Elbow Pain from Skull Crushers (A Helpful Guide)

 Nurudeen Tijani (T.J.) Founder of TitaniumPhysique | Pain Relief Fitness Coach

Written by: Nurudeen Tijani

Last updated: May 29, 2024

I've been lifting for ten years, and I've dealt with and overcome many elbow injuries. This exercise fixed my elbows. The primary cause of elbow pain from skull crushers is restricted triceps and forearm muscles that strain the elbow tendons during the movement. To prevent discomfort, maintain pliable triceps and forearms through self-myofascial release exercises. These exercises can instantly relieve the restrictions in the muscles and minimize the risk of injury, overuse, and inflammation.

Take the first step to eliminate muscle and tendon pain. Get Started Now.

Nurudeen has elbow pain from skull crushers while exercising

Listen to the article: 15 minutes

Understanding Elbow Pain from Skull Crushers


Why do I have elbow pain from skull crushers? How do I fix it?

Elbow pain from skull crushers can occur for several reasons, including:

  1. Restricted biceps, triceps, and forearms (shortened, tight, and tense muscles)
  2. Inadequate stretching or warm-up of these muscles before working out
  3. Using excessive resistance
  4. Incorrect form or lifting technique
  5. Overtraining
  6. Inadequate recovery
  7. Lack of myofascial release

These factors, individually or in combination, can cause your elbow to hurt from skull crushers. Yet, for most people, the primary cause is restricted biceps, triceps, and forearms that strain the elbow tendons due to lack of myofascial release.

To prevent this condition, prioritize proper form, gradually increase weights, and, most importantly, maintain pliable biceps, triceps, and forearms through self-myofascial release "SMR" exercises.

SMR involves using tools like foam rollers or massage balls to release tight and tense muscles. Restricted muscles exert tension and strain tendons. When you release these muscles, they become more pliable and elastic, reducing the pulling tension on the elbow tendons and joints.

SMR is the fastest way to treat and alleviate muscle and tendon pain. Follow the step-by-step guidance of the TitaniumPhysique Program to see fast results. Get Started Now.

Why does my elbow hurt after doing skull crushers?

"Push exercises" like skull crushers can trigger or worsen elbow pain because the exercise impacts the forearms, triceps, and elbow tendons.

The repetitive use of the elbow joint during skull crushers can strain and inflame the forearm and triceps tendons, leading to acute elbow pain after the exercise. This situation is what causes your elbow to hurt after doing skull crushers.

Acute elbow pain is an inflammatory pain experienced during or immediately after a workout. In this case, symptoms of acute elbow pain include:

  • Burning pain around the tip and joint of the elbow.
  • A sensation of heat, swelling, or redness in the elbow area.
  • Soreness in the elbow after doing skull crushers.
  • Elbow pain when bending and straightening the arm.
  • Sharp or severe elbow discomfort during or after performing skull crushers.
A comparison photo of the forearm flexors and triceps muscle/tendon

A side-by-side comparison photo of the triceps and forearm flexor muscles. Left image: Illustration of the shoulder joint, scapula, arm bone, and triceps brachii muscle and tendon. Right photo: Illustration of the forearm flexor muscles and tendon. When these muscle groups become shortened, they cause pain on the inside and back part of the elbow during skull crushers. The "X" indicated on each photo is where trigger points in the forearm flexors and triceps muscle tend to occur. Trigger points, known as muscle knots, are small, hyperirritable spots within a muscle. They cause pain and tenderness and can develop due to muscle overuse, stress, or injury.

Why am I experiencing pain inside, outside, or at the back part of my elbow while doing skull crushers?

  1. Inner elbow pain - during skull crushers, the forearm flexors can strain and inflame the tendon on the inside part of the elbow (medial elbow tendon), causing inner elbow pain. This condition is known as golfer's elbow or medial epicondylitis. Brachialis injury can also cause discomfort at the inner part of the elbow crease.
  2. Outer elbow pain - during skull crushers, the forearm extensor muscles can overload and inflame the tendon outside the elbow (common extensor tendon), causing outer elbow pain. Medically, this is called tennis elbow or lateral epicondylitis. Lower bicep injury can also cause discomfort at the outer part of the elbow crease.
  3. Pain at the back of the elbow - finally, during most variations of skull crushers (dumbbell and barbell), the triceps muscle can become overloaded and strain the triceps tendon, causing pain at the back of the elbow. This condition is known as triceps tendonitis.

Why do I suddenly experience elbow pain from skull crushers without an apparent cause?

The muscle conditions that lead to elbow pain during skull crushers develop gradually and cumulatively. Over time, the repetitive use of the triceps and forearm muscles can lead to muscle restriction, causing them to become shortened and inelastic.

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

When the biceps, triceps, and forearm muscles are chronically restricted, everyday activities at the gym, picking up weights, gripping exercise bars or dumbbells, and skull crusher workouts can unexpectedly trigger elbow pain without an apparent cause.

Unfortunately, most people are often unaware of the restricted state of their forearm or triceps muscles until they experience this sudden onset of elbow pain during these activities. This point is the biggest takeaway from this article.

Whenever someone tells me they have elbow discomfort, I show them how to perform the forearm pliability test (see the video below).

During the test, most people will feel a dull but intense pain in the area, usually within a few seconds. Every time I have performed this test on friends at the gym, they are surprised by the tense and restricted states of these muscles.

YouTube video

In this video, I demonstrate how to perform the forearm pliability test to discover the hidden/root cause of most elbow tendonitis injuries.

Impact of Skull Crushers on Elbows


Can muscle tension in the forearm contribute to elbow pain during skull crushers?

Yes, muscle tension in the forearm and triceps contributes to pain in the elbow during skull crushers. Muscle tension is one of the root causes of elbow pain.

The biceps, triceps, and forearm muscles activate and contract when you perform skull crushers. As you continue to lift, the forearm flexor, forearm extensor, and triceps muscles can become tighter and shorter.

The shortened triceps and forearm muscles exert increased tension on the elbow and triceps tendon, reducing their elasticity. As a result, the elbow tendons get overloaded and inflamed, causing elbow discomfort.

For a deep dive into the root causes of elbow tendonitis, bursitis, chronic versus acute pain, and the fastest way to fix these conditions, you can check out these helpful resources:

A comparison photo of the forearm extensors and flexor muscles

A side-by-side comparison photo of the forearm extensors and flexor muscles. Left image: Illustration of the forearm extensor muscle group and tendon. Right photo: Illustration of the wrist flexor muscles and tendon. When these muscle groups become shortened, they cause outer and inner elbow pain during skull crushers.

Are skull crushers bad for the elbows?

Skull crushers are not harmful to the elbows when performed using proper form and technique. However, it's important to note that inadequate warm-up, excessive resistance, or sudden increases in training volume can overload the elbow and triceps tendons, leading to elbow tendonitis and pain.

Can skull crushers cause damage to the elbows?

When performed using proper technique, skull crushers do not cause damage to the elbows. However, individuals with elbow tendonitis may experience worsening chronic pain or relapse of acute elbow pain, leading to elbow tendinosis.

Tendinosis is a condition characterized by the degeneration of tendon collagen due to repetitive stress and chronic injury. It can result in a loss of strength in the tendon and may even lead to tendon tear or rupture.

Therefore, performing skull crushers with pre-existing elbow or triceps tendonitis (i.e., inflammatory tendon pain) can increase the risk of developing elbow tendinosis and potentially cause damage to the elbows.

Illustration of elbow tendinopathy | elbow tendon tear

Illustration of elbow tendinopathy in the medial (inner) and lateral (outer) elbow tendon.

What happens if elbow pain from skull crushers 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 pain and weakness.
  • Arthritis of the Elbow: untreated elbow pain can contribute to autoimmune conditions like elbow arthritis.
  • Reduced Range of Motion: Neglecting the pain may lead to stiffness and reduced range of motion in the affected elbow, hindering your ability to perform exercises and 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.
  • Shoulder Problems: When restricted muscles in the triceps are left untreated, they become dysfunctional and can cause shoulder pain.

Managing Elbow Pain and Modifications


Can I still do skull crushers if I have elbow pain?

Whether or not you can do skull crushers with elbow pain depends on the severity of the injury. If it's mild, you can use short-term pain relief solutions such as sports or kinesiology tape, elbow sleeves, braces, or straps to reduce pain during the movement. Suppose it's chronic, severe, or causes sharp pain. In that case, it's best to treat the underlying cause of the pain before resuming exercise.

Which skull crusher variation is better for avoiding elbow pain?

All skull crusher variations can trigger or worsen elbow pain; however, resistance bands or cable machine variations are better when avoiding pain.

Here is a list of five skull crusher variations ranked from best to worst to avoid elbow pain:

  1. Resistance skull crushers
  2. Lying cable machine skull crushers
  3. Dumbbell skull crushers
  4. Smith Machine skull crushers
  5. Barbell skull crushers

Here's the reason why resistance band or cable machine variations are better.

  • Resistance Band Skull Crushers: Provides constant tension in the muscle throughout the entire range of motion, reducing the risk of injury compared to using heavy dumbbells, barbells, or a cable machine. It allows you to modify arm and elbow position, reducing pressure on the elbow.
  • Cable Machine Skull Crushers: Enables arm isolation and less weight on one arm if needed, which helps prevent and avoid elbow pain. You can adjust the exercise by increasing weights in smaller increments and varying the speed of reps.
  • Dumbbell vs. Barbell: Dumbbells are preferable to barbell skull crushers because they isolate the arm and promote a natural range of motion, requiring lighter weights. On the other hand, the barbell skull crushers enable heavier weights, increasing resistance and potentially overloading the triceps and forearm tendons.
  • Smith Machine: The Smith Machine provides guided and controlled motion during skull crushers, reducing strain on the elbow joint. The fixed movement pattern promotes proper form and minimizes unnecessary stress on the elbows. However, it is necessary to properly align and position the bench, your body, and arms to avoid injury.
Nurudeen performs barbell triceps extension

A photo of me performing barbell overhead tricep extension (2019), a variation of skull crushers.

What are alternative exercises to skull crushers?

Skull crushers with an overhand or reverse underhand grip can exert excessive tension on the elbow and triceps tendons. As such, you can perform alternative exercises that minimize tension in these areas and alleviate pain. Below are 12 alternatives you can try.

Additionally, for the exercises listed below, performing partial reps, where you don't fully bend or extend the elbow during the movement, can further reduce tension on the elbow tendons and joints.

  1. Cable Rope Triceps Pushdown
  2. Cable Triceps Pushdown
  3. Triceps Pushdown V Bar
  4. Machine Triceps Extension
  5. Cable Triceps Kickback
  6. Cable Reverse Grip Triceps Pushdown
  7. Band Back Flys
  8. Cable Kneeling Triceps Extension
  9. Stability Ball Weight Plate Pullover
  10. Cable Triceps Incline Pushdown
  11. Cable Low Triceps Extension
  12. Cable Rope Supine Triceps Extension

You can access the JEFIT exercise library to learn how to perform these exercises.

Can elbow compression sleeves alleviate pain from skull crushers?

Yes. Compression sleeves, such as elbow wraps, straps, and braces, can alleviate pain from skull crushers. However, it's essential to consider the pros and cons of using elbow sleeves to manage pain.

Pros: Elbow compression sleeves provide compression, which improves blood flow, enhances joint position awareness (proprioception), and offers support to the muscles and tendons surrounding the elbow joint. The compression promotes better circulation, stabilizes the joint, reduces swelling, alleviates pain, and can help prevent further damage during heavy skull crushers.

Cons: Relying only on sleeves for pain relief can mask the underlying problem, allowing athletes to continue performing skull crushers without addressing the root cause of their pain. This masking will further perpetuate the injury and potentially lead to long-term degenerative conditions in the elbow.

How do I perform skull crushers without elbow pain?

Here are six tips on how to perform skull crushers without pain:

  1. Stretch the forearm and triceps muscles before exercises.
  2. Perform skull crushers with cables or dumbbells instead of barbells.
  3. Perform two warm-up sets with lighter weights before increasing the resistance.
  4. Use lifting straps to help reduce forearm muscle tension from gripping the weights.
  5. Use elbow sleeves or wraps to help compress the elbow and triceps tendon.
  6. Try not to flare your elbows during the movement.

Watch the video below to see how I perform skull crushers. You can also watch this video on YouTube for another perspective.

YouTube video

Here is a video of me performing barbell skull crushers (without pain).

Healing and Prevention


How long does it take to heal elbow pain caused by skull crushers?

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 pain), it is possible to heal elbow pain caused by skull crushers within 7-10 days.

It will involve performing self-myofascial release (SMR) on the triceps and forearm muscles at least 2-3 times daily.

Get step-by-step guidance with my TitaniumPhysique Program to ensure you do these exercises correctly and effectively, and see results as fast as possible. Get Started Now.

Remember that while resting the elbow (i.e., taking a break from working out) may provide temporary relief, it will not fix the root cause of the pain - restricted triceps and forearm muscles that overload the elbow tendons and lead to elbow discomfort during skull crushers.

What options do I have to stop elbow pain?

To stop your elbows from hurting during skull crushers, 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

Option #2: Fix the root cause to prevent elbow problems from interfering with your skull crusher workouts. Address muscle restriction by improving forearm, triceps, and biceps muscle pliability.

Learn how my TitaniumPhysique Program can help you quickly eliminate pain at its source. Get Started Now.

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