Bodybuilder's Elbow: A Helpful Guide to Elbow Bursitis

Written by: Nurudeen Tijani (Wellness and Pain Relief Fitness Coach)

Bodybuilders can develop big or pointy elbows due to strain, injuries, and repetitive movements from intense training programs. These repetitive actions can lead to chronic injuries like bursitis. This article will answer common questions about bursitis resulting from weight training (also known as bodybuilder's elbow and pointy elbows).

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Table of Contents:

Causes  |  Symptoms  |  Prevention  |  Treatment  |  Resources

Causes

Understanding Bodybuilder's Elbow

Bodybuilder's elbow, medically known as olecranon bursitis, is frequently observed in bodybuilders. This condition involves the inflammation of the bursa, a small fluid-filled sac that cushions the joint. It often results in swelling, tenderness, and pain at the back of the joint.

Bodybuilders who frequently engage in intense workouts, heavy lifting, and repetitive movements are more prone to developing this condition.

Causes of Bodybuilder's Elbow

Repetitive motions from intense bodybuilding workouts contribute to this condition. Potential causes include:

• Chronic and recurring tendon injuries that cause inflammation
• Excessive strain on the joint
• Repeatedly performing exercises that stress the triceps and arm joints.
• Poor technique or improper form during exercises that lead to increased joint stress
• Direct trauma or injury, such as a fracture, tendon, or ligament rupture
• Prolonged pressure on the bursa over some time, for instance, placing the tip of the arm joint on a hard surface as part of a daily activity or job
• Age, gender, and occupational inclination to developing bursitis. According to the National Institutes of Health (NIH), men are more often affected by olecranon bursitis due to the higher incidence of men engaged in manual labor.

Difference Between Bodybuilder's Elbow and Lifter's Elbow

While the terms are interchangeable, there is a distinction between the two.

• "Bodybuilder's elbow" refers to bursitis, indicated by the appearance of a big lump or pointy elbow often observed in bodybuilders.
• "Weightlifter's Elbow" is the term used to describe the collective group of tendonitis injuries observed in athletes. Learn how to fix weightlifter's elbow.

Why Bodybuilders Experience Elbow Pain

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

• Muscle restriction: Over time, weight training can cause the biceps, triceps, and forearms to 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 joint, resulting in pain.
• Ligament and tendon strain: Significant stress on the joint can lead to strain or overuse injuries in the ligaments and tendons surrounding it.
• Repetitive motions: Performing the same exercises repeatedly, especially those that involve joint extension or flexion, can put repetitive strain on the area, leading to discomfort.
• Joint instability: Wrist and shoulder injuries can lead to instability in the arm joint. These injuries disrupt the balance of muscles, tendons, and ligaments supporting the joint, causing instability and pain during specific movements or exercises.
• Joint degeneration: Over time, the repetitive stress placed on the joint by bodybuilding activities can accelerate deterioration, leading to conditions like osteoarthritis or cartilage wear, resulting in pain and inflammation.
• Poor warm-up or inadequate stretching: Insufficient warm-up or neglecting proper stretching routines before workouts can increase the risk of pain and injuries.
• Overtraining: Excessive training without adequate rest and recovery periods can overload joints, including the elbows, leading to pain and overuse injuries.
• Pre-existing conditions: Some bodybuilders may have underlying conditions, such as previous injuries or disorders like tendinitis or bursitis, making them more susceptible to joint pain.

These factors, alone or in combination, can lead to pain. However, the primary cause is restricted (shortened, tight, and tense) biceps, triceps, and forearms.

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Causes of Elbow Bone Grows and the Bursa Thickening

The tip of the elbow joint, known as the olecranon process, doesn't grow as a bone. Instead, it's associated with chronic injuries and degenerative conditions such as osteoarthritis, rheumatoid arthritis, tendonitis, and inflammation. Chronic injuries trigger repair processes, leading to bursitis, which causes swelling and a "pointy elbow" appearance. Chronic and degenerative conditions can also stimulate bone spur formation, contributing to visible changes in the joint's shape.

Therefore, the prominence of the elbow's tip isn't actual bone growth but a result of these factors. Individuals with a history of health complications can also develop a lump on the joint due to various medical conditions. Check out 18 Causes of a Bump on Your Elbow by Healthline for more information.

Typically, the bursa, a fluid-filled sac, feels soft. However, depending on the severity of inflammation and the fluid present, it can swell, resulting in a firmer or tender sensation when touched. Chronic inflammation within the bursa over an extended period causes thickening and the formation of a hard lump.

Activities or jobs that involve constant pressure on the arm, such as resting them on a hard surface, can repeatedly injure the bursa. According to the Cleveland Clinic, this can lead to non-infectious bursitis, which is quite common.

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 joint. Over time, the bursa can thicken significantly, resembling a pad on the olecranon (the joint's tip).

The photo above shows 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 bursitis. Image source: Encyclopedia of Modern Bodybuilding, Book by Arnold Schwarzenegger.

The 3D illustration below depict bursitis in the arm. The image on the left shows the left arm of a person with 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.

Symptoms

Signs and Symptoms of Elbow Bursitis

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

• Swelling and tenderness at the back of the arm joint
• 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 arm 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

Acute vs. Chronic Elbow Bursitis

Acute Bursitis: This type typically results from an injury or trauma to the joint, such as falling on your arm. It can occur suddenly and cause immediate inflammation of the bursa. Symptoms often include pain, swelling, redness, and tenderness in the affected area. Acute bursitis symptoms are usually more noticeable and may develop rapidly after the injury.

Chronic Bursitis: This type develops gradually over time and is often associated with repetitive motions or prolonged pressure on the joint. Chronic bursitis may not cause significant pain or discomfort in the early stages. As it progresses, the bursa can thicken, forming a hard lump and potentially causing more noticeable symptoms, such as pain, restricted movement, and increased tenderness. In bodybuilders, chronic bursitis often develops over many years due to strain and injuries from intense workouts, leading to the appearance of a "pointy elbow" rather than an enlarged swollen joint.

In the photo blow (2019), I'm performing overhead tricep extension with signs of chronic bursitis in my elbow.

Prevention and Management

Pointy Elbows: Common or Cause for Concern?

Pointy elbows, which can result from bursitis, are not inherently bad or abnormal and are relatively common among younger and older adults. For example, bursitis, sometimes referred to as student's elbow, can develop in younger adults who repeatedly lean their arms on a desk while studying. This prolonged pressure can lead to a form of chronic 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 arms 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.

Prevention Tips

To prevent bursitis and maintain healthy joints, consider the following tips:

• Perform thorough warm-ups and stretching exercises: Before starting your workout, warm up your arm joints and muscles with dynamic stretches and exercises.
• Incorporate regular rest days: Allow your body adequate time to recover between workouts to avoid overuse injuries.
• Ensure proper form and technique: Always use the correct form during exercises to minimize undue joint stress. Check out this video resource to learn the proper technique for various bodybuilding exercises.
• Gradually increase resistance: Incrementally increase the weight you lift to allow your muscles and tendons to adapt without sudden overload.
• Protective padding: When resting your arms on hard surfaces, use protective padding to reduce pressure on the arm joints.

Activities to Avoid or Modify

Certain activities can exacerbate elbow bursitis. Avoid repetitive or strenuous arm movements and activities involving placing excessive pressure on the arm joints. Examples include:

• Leaning on hard surfaces for extended periods
• Repeatedly performing exercises that stress the triceps and elbow joints without adequate rest
• Using improper techniques during weightlifting or other physical activities

Compression Sleeves: Pros and Cons

Compression sleeves, such as elbow wraps, straps, and support braces, can alleviate joint discomfort during various activities. However, it's essential to consider the pros and cons:

Pros:

• Improved blood flow and joint support
• Enhanced proprioception and stability
• Reduced swelling and pain during activities

Cons:

• Masking the underlying problem without addressing the root cause can perpetuate the injury
• Over-reliance on compression sleeves may worsen bursitis

Working Out with Bursitis

If you have bursitis, whether you can continue lifting weights depends on the severity of your condition.

Acute Bursitis: If it results from an injury or trauma and causes swelling, pain, redness, tenderness, or a fluid lump, seek medical advice for proper diagnosis and treatment. Allow the injury to heal before resuming strength training.

Chronic Bursitis: If it develops gradually over time due to prolonged pressure on the joint, you may be able to continue working out 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.

In the video below (2017), I bench while wearing compression sleeves to manage pain. In this video (2022), I perform variations of bench presses without joint issues.

Treatment

Short-Term Relief

If you experience discomfort from bodybuilding, there are several short-term relief methods you can use to alleviate discomfort:

• Joint supplements and vitamins
• Anti-inflammatory painkillers (NSAIDs)
• Physical therapy
• Stretching exercises
• Cold therapy
• Heat therapy
• Elbow braces or straps
• Topical anti-inflammatory solutions

Check out this article for the complete list and their pros and cons.

Addressing Underlying Causes

To effectively treat elbow discomfort from bodybuilding training, address the underlying causes. These methods can help:

• Self-Myofascial Release (SMR): Use foam rollers or massage balls to release tight forearm muscles.
• Cold Therapy: Apply ice to relieve burning pain and reduce inflammation.
• Heat Therapy: Wrap or apply a heat pad around the forearm and triceps to help relieve muscle tension, which can promote healing.
• Magnesium Supplementation: Reduce inflammation and improve muscle function with magnesium.
• Rest and Recovery: Take breaks from physical activity to allow the tendon to heal.

Healing Time

Elbow Pain from Bodybuilding:

With proper treatment, including cold and heat therapy, magnesium supplementation, and self-myofascial release, elbow pain from bodybuilding can heal within 7-10 days. Performing SMR on the forearm flexor muscles at least 2-3 times daily is crucial for fast results.

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Acute vs Chronic Bursitis:

According to the Cleveland Clinic, most acute 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 bursitis or pointy elbows) can persist if the underlying causes of overuse or continuous pressure continue. Without addressing the root cause, this condition can last for years.

In the photo below, you can see the difference in my elbow between 2014 and 2023. Despite developing bursitis early in my bodybuilding journey, my chronic injuries have improved since 2014. I now lift heavier weights, but spending long hours at a desk contributed to more prominent joints by 2023. I use protective pads to prevent further issues.

Additional Resources

For more information on managing tendon pain, explore these helpful articles:

• Elbow Tendonitis
• Tennis Elbow
• Golfer's Elbow
• Triceps Tendonitis
• Brachialis Tendonitis
• Distal Biceps Injury
• Elbow Mobility

Remember, addressing the root cause of the injuries is crucial for long-term relief. Take proactive steps today to ensure your joints stay healthy and pain-free.

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