Elbow Pain from Lifting Weights: (A Helpful Guide for Lifters)

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

Athletes and gym-goers often experience elbow pain from lifting weights. Common injuries include triceps tendonitis, tennis, and golfer's elbow.

These injuries are primarily caused by restricted muscles straining the elbow tendons during repetitive movements involved in heavy lifting.

To fix this condition, keep your triceps and forearms pliable with self-myofascial release (SMR) exercises. This practice can immediately relieve muscle restrictions and reduce injury risk. It is the fastest way to fix elbow pain from weightlifting.

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Table of Contents:

Overview  |  Causes  |  Symptoms  |  Treatment  |  FAQ

Overview

A quick review of the elbow anatomy will pave the way to understanding the simple treatment required to fix and prevent the root cause of this condition.

Elbow Anatomy: Understanding the Basics

The elbow joint is a complex structure that allows for both bending (flexion) and straightening (extension) of the arm, as well as rotational movements of the forearm. It is made up of three bones:

• Humerus: The upper arm bone.
• Ulna: The larger bone of the forearm, located on the side opposite the thumb.
• Radius: The smaller forearm bone, located on the thumb side.

These bones come together to form the hinge joint of the elbow. Surrounding the joint are several key structures:

• Tendons: Connect muscles to bones, facilitating movement. The most commonly affected tendons in elbow pain are the common extensor tendon (on the outside of the elbow) and the common flexor tendon (on the inside).
• Ligaments: Connect bones to other bones, providing stability to the joint. The ulnar collateral ligament (UCL) and the radial collateral ligament are crucial for stabilizing the elbow during lifting and other activities.
• Muscles: Several muscles work together to move the elbow. The biceps brachii helps with flexion (bending), while the triceps brachii aids in extension (straightening). Muscles in the forearm, like the extensors and flexors, control wrist and finger movements and are often involved in lifting-related elbow injuries.
• Bursa: Small fluid-filled sacs, such as the olecranon bursa, cushion the joint and reduce friction during movement.

Causes

In this section, we'll cover root causes, general causes, elbow injuries, and lifting mechanic that lead to elbow discomfort.

Root Causes

1. Magnesium deficiency: Magnesium dissolves calcium and prevents the calcification of soft tissues, which can harden tendons and cause pain. Magnesium deficiency leads to muscle tension, joint inflammation, and tendonitis by allowing excess calcium to keep muscles tense. "The Magnesium Miracle" by Carolyn Dean, MD, ND, highlights that a significant portion of the population is deficient in this essential mineral.
2. Muscle restriction: Restrictions occurs when inelastic fibers shorten and cannot relax to their normal state. Lifting, pulling, or pushing heavy objects can overstretch and overload the triceps and forearm muscles, leading to restriction. This restriction is the trigger that initiates pain in the tendon, leading to inflammation and discomfort.
3. Chronic inflammation: Physical activity helps build and strengthen muscles but can also lead to inflammation in tendons, ligaments, and joints. If the body's healing process fails, chronic inflammation can occur, which prevents proper healing of muscles, tendons, and ligaments, leading to chronic tendonitis.

By addressing these root causes, you can instantly eliminate pain and counteract injuries. To learn more about these root causes, check out this article: Elbow Tendonitis: Causes and Treatments.

Overuse and General Causes

Weightlifter's elbow is an overuse injury. It results from repetitive movements with restricted muscles.

Muscle restriction includes conditions like tightness, tension, tenderness, shortening, inelasticity, knots, and dehydration of the tissues.

Overuse injuries can develop gradually over time (chronic) or occur suddenly (acute). Additional factors that contribute to this condition include:

• Insufficient warm-up
• Inadequate stretching
• Poor weight lifting form
• Excessive resistance or weights
• Overtraining
• Inadequate recovery
• Lack of myofascial release

Elbow Injuries

Tennis elbow and triceps tendonitis are often associated with a lifter's elbow. However, they are not the only cause. The following tendon injuries can also contribute to pain. They are listed from most to least common.

Follow the links below to learn more about each condition.

Tennis Elbow (Pain Outside the Elbow)

Tennis elbow or lateral epicondylitis is a form of tendonitis that causes discomfort at the outer part of the elbow due to inflammation of the common extensor tendon. It results from repetitive wrist extension during "press" or "push" activities such as bench presses or push-ups. According to the National Health Service, this condition is the most common cause of discomfort in the arm joint.

Triceps Tendonitis (Pain at the Back of the Elbow)

Triceps tendonitis is inflammation of the triceps tendon, resulting in pain at the back of the arm joint. This condition is common among lifters and athletes because of the repetitive strain on the connective tissue during popular "push" or "press" movements.

Golfer's Elbow (Pain Inside the Elbow)

Golfer's elbow or medial epicondylitis is another type of tendonitis that causes pain at the inside part of the arm joint due to inflammation of the medial elbow tendon. It results from repetitive wrist flexion during "pull" activities such as chin-ups, bicep curls, rows, and lat pulldowns.

The TitaniumPhysique Program can help you recover from these injuries. Ready to get started?  Yes, I'm ready to heal my elbow .

Elbow Bursitis

Elbow 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. Athletes, weight lifters, and gym-goers who frequently engage in intense workouts, heavy lifting, or placing the elbow tip on hard surfaces are more prone to developing this condition.

Distal Bicep Tendonitis

Distal biceps tendonitis is inflammation of the connective tissue that attaches the biceps muscle to the radius (forearm bone) just below the elbow. This condition causes pain in the lower biceps at the front crease of the arm joint, primarily during elbow flexion and forearm rotation. Lifters experience discomfort during activities that involve heavy pulling or lifting motions, such as bicep curls and rows.

Brachialis Tendonitis

Brachialis tendonitis is inflammation or irritation of the brachialis tendon, which connects the upper arm bone (humerus) to the forearm bone (ulna). An injured or restricted brachialis can cause pain, weakness, instability, and swelling on the inside part/front elbow crease. According to the National Institutes of Health, this condition is rare.

Lifting Mechanics and Other Factors

This section explains general factors, including lifting mechanics, that cause pain and affect the elbow.

1. Overly Extended Wrists: Occurs when the wrists are bent too far backward, causing strain on the wrist flexors and connective tissues at the inner elbow.
2. Overload of the Wrist Flexors and Extensors: Excessive load on these muscles can lead to discomfort and inflammation at the outer part of the elbow.
3. Overstretching of the Triceps: During lifting movements that bend the arm, inelastic triceps can cause discomfort at the back of the arm joint due to excessive stretching.
4. Pain at the Front Crease of the Elbow: During exercises that bend the arm, the biceps' role in elbow flexion can lead to discomfort if the brachialis or lower biceps tendon is injured.
5. Weight Load and Joint Compensation: Lifting too heavy without proper progression or compensatory movements due to weak or tight muscles can place additional stress on the elbows.
6. Type of Grip: The grip used (overhand, underhand, narrow, wide) can affect where tension occurs in the elbow.
   
7. Type of Equipment Used: Different equipment (dumbbells, barbells, machines) can contribute to varying strains on the elbow. Dumbbells and barbells exert the most tension.

If you experience elbow pain during a specific exercise and would like to learn about the exercise-specific injuries, form mistakes, and mechanical issues, follow the respective links below:

• Bench press
• Bicep curl
• Chest flys
• Deadlift
• Lat pulldown
• Overhead press (Shoulder presses)
• Pull-ups (or Chin-ups)
• Push-ups
• Row exercises (Upright row, seated or bent-over rows)
• Skull crushers
• Squats
• Triceps workouts exercises (Tricep extensions, dips, pushdown, kickback)

The images below illustrate common elbow injuries. The "X" indicated in the images are where trigger points in the tissue tend to occur.

Trigger points, known as muscle knots, are small, hyperirritable spots within a muscle. They cause tenderness and discomfort and can develop due to muscle overuse or injury.

Symptoms

Here are the symptoms you might experience during or after working out:

• A burning sensation at the tip of the elbow
• Pain inside, outside, or at the back part of the arm joint.
• Tenderness, swelling, and soreness.
• Sharp (shooting and sudden) or dull aches.
• Difficulty bending and straightening the arm due to tightness and stiffness in the arm joint (you might feel this when taking off your shirt after an elbow-intensive workout).
• Weak grip strength.
• Discomfort when gripping objects, such as barbells, dumbbells, exercise bars, or equipment.
• Increased discomfort when applying pressure to the affected area.
• Pain that worsens with repetitive movements.

Treatment and Prevention

To treat and prevent elbow pain from lifting, you have two options:

1. Short-term relief methods: painkillers, remedies, and therapies
2. Address the root cause to fix and prevent its recurrence
   

How to Fix the Root Cause

Self-myofascial release (SMR) exercises address the root cause of tendonitis. This method helped me fix my chronic injuries. When done correctly with the right tools, SMR can provide instant relief.

In my ten years of bodybuilding, I've found this to be the fastest way to self-treat and prevent tendon issues from heavy lifting.

Get step-by-step guidance with the TitaniumPhysique Program to ensure you see results as fast as possible. Ready to begin?  Yes, I'm ready to eliminate pain .

If you'd like to see a demonstration of these exercises, click here to view photos.

Short-Term Relief Methods

Conventional pain relief methods provide temporary symptom relief but do not treat the underlying causes. As a result, the injury returns when most gym-goers resume working out.

Below are their pros and cons. FYI, I've tried all of these except joint injections.

• Joint Supplements & Health Vitamins: Provide short-term relief but do not fix the root causes of the injury.
• Painkillers (NSAIDs): Temporarily reduce inflammation and joint aches but only address symptoms and may cause long-term health issues.
• Joint Injection (Cortisone Shot): Offers temporary relief but may lead to long-term side effects and does not address root causes.
• Topical Anti-Inflammatory Remedies: Effective for alleviating acute pain but not chronic injuries.
• Strength Therapy & Physical Therapy: Important for tendinosis recovery but may be ineffective without addressing underlying issues like inflammation and muscle restriction.
• Manual Therapy (Massage, Dry Needling, Cupping): Effective in providing short-to-medium term relief but not a sustainable long-term solution due to high cost.
• Compression Sleeves, Straps, and Brace: Provide temporary relief but don't treat the root cause; they also mask injuries and can lead to prolonged symptoms.
• Sports & Kinesiology Tape Therapy: Temporarily relieves muscle and joint discomfort but may mask symptoms and prolong the injury.
  
• Pain Relief Patches: Offer short-term relief but don't address root causes; may have long-term side effects.
• Stretching Therapy: Stretching is essential for healing and preventing injuries but is ineffective without addressing underlying issues like muscle restriction.
• Heat Therapy: Helps to relieve muscle tension and can improve blood flow to the elbow area, which can promote healing.

Frequently Asked Questions

Why do I suddenly experience pain without an apparent cause?

The muscle conditions that lead to pain develop gradually and cumulatively. Over time, the repetitive use of the biceps, triceps, and forearms can lead to restriction, causing them to become shortened and inelastic.

This process of muscle restriction can take months or even years to develop.

When these tissues are chronically restricted, everyday activities at the gym, picking up weights, and gripping exercise bars or dumbbells during a workout can unexpectedly trigger pain without an apparent cause.

Unfortunately, most people are often unaware of the restricted state of these muscles until they experience a sudden onset of discomfort during physical activities. This point is one of the biggest takeaway from this article.

When someone mentions elbow or forearm pain from heavy lifting, I guide them through the forearm pliability test to help pinpoint the root cause.

What happens if tennis or golfer's elbow is left untreated?

• Worsening of the Pain: The initial discomfort can progress into more severe and persistent pain, making everyday activities challenging and affecting your ability to lift effectively.
• Chronic Inflammation: The inflammation in the elbow tendons may become chronic, leading to a condition known as tendinosis, which involves degeneration of the tendon collagen and can cause long-term problems.
• Arthritis of the Elbow: Untreated pain in the arm can contribute to autoimmune conditions like elbow arthritis.
• Reduced Range of Motion: Neglecting these injuries may lead to stiffness and reduced range of motion in the affected arm, hindering your ability to work out or perform daily tasks.
• Tendon Rupture: In severe cases, continued stress on the already injured tendons could lead to a partial or complete tear, requiring more extensive medical treatment and a longer recovery.
• Compromised Training Progress: Persisting pain may force you to avoid some exercises or reduce the intensity of your workouts.
• Wrist Issues: When restricted wrist extensors and flexors are left untreated, they become dysfunctional and affect connected joints.
  

Can I still lift weights or work out?

It depends on the severity of the pain and injury.

If it's mild, you can use conventional relief medicine or short-term remedies such as sports or kinesiology tape, compression sleeves, braces, or straps to reduce discomfort from lifting. However, if it's chronic, severe, or causes sharp aches, treat the underlying cause before resuming working out.

Which exercise variation is better to avoid elbow injuries?

All variations can trigger or worsen an injury; however, resistance bands or cable machine variations are better.

Here is a list of variations ranked from best to worst in terms of preventing injuries:

1. Resistance band
2. Cable machine
3. Stationary machines
4. Dumbbell
5. Smith machine
6. Barbell

Here are the reasons why:

• Resistance Band: Provides constant tension in the muscle throughout the entire range of motion, reducing the risk of injury compared to heavy dumbbells or a cable machine. It allows you to modify the arm position, reducing pressure on the elbow.
• Cable Machine: Enables arm isolation and less weight on one arm if needed, which helps prevent discomfort. You can adjust the exercise by increasing weights in smaller increments and varying the speed of reps.
• Dumbbell and Barbell: Dumbbells are preferable to barbells because they isolate the arm and promote a natural range of motion, requiring lighter weights. On the other hand, barbells enable heavier lifting, potentially overloading the joint.
• Stationary Exercise and Smith Machine: These variations provide guided and controlled motion, reducing strain on the elbow. The fixed movement pattern promotes proper form and minimizes unnecessary stress on the arm, making them suitable options for individuals experiencing pain.

While specific variations of exercises can worsen pain more than others, remember that the issue is not the type of equipment or exercise. The root cause is usually inelastic muscles.

What exercise should I avoid with tennis or golfer's elbow?

For tennis elbow, avoid "pressing" or "push" exercises. They can place excessive load on the forearm extensors. Here's a list of 10 exercises to avoid:

1. Bench Press
2. Shoulder and Overhead Press
3. Push-Ups
4. Pull-Ups
5. Tricep Dips
6. Tricep Pressdown
7. Reverse and Hammer Curls
8. Heavy Upright Rows
9. Lat Pulldowns (overhand grip)
10. Overhead Tricep Extensions

For golfer's elbow, avoid "pull" exercises. They can place excessive load on the wrist flexors. Here's a list of 10 exercises to avoid:

1. Chin-Ups
2. Chest Flys (machine, dumbbell, cable)
3. Bicep Curls
4. Triceps Pushdowns
5. Triceps Extensions
6. Bar Dips/Chair Dips
7. Close Grip Lat Pulldown
8. Cable Rows
9. Skull Crushers
10. Close-Grip Bench Press
    

Will the injury and pain go away by itself?

Yes, the acute symptoms of the condition can go away with rest. According to the Cleveland Clinic, recovery can take six to 18 months.

However, the underlying factors contributing to the condition, such as muscle restriction, do not resolve themselves. For many weight lifters, it often worsens over time.

Here's why: the root causes of this tendonitis injury include chronic inflammation, magnesium deficiency, and muscle restriction.

1. Firstly, once a muscle becomes restricted and dysfunctional, it tends to remain in that state or worsen unless specifically addressed.
2. Secondly, muscle dysfunction is often associated with magnesium deficiency. "The Magnesium Miracle," a scientific reference on the health effects of magnesium, highlights that around 40% of magnesium in the body is in the muscles. A significant portion of the population is magnesium deficient. Heavy weight lifting and various factors like caffeine, stimulants, diuretics, stress, and dehydration can deplete magnesium levels in athletes. These factors are one reason why restrictions persist and worsen.
3. Thirdly, chronically tight tissues eventually become dysfunctional and stop working correctly. This condition leads to repeated injury that affects other joints and stress on connective tissues, resulting in chronic tendonitis (i.e., chronic lifter's elbow).
   

How long does it take to heal a tennis or golfer's elbow?

By combining post-workout treatments such as cold therapy (to relieve burning pain), magnesium supplementation (to reduce inflammation), and self-myofascial release (to alleviate sharp or dull muscle pain), it is possible to heal these injuries within 7-10 days.

This process involves performing self-myofascial release (SMR) on the biceps, triceps, and forearms at least 2 to 3 times daily.

Get step-by-step guidance with the TitaniumPhysique Program to ensure you see results as fast as possible.  Yes, I'm ready to heal my elbow .

Remember that while resting (i.e., taking a break from working out) may provide relief, it will not fix the root cause of the injury.

How can I prevent injuries and protect my elbows?

The best thing you can do to prevent overuse injuries and protect your elbow is to include self-myofascial release into your recovery routine.

Here are additional tips:

1. Listen to your body. If you experience pain while lifting, don't ignore it.
2. Stretch and warm up properly before exercising.
3. Gradually increase resistance during your workouts.
4. Consider assisted variations of exercises that provide additional support to prevent strain.
5. Choose exercises that allow a neutral grip (palms facing in).
6. If you're training while recovering from an injury, performing partial reps, where you don't fully bend or extend the arm, can help.
7. Utilize lifting straps to reduce grip tension in the forearms.
8. Supplement with magnesium. It helps to relax tense muscles.
9. Incorporate sauna therapy.
10. Use a soft pad or cushion if your workout (e.g., yoga), hobbies, or profession requires placing your elbow on hard surfaces.
11. Incorporate forearm and wrist strengthening exercises to improve overall tendon resilience.

For the complete list with explanations, here are my best tips for keeping your elbows healthy.

How can I treat and eliminate elbow pain?

To treat and eliminate discomfort, maintain pliable biceps, triceps, and forearms through self-myofascial release (SMR) exercises.

SMR uses tools like foam rollers or massage balls to relax tight muscles. When muscles are restricted, they strain tendons. Releasing these muscles makes them more flexible, reducing tension on connective tissues and the arm joint. SMR is the quickest method to treat and eliminate tendon injuries.

Follow the guidance of the TitaniumPhysique Program to see fast results.

Ready to begin?  Yes, I'm ready to fix my elbow .

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