A Helpful Guide To Elbow Bursitis & Bodybuilder's Elbow

Suppose you are a bodybuilder experiencing elbow pain from lifting weights or have questions about bodybuilder's elbow, elbow bursitis, elbow growth, or pointy elbows from lifting weights. In that case, you've come to the right place. I struggled with severe elbow problems caused by my bodybuilding workouts for years. I fixed my elbow pain. I will show you how to do the same. Let's begin!

Bodybuilders often develop big or pointy elbows due to strain, injuries, and repetitive movements from intense weightlifting. These repetitive actions can lead to chronic elbow injuries, such as tennis elbow, golfer's elbow, and triceps tendonitis. Over time, these injuries can result in degenerative conditions such as osteoarthritis, autoimmune diseases like rheumatoid arthritis, tendonitis, and other forms of inflammation.

The body's response to these chronic injuries includes stimulating repair processes, which can result in the formation of elbow bursitis. Additionally, conditions such as elbow gout and elbow bone spurs can contribute to the appearance of pointy elbows. Elbow bone spurs are often the result of the body's attempts to repair and protect the injured elbow joint.

A photo features Chris Dickerson on the left and Flex Wheeler on the right. Chris's elbow tip appears enlarged in comparison to Flex's. Many prominent bodybuilders, including most recently Ronnie Coleman, have been spotted with elbow bursitis. Image source: Encyclopedia of modern bodybuilding, Book by Arnold Schwarzenegger.

Bodybuilder's elbow refers to a medical condition commonly known as elbow bursitis, which can occur among bodybuilders and weightlifters. Elbow bursitis (or olecranon bursitis) is the inflammation of the bursa, a small fluid-filled sac that cushions the joint. This condition often results in swelling, tenderness, and pain at the back of the elbow. Bodybuilders and weightlifters who frequently engage in intense workouts, heavy lifting, and repetitive elbow movements are more prone to developing this condition.

A photo and a 3D illustration depict elbow bursitis. The image on the left shows the left arm of a person with elbow bursitis. The picture on the right is a 3D illustration comparing a normal versus an inflamed olecranon bursa. The image sources are as follows: the left photo is from the American Academy of Orthopaedic Surgeons, and the right illustration is from the Cleveland Clinic.

While the terms "bodybuilder's elbow" and "lifter's elbow" are sometimes used interchangeably, there is a distinction between the two. Bodybuilder's elbow refers to elbow bursitis, indicated by the appearance of a big lump or pointy elbow often associated with bodybuilders and weightlifters.

On the other hand, lifter's elbow is triceps tendonitis or posterior elbow pain, which involves experiencing pain at the back of the elbow. This condition occurs due to irritation or inflammation of the triceps tendon. Bodybuilders and weightlifting athletes often experience triceps tendonitis due to the repeated use of the triceps muscle and tendon during weight-training exercises. While both bodybuilder's and lifter's elbow can affect athletes, bodybuilders, and weightlifters, they refer to different conditions.

Intense weightlifting and repetitive motions contribute to bodybuilder's elbow. Potential causes include:

1. Chronic and recurring elbow injuries, such as inflammation, tennis elbow (outer elbow pain), golfer's elbow (inner elbow pain), and triceps tendonitis (posterior elbow pain)
2. Excessive strain on the elbow joint due to heavy lifting
3. Repeatedly performing exercises that stress the triceps and elbows, such as tricep extensions or skull crushers.
4. Poor technique or improper form during exercises that leads to increased elbow joint stress
5. Direct trauma or injury to the elbow when lifting, such as an elbow fracture, tendon, or ligament rupture
6. Prolonged pressure on the bursa over some time, for instance, placing the tip of the elbow on a hard surface as part of a daily activity or job
7. Age, gender, and occupational inclination to developing bursitis. According to the National Institutes of Health (NIH), men are more often affected by olecranon (elbow) bursitis due to the higher incidence of men engaged in manual labor.

For a detailed article on the root causes of elbow pain from weightlifting, including the types of elbow tendonitis (tennis elbow, golfer's elbow, triceps tendonitis), chronic vs. acute elbow pain, and the fastest way to cure elbow pain, check out this complete guide: how to relieve elbow pain from lifting.

The elbow's tip, the olecranon process, doesn't grow as a bone. Instead, it's associated with factors related to chronic injuries and degenerative conditions. These factors include osteoarthritis, autoimmune diseases such as rheumatoid arthritis, tendonitis, and inflammation.

Chronic injuries trigger repair processes, leading to elbow bursitis. This process causes swelling and a "pointy elbow" appearance. Chronic and degenerative conditions can also stimulate elbow bone spur formation. These bony outgrowths protect and repair the injured joint, contributing to visible changes in the elbow's shape. Therefore, the growth or prominence of the elbow's tip isn't actual bone growth. It's a combination of factors related to chronic injuries, degenerative conditions, and the body's repair processes.

Further, individuals with a history of health complications can also develop a lump on the elbow due to various medical conditions. Here are 18 Causes of a Bump on Your Elbow by Healthline.

Typically, the bursa, which is a fluid-filled sac, feels soft. However, depending on the severity of inflammation and the amount of fluid present, the bursa can swell, resulting in a firmer or tender sensation when touched.

Chronic inflammation within the bursa over an extended period typically causes the thickening of the elbow bursa and the formation of a hard lump. Activities or jobs that involve constant pressure on the elbows, such as resting them on a hard surface, can repeatedly injure the bursa. According to the Cleveland Clinic, this can lead to non-infectious elbow bursitis, which is quite common.

The persistent injury, irritation, and inflammation trigger excessive production of synovial fluid, causing the bursa to enlarge and create a firm or hard lump at the back of the elbow. The bursa can thicken significantly with time, resembling an elbow pad on the olecranon (the elbow's tip).

Acute bursitis is typically the result of an injury or trauma to the elbow, such as falling on your elbow. It can occur suddenly and cause immediate inflammation of the bursa. Pain, swelling, redness, and tenderness in the affected area often accompany acute bursitis. Acute bursitis symptoms are usually more noticeable and may develop rapidly after the injury.

On the other hand, chronic bursitis develops gradually over time. It is often associated with repetitive motions or prolonged pressure on the elbow joint. Chronic bursitis may not cause significant pain or discomfort in the early stages. As chronic bursitis progresses, the bursa can thicken, forming a hard lump and potentially causing more noticeable symptoms, such as pain, restricted movement, and increased tenderness.

In this case, most bodybuilders experience chronic bursitis, which develops over many years due to strain and elbow injuries from intense bodybuilding training. This chronic bursitis leads to the appearance of a "pointy elbow" rather than an enlarged swollen elbow.

Nurudeen performing overhead barbell tricep extension at the gym (2019) - with signs of chronic elbow bursitis (pointy elbow). The overhead triceps extension is a push exercise that specifically targets and develops the triceps muscle (triceps brachii and triceps tendon). It is a highly effective exercise for building bigger arms. Improper execution or too much weight can lead to elbow injuries. It may trigger conditions such as golfer's elbow and triceps tendonitis. These conditions can contribute to the development of elbow bursitis.

The signs and symptoms of elbow bursitis, or bodybuilder's elbow, may include:

• Swelling and tenderness at the back of the elbow
• A visible or palpable lump or bump
• Pain or discomfort, especially with movement or pressure on the affected area
• Restricted range of motion in the elbow joint
• Warmth or redness over the inflamed bursa
• Occasional infection of the bursa, leading to additional symptoms such as fever, increased pain, and pus drainage

Bodybuilders experience elbow pain due to various factors associated with their training program. Some reasons include:

1. Muscle restriction: When you lift weights over time, the triceps and forearm muscles can become restricted, meaning they shorten, tighten, and tense up due to muscular contraction, overuse, and a lack of myofascial release. These tight muscles then overstretch, strain, and inflame the tendons and tissues around the elbow, resulting in elbow pain.
2. Ligament and tendon strain: Bodybuilders often subject their elbows to significant stress, leading to strain or overuse injuries in the ligaments and tendons surrounding the joint.
3. Repetitive motions: Performing the same exercises repeatedly, especially those that involve elbow extension or flexion, can put repetitive strain on the elbow joint, leading to pain and discomfort.
4. Elbow instability: Wrist and shoulder injuries can lead to elbow instability. These injuries disrupt the balance of muscles, tendons, and ligaments supporting the elbow, causing instability and pain during specific movements or exercises.
5. Joint degeneration: Over time, the repetitive stress placed on the elbow joint by bodybuilding activities can accelerate joint deterioration, leading to conditions like osteoarthritis or cartilage wear, resulting in pain and inflammation.
   
6. Poor warm-up or inadequate stretching: Insufficient warm-up or neglecting proper stretching routines before workouts can increase the risk of elbow pain and injuries.
7. Overtraining: Bodybuilders who train excessively without adequate rest and recovery periods can overload their joints, including the elbows, leading to pain and overuse injuries.
8. Pre-existing conditions: Some bodybuilders may already have underlying conditions, such as previous injuries or disorders like tendinitis or bursitis, which can make them more susceptible to elbow pain.
   

Any of these factors, alone or in combination, can lead to pain in the elbow during weightlifting. However, the primary cause is restricted (shortened, tight, and tense) triceps and forearm muscles.

Bodybuilding is not bad for the elbows. However, specific training practices, improper techniques, and insufficient attention to maintaining pliable triceps and forearm muscles can increase the risk of developing elbow-related issues. It is crucial to prioritize proper form, adequate rest periods, progressive overload, and myofascial release to alleviate restricted triceps and forearm muscles and minimize the chances of injury, overuse, and inflammation. Additionally, exercises targeting all major muscle groups, including those supporting the elbow joint, can help maintain muscular balance and reduce strain on the elbows.

Check out this video of Nurudeen performing barbell bench presses at the gym (2021). The incline bench press is a classic bodybuilding exercise and a variation of the traditional bench press. It primarily targets the upper pectoral and deltoid muscles. However, "push" exercises like the incline bench press can aggravate as tennis elbow, golfer's elbow, and triceps tendonitis (posterior elbow pain) in athletes, bodybuilders, and weightlifters.

Yes, tennis elbow, also known as lateral epicondylitis, is typical among bodybuilders. Exercises that overload the forearm muscles and stress the extensor tendon and ECRB muscles trigger tennis elbow.

These exercises include the bench press, shoulder press, push-up, pull-up, triceps pushdown, bar dips, machine chest press, wide-grip lat pulldown, and barbell upright row. Likewise, improper technique during movements like reverse curls can strain these tendons, leading to tennis elbow.

Additionally, restricted forearm muscles can contribute to the development of tennis elbow. According to The National Health Service, tennis elbow is the most common cause of persistent elbow pain, accounting for two-thirds of cases.

Bodybuilders wear elbow sleeves for the following reasons:

• Elbow sleeves provide compression and support to the elbow joint and surrounding muscles.
• They help increase blood flow, provide stability, and reduce inflammation.
• The compression offered by elbow sleeves helps alleviate pain and discomfort during intense workouts.
• Wearing elbow sleeves helps maintain joint warmth, which can be beneficial for injury prevention and performance during heavy lifting.

Photos of Nurudeen wearing elbow sleeves in the gym (2016) while performing bench presses during a chest and back workout (watch video here). Elbow sleeves can serve as a short-term solution to manage elbow pain. Still, they do not fix the pain's root cause- restricted triceps and forearm muscles that overload and strain the elbow and triceps tendons during exercise.

Elbow compression sleeves, elbow straps, and support braces offer advantages and disadvantages for bodybuilders.

Advantages of elbow sleeves:

1. These sleeves provide compression, which improves blood flow, enhances proprioception (joint position awareness), and supports the muscles and tendons around the elbow joint.
2. The compression increases circulation, stabilizes the joint, reduces swelling, alleviates pain, and helps prevent further damage during intense workouts.

Disadvantages of elbow sleeves:

There are potential drawbacks to using elbow compression sleeves, especially if a bodybuilder has chronic elbow injuries like tennis elbow, golfer's elbow, triceps tendonitis, or elbow bursitis. Relying solely on these sleeves can mask the underlying problem, allowing bodybuilders to continue lifting without addressing the root cause of their pain or muscle restrictions.

If left untreated, elbow tendonitis (tennis elbow, golfer's elbow, and triceps tendonitis) can progress to elbow tendinosis and cause irreversible degeneration of the elbow tendons and joints. Additionally, the use of compression sleeves may worsen elbow bursitis. It is vital for bodybuilders to seek solutions that address the underlying causes of their elbow pain, rather than relying solely on compression sleeves, to ensure long-term joint health and prevent further injury.

The bench press and skull crushers can contribute to bodybuilder's elbow. Yet, they are not the primary cause of elbow bursitis. These exercises involve the triceps and forearm muscles, which can become tighter and shorter over time, reducing their elasticity. This tightness and lack of flexibility put excessive tension on the elbow and triceps tendon. While these exercises can stress the tendons, multiple factors influence the development of bodybuilder's elbow.

Restricted forearm and triceps muscles, along with inflamed elbow tendons, combined with improper technique, heavy weights, or insufficient rest and recovery, further increase the risk of inflammation and bursa injury. To minimize the likelihood of developing acute or chronic elbow bursitis from bench presses or skull crushers, individuals must prioritize proper form, gradually increase weights, and maintain pliable triceps and forearm muscles through myofascial release exercises.

Check out this video of Nurudeen demonstrating skull crushers (2021). Skull crushers, or lying triceps extensions, are popular in bodybuilding. This exercise targets the triceps muscles and plays a crucial role in developing muscular arms. However, athletes, bodybuilders, and weightlifters who regularly engage in "push" exercises like skull crushers may experience discomfort or even develop conditions such as tennis elbow, golfer's elbow, or triceps tendonitis (posterior elbow pain).

It depends on the severity of the bursitis. Suppose the bursitis is acute, resulting from an injury or trauma to the elbow, such as a hard blow or falling on your elbow. It produces swelling, pain, redness, tenderness, or a fluid lump, restricting elbow movement. In that case, seeking medical advice for proper diagnosis and treatment is essential. Allow the injury to heal before resuming physical training.

In the case of chronic elbow bursitis, which develops gradually over time and is often associated with prolonged pressure on the elbow, such as resting on a hard surface, it may be possible to continue lifting weights as long as it does not cause pain or swelling. According to the National Institutes of Health (NIH), this form of bursitis is often painless because the bursa has time to accommodate the increased fluid, resulting in the thickening of the bursa.

Pointy elbows, which can result from elbow bursitis, are not inherently bad or abnormal and are relatively common among younger and older adults.

For example, elbow bursitis, sometimes referred to as student's elbow, can develop in younger adults who repeatedly lean their elbows on a desk while studying. This prolonged pressure on the elbow can lead to a form of chronic elbow bursitis, resulting in the appearance of pointy elbows.

Adults engaged in manual labor jobs, such as plumbers, mechanics, construction workers, and office workers who frequently rest their elbows on a desk or chair arm, can also be affected by this condition. While some individuals may find pointy elbows aesthetically displeasing, it's important to note that they are prevalent and not considered abnormal.

Most acute elbow bursitis and its symptoms will heal within three to six weeks with self-care remedies like rest, ice, and anti-inflammatory medication (NSAIDs). However, severe or infected forms, such as septic bursitis, may require medical intervention. In contrast, bodybuilder's elbow (chronic elbow bursitis or pointy elbows) can persist if the underlying causes of overuse or continuous pressure on the elbows continue. Without modifying the root cause, bodybuilder's elbow can last for years.

The photo provides a comparison between Nurudeen Tijani in 2014 and 2023. It may be hard to see from the left picture (double bicep pose), but I've had some form of elbow bursitis since I started lifting weights in 2013. Around 2014, about a year into my bodybuilding journey, I began experiencing elbow pain, including tennis elbow, golfer's elbow, and triceps tendonitis. Between 2015 and 2017, the elbow tendonitis became chronic and severe. Additionally, spending at least 10+ hours a day on my computer, with my elbow resting on the arm of my chair, contributed to slightly more prominent and pointier elbows by 2023 compared to 2014. Since 2019, I have only experienced occasional elbow soreness after a heavy chest or triceps workout, without severe or chronic inflammation or tendonitis. I lift heavier now (2023) than I did ten years ago when I first experienced the discomfort. Additionally, I am mindful of using protecting elbow pads when I sit at my desk for long periods.

To relieve elbow pain from bodybuilding, you have two options: using short-term pain relief remedies for temporary relief or addressing the root cause of the pain to prevent its recurrence.

Option #1: Short-term relief remedies. These include:

• Using joint supplements and vitamins
• Taking anti-inflammatory painkillers (NSAIDs)
• Undergoing physical therapy
• Incorporating stretching exercises
• Applying ice and resting the affected area
• Wearing elbow braces or straps
• Using kinesiology tape
• Applying topical anti-inflammatory solutions such as oils and creams

Please refer to this article for a detailed explanation of the pros and cons of these remedies.

Option #2: Fix the root cause. To cure and prevent elbow pain from interfering with your workouts, fix the root causes. These include chronic inflammation, magnesium deficiency, and muscle restriction. The TitaniumPhysique Program can help you accomplish this.

The exercises below can help you relieve acute or chronic elbow pain from bodybuilding, including tennis elbow (outer pain), golfer's elbow (inner pain), or triceps tendonitis (posterior pain).

You will need a peanut ball and a lacrosse ball, found on Amazon or your local sporting goods store.

If your elbow pain is acute (causing burning pain after working out), you can place an ice pack on the elbow when you are not using the massage ball. Suppose your elbow pain is chronic (causing dull or achy pain during/after working out). In that case, you can supplement it with magnesium to heal and decalcify the elbow tendons.

Important: Restricted muscles that cause elbow pain develops over many years, so using the correct treatment strategy is necessary, for example, including magnesium supplementation therapy to get faster results.

For a step-by-step, easy-to-follow video-based guide on curing bodybuilding-related injuries (neck, shoulder, elbow, forearm, wrist, back, knee, and foot pain), try the TitaniumPhysique Program today. Use the code "blog10" for a limited time to save an extra 10%.

Here is how to relieve elbow pain:

To fix tennis elbow (outer pain), use a peanut ball to massage the forearm extensor muscles (click the link to see photo). Lean against a wall and place the peanut ball on the forearm extensor muscles. Roll out (massage) the muscles with the peanut ball for 3-5 minutes. Stretch the forearm extensor muscles. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.

Nurudeen demonstrates how to fix tennis elbow using a peanut ball to massage the forearm extensor muscles.

To fix golfer's elbow (inner pain), use a peanut or lacrosse ball to massage the forearm flexor muscles (click the link to see photo). Sit on a chair next to a table. Place the ball on the table and position your forearm flexor muscles on top of it. Roll out (massage) the muscle with the ball for 3-5 minutes. Stretch the forearm flexor muscles. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.

Nurudeen demonstrates how to fix golfer's elbow using a lacrosse ball to massage the forearm flexor muscles.

To fix triceps tendonitis (posterior pain), use a peanut ball to massage the triceps muscle and tendon (click the link to see photo). Sit on a chair next to a table. Place the ball on the table and position your triceps muscle on top of it. Roll out (massage) the triceps muscle and tendon with the ball for 3-5 minutes. Start near your armpit and roll to the triceps tendon above the elbow joint. Stretch the triceps muscle. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.

Nurudeen demonstrates how to fix triceps tendonitis using a peanut ball to massage the triceps muscle.

Firstly, it's important to note that part of avoiding chronic elbow pain is preventing acute pain. If you experience elbow pain during weight training, use less weight/reduce the resistance. If the pain continues, cease the exercise and focus on training a different body part unaffected by pain. Pushing through the pain will only increase post-workout inflammation, exacerbate pain symptoms, and prolong elbow recovery.

To avoid and prevent elbow bursitis and bodybuilder's elbow, follow these steps:

1. Stretch your forearms and triceps before training, such as a forearm flexor stretch.
2. Warm up your elbow tendons with resistance band pull-apart or other suitable exercises.
3. If you're doing power training, incrementally add weights to avoid sudden overload of the forearm, triceps muscles, and elbow/triceps tendon.
4. Learn and always use proper form and technique during bodybuilding training. Check out this video resource to learn the proper technique for various bodybuilding exercises.
5. Be mindful about doing excessive sets and incrementally increase your training volume.
6. Supplement with magnesium to counteract inflammation and decalcify the elbow tendons and joints. Magnesium also relaxes muscles to reduce pain.
7. Incorporate self-myofascial release (SMR) exercises into your recovery routine. Perform SMR on the forearm extensors, forearm flexors, and triceps muscle/tendon at least twice a week to keep the forearms and triceps pliable.
8. Use protective equipment such as elbow pads if your job, hobby, or daily routine involves placing your elbow on hard surfaces.

If you want an easy-to-follow, step-by-step video-based guide to cure and prevent bodybuilding elbow pain, try the TitaniumPhysique Program today. Use the code "blog10" for a limited time to save an extra 10%.

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Written by: Nurudeen Tijani

Nurudeen (aka TJ) is passionate about helping people build the body they desire through weight training. He is a physique and fitness trainer, nutritionist, yoga instructor, vegan natural bodybuilder, National Physique Committee (NPC) competitor, and founder at TitaniumPhysique. Nurudeen is a member of the International Association Study of Pain (IASP) and the American Chronic Pain Association (ACPA).

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