Do you experience pain or discomfort in your elbows when you do upper body training? It’s not just tennis players and baseball players that suffer from elbow problems – if you weight train, especially with heavy weights, you could end up with elbows that are sore enough to interfere with your training.
Elbows and Why They’re Prone toward Problems
The elbow is a hinge joint lying between the large bone in the upper arm called the humerus and the two smaller bones in your lower arm, the radius, and ulna. Surrounding these bones is a joint capsule lined with articular cartilage and filled with synovial fluid to keep the elbow joint lubricated. With the help of your elbows, you can easily flex and extend your forearms and rotate your forearms.
Surrounding the joint capsule are a number of ligaments that help keep the elbow joint stable so it doesn’t easily dislocate. Seven major muscles attach to the elbow and an additional nine muscles cross over it. Tendons, made of dense, fibrous connective tissue, attach muscle to bone. These tough bands of tissue help carry force generated by the muscles in the elbow to the underlying bone, which helps with movement.
With so many ligaments, tendons and muscles attaching to and crossing the elbow joint, it’s not surprising that it’s a common site for inflammation and injury. As mentioned, tennis players and baseball pitchers are prone towards elbow injuries – but so are weight lifters. One of the most common injuries among tennis players and weight trainers alike is “tennis elbow,” known medically as lateral epicondylitis.
What is Lateral Epicondylitis?
Lateral epicondylitis is an overuse syndrome involving the extensor tendons and muscles in the elbow region. You might hear lateral epicondylitis referred to as an inflammatory condition, but more orthopedists now believe it’s a degenerative condition due to repetitive microtrauma. One theory is when an extensor tendon is overused or subject to more load than it’s accustomed too, it activates enzymes that break down the collagen in tendons.
What kind of symptoms might you have with lateral epicondylitis? You might experience pain along the outside of the elbow and, possibly, mild swelling and the pain would typically worsen when you do certain resistance exercises. Some weight training exercises place more stress on your elbow joint, and the surrounding muscles and tendons than others. Pull-ups, skull crushers, triceps extensions with elbow locking, and dips are exercises that place an inordinate amount of stress on the elbows. Exercises that involve forearm rotation and wrist extension tend to be stressful on the elbow joints and can bring about a bad case of lateral epicondylitis, especially if you increase the volume too quickly.
Medial Epicondylitis: Another Cause of Elbow Pain
Less commonly, weight trainers can develop medial epicondylitis, injury to the flexor tendons that attach at the elbow. With medial epicondylitis, you typically experience pain on the inner aspect of your elbow. Medial epicondylitis is also called “golfer’s elbow,” since it’s so common among golf players. If you do biceps curls using poor technique or using a weight that’s too heavy, you’re at risk for medial epicondylitis.
Both lateral epicondylitis and medial epicondylitis can take months to heal, especially if you don’t modify your training. Icing the elbow several times a day helps, but in severe cases, you might need physical therapy. One therapy that helps some people is to wear a counterforce brace, a strap that wraps below your elbow when you’re lifting. According to Dr. Edward McFarland, an orthopedic surgery professor from Johns Hopkins University School of Medicine, they help about half of the people who wear them. By applying counter-pressure to the area below the elbow, they seem to alter pain transmission of pain signals to the brain.
Modifying Your Training
Lateral and medial epicondylitis can become chronic unless you reduce stress on the elbow. Avoid doing exercises that lock out your elbows, and, when you train your upper body, reduce the weight you’re using. You can still get benefits using lighter weights by slowing the tempo of the movement so you keep tension on the muscles without locking your elbows. After a workout, stretch and ice your elbows. Hold off on doing body weight exercises like pull-ups, push-ups, skull crushers, and dips. Also, avoid long-lever exercises where your arms are extended and your elbows locked, like lateral raises and anterior raises.
As always when lifting, start with a 5 to 10-minute warm-up to get the blood flowing before picking up weights. Begin with very light weights first and see how your elbows feel before using a more challenging weight. When lifting, use pain as your guide. Stop if it hurts! Also, monitor how your elbows feel the next day. If they’re painful and sore, you’re doing too much and need to cut back further or stop doing exercises that exacerbate the pain until your elbows heal.
If you’re experiencing discomfort using lighter weights, take a break from upper body training and focus on icing your elbows several times a day until the pain improves. If it worsens or doesn’t improve after 10 days, see your doctor.
How Can You Avoid Epicondylitis?
Make sure you’re not overtraining on biceps and triceps isolation exercises like triceps extensions and biceps curls. Isolation arm work places focused stress on your upper arms and elbows, so it’s easy to overtrain when doing them. If you’re doing a variety of compound exercises, you don’t need as much focused arm work.
The Bottom Line
Elbow overuse injuries like lateral and medial epicondylitis are painful and inconvenient. Plus, the symptoms can hang around for quite a while, throwing a wrench into your weight training routine. The best way to avoid this common problem is to train sensibly. Always do a thorough warm-up before working with weights, and don’t overdo the upper body isolation exercises that place focused stress on your elbows. If you’re prone towards elbow problems, avoid exercises like pull-ups and skull crushers, two exercises that are particularly hard on your elbows.
References:
Inner Body. “Elbow”
The Wall Street Journal. “Bracing for the Pain From Golf and Tennis”
MLTJ Muscles, Ligaments and Tendons Journal CIC Edizioni Internazionali 2013 January-March; 3(1): 12-22. ISSN: 2240-4554. Published online 2013 May 21. doi: 10.11138/mltj/2013.3.1.01
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This article was very helpful to me! Thank you Cathe!