip. Avoid these if you have elbow pain.
The position at the very bottom of a pull-up, or the very top of a pulldown, is a position of high strain for the elbows. Either alter your technique to avoid full stretch, or use lighter weights.
Don’t do so many sets of heavy pressing. Throw in isolation exercises that don’t involve the elbow. Instead of doing 10 sets on the bench, swap some for flyes. Drop some shoulder presses for lateral raises. Pulling is also not great. Try doing straight arm pulldowns or pullovers instead of set after set of pull-ups and rows.
Keep an eye on your form and make sure you aren’t putting excess pressure on the elbows. Try to keep movements natural, and maintain a straight line between the hands and elbows. For example, when bent rowing, don’t let your wrists flop out of position, keep them straight. The same goes for bench pressing, press downs, etc.
So, if you have stubborn elbow pain, it’s time to take a break. Rest and recuperate. When you get back in the gym, warm up well, use good elbow strapping, and take heed of all the tips above. Poor grip places huge strain on the elbows. If you think this is an issue, work on it. Try to use a neutral grip whenever you can.
Take Sheer Strength Labs Sheer Post-Workout and recover after each tough session you complete.
Jonathan Warren is a national level physique competitor and personal trainer with multiple certifications including NASM, NCCPT, and IKFF. His specializations include mobility training and corrective exercise as well as contest preparation.
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