Beat Elbow Pain, Finally
Few things will derail your training more than elbow pain. The problem? The typical solutions don't address the real causes. Instead, people focus on short-term fixes like anti-inflammatories and elbow sleeves.
The elbow is a simple hinge joint with the proximal bone joining two distal bones. Flexion and extension is all it does. But there's a conundrum with elbow pain: it may not originate where you think.
There's a simple saying about assessing joint pain: "Look at the joint above and the joint below."
Your elbow pain may not be a problem with the elbow itself or even weak biceps and triceps. The real problem (and solution) is often found in the joints above or below the elbow. That means you may need to focus on the shoulder or the wrist to see if addressing one or the other improves your elbow pain.
That's why you'll see exercises and drills here that address all three: the elbows, shoulders, and wrists. Put these principles into practice and they'll ease your elbow issues.
If you're at a point where you're constantly having to take pain medication, wrap up, and BioFreeze your way through a workout, you're dealing with an inflamed joint. The common term is tendinitis, but long-term abuse creates actual tissue changes around the joints leading to tendonosis. Breaking the cycle starts with rest, but nobody seems to agree on how long.
I suggest temporarily eliminating direct arm work and pressing for a week or two, tops. Motion is lotion, and if you rest longer than this, you're setting yourself up for long-term weakness and a loss of muscle. Rest, then take an intelligent approach to building back your joints.
While the triceps primarily function as extensors of the elbow, the long head actually originates at the scapula. This means the triceps also serve as shoulder stabilizers.
The triceps is fully shortened when your arm is behind you and straight (shoulder extension) and most stretched when overhead and the elbow is bent.
When you go back to training triceps after a short break, one of the simplest things you can do to stimulate the muscle without making the joints angry is to limit the range of motion (ROM). At this point, avoid things like overhead tricep extensions, but you can still introduce pressing exercises that limit ROM. Examples include pin presses, floor presses, or close-grip bench presses using a bench block or boards.
Powerlifters have used the technique of tucking the elbows on a bench press to protect the shoulder. While this can be helpful and bench pressing with super flared elbows will probably be problematic for the shoulder, excessively tucked elbows on the barbell (and especially dumbbell) press puts a ton of load on a very flexed elbow joint.
Reintegrate exercises that are in the shoulder-extended position. These also tend to be joint-friendly isolation exercises. Pushdowns are great, but placing yourself into a forced pillar position with more tension at the end will be better. Bonus points if you use a band, like with the half-kneeling banded tricep extension.
Next, address tightness in the bicep as well as ulnar nerve tension. The biceps, just like the triceps, partially originate on the scapula. Not only do they flex the elbow and supinate the wrist, but they're also at work when flexing the shoulder.
Because of this orientation, the biceps pull the head of the humerus forward in the glenoid (socket). This is the exact opposite function of your rotator cuff.
You can stretch your bicep by placing your shoulder in extension with the elbow straight and palm facing down.
The ulnar nerve runs behind the elbow joint. Ever hit your funny bone? Well, it's not funny when it happens, nor is it a bone – it's your ulnar nerve. Peripheral nerve irritation can occur with repetitive stress injuries.
Healthy nerves need three things: space, blood, and motion.
Nerve glides can provide all three of these things. Yes, it looks like a weird dance, but elbow pain sucks more than looking weird.
Remember, bicep tightness has the opposite effect of what the rotator cuff is supposed to do. The function of the rotator cuff is not to internally and externally rotate your shoulder. It stabilizes the humeral head while your arm is in motion, particularly overhead.
Keeping the humeral head "centrated" is how the four rotator cuff muscles work synergistically. If your biceps are tight and your cuff is weak, you're going to be a lot more prone to shoulder problems.
So what does that have to do with your elbow? Remember that the triceps also serve to stabilize the shoulder, but it's not their primary function. If the cuff is weak, then your brain will call on the muscles that are strong enough to get the job done. In many cases, that's the triceps. But it's too much work for that muscle, so the result is tendon/elbow pain.
Lifters often use physical therapy exercises to strengthen their rotator cuff and come up short as a result. Sure, banded internal and external rotations for strengthening the cuff in isolation are great when there's been a surgical repair or more severe cuff tendinitis. But if you're a lifter, you want to do exercises that integrate cuff strengthening into more gross motions.
Banded pull-aparts and face pulls are better for this. Another great option? External rotation with a press out.
The pain in your elbows could be caused by dysfunction in a nearby joint. So, sometimes, you have to address your shoulders to fix your elbow pain.
One of the problems that plague lifters with shoulder problems is poor scapular mobility. Popular fitness literature is to blame. We've been told to keep the shoulders down and back in our bench pressing. This often gets confused with the cue to "pack the shoulders." This is where having a strength coach's eye comes in handy to assess whether or not this is actually happening.
Your scapulae are designed to move in conjunction with your arms. Trying to keep them pulled back and stationary while pressing will make your shoulders MORE unstable, not less. More specifically, you want your serratus anterior involved.
A simple drill for getting this muscle to fire and getting your thoracic mobility in order (you need both for shoulder health) is the cat-camel exercise. You'll go immediately from this to a bent-knee plank position and raise your hips up by pushing your shoulder blades forward with intention. Your intention here is to get your serratus anterior going.
A weak grip is a recipe for elbow pain. Loaded carries are one of the best ways to build grip while integrating shoulder and core stability. The type of carry you opt for will depend greatly on what you want to bias.
In the case of really building the grip as well as unilateral shoulder stability, the barbell suitcase carry is tough to beat.
These are more challenging than using a dumbbell because of the length of the bar. Your wrist doesn't just flex and extend; it also deviates towards the ulna or radius bones. Stabilizing the barbell will challenge those muscle actions much more effectively than a dumbbell or kettlebell.
If you have a squat bar with knurling in the middle, use it. Thirty to 60 seconds on each side for 3 rounds will toast your grip!
As you reintroduce heavier loads, minimize elbow pain by limiting the amount of gripping you actually have to do. This is where straps come in.
Yes, they can become a crutch, but we're meant to wean ourselves off crutches. Also, if your physique is a priority, then using straps will help you focus on the target muscles and build the mind-muscle connection better than just having to grip a heavy weight.
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