Why Your Elbows Hurt During Lat Pulldowns: Common Injuries and Mechanical Issues

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

Nurudeen performs cable lat pulldown in a gym

I've been lifting for ten years and have personally experienced and overcome elbow pain from performing lat pulldowns.

In this article:

I’ll explain the causes of this issue and suggest alternative lat pulldown exercises you can try.
I’ll also share treatment exercises and a detailed program to fix and prevent elbow problems.

Injuries That Cause Elbow Pain During Lat Pulldowns

Here is a list of elbow injuries that can cause discomfort during lat pulldowns.

Based on my experience, I’ve listed these injuries in order of prevalence among athletes and gym-goers who perform this exercise.

Follow the links below to learn more about each specific condition.

Tennis Elbow (pain at the outside part of the elbow): Tennis elbow, or lateral epicondylitis, is caused by tension and strain that lead to overload and irritation of the tendons on the outer elbow. During lat pulldowns, repetitive motion and improper grip mechanics can exacerbate this condition, resulting in discomfort. Learn more about tennis elbow.
Golfer's Elbow (pain at the inside part of the elbow): Golfer’s elbow, also known as medial epicondylitis, involves inflammation of the forearm flexor tendons. A narrow grip or improper hand positioning during lat pulldowns can increase strain on the inside of the elbow, leading to pain. Learn more about golfer's elbow.
Brachioradialis Tendonitis (pain at the outside of the elbow near the forearm and triceps): This condition involves irritation of the brachioradialis tendon and can occur when using improper grip width or heavy resistance. It leads to pain near the outer elbow but is distinct from tennis elbow or triceps tendonitis.
Triceps Tendonitis (pain at the back part of the elbow): Triceps tendonitis occurs when the tendon connecting the triceps muscle to the elbow becomes inflamed due to overuse. Excessive load or poor form during lat pulldowns can strain this tendon, causing discomfort at the back of the elbow. Learn more about triceps tendonitis.
Distal Bicep Tendonitis (pain in the lower biceps near the elbow): This injury stems from inflammation of the tendon connecting the biceps to the elbow. A poorly controlled range of motion or excessive weight during lat pulldowns can increase the risk of this condition. Learn more about distal bicep tendonitis.
Brachialis Tendonitis (pain at the crease of the elbow): Brachialis tendonitis affects the tendon of the brachialis muscle, located at the front of the elbow. This injury can occur when lifting heavy resistance without proper warm-up, causing pain at the elbow crease. Learn more about brachialis tendonitis.

Tip: Recognizing these injuries early and taking a holistic approach to treatment—including addressing the entire arm, such as the triceps, biceps, and forearm—can fix and prevent elbow issues during lat pulldowns.

Ready to get started? Yes, I’m ready to eliminate pain .

Lat Pulldown Specific-Issues and Elbow Mechanics That Cause Pain

This section explains specific factors related to lat pulldowns that can contribute to elbow pain.

While the details below explain unique issues and mechanics, the underlying cause for most individuals remains the same: muscle stiffness.

When muscles are pliable and flexible, many of these issues become less significant.

Type of Grip: Overhand vs. Underhand: Overhand grip can create excess tension on the forearm extensors, while an underhand grip may cause discomfort by overloading the biceps and forearm flexors. Neutral Grip: Often reduces stress on the elbow by promoting a more natural wrist and forearm alignment. Wide vs. Close Grip: A wide grip increases pressure on the outer elbow tendons, while a close grip may lead to discomfort on the inner elbow.
Type of Lat Pulldown: Cable Lat Pulldown: Allows for smoother motion but requires attention to form to prevent overloading tendons. Machine Lat Pulldown: Offers fixed movement paths, which can either stabilize or irritate the elbows depending on setup. Resistance Band Lat Pulldown: Provides variable resistance but can cause irritation if bands are over-tensioned. One-Arm Lat Pulldown: Helps isolate muscles but may increase the risk of imbalance-related issues. Kneeling Pulldown: Engages the core but may inflame the elbow tendons if the motion isn’t controlled.
Type of Cable Attachment Used: Tricep Rope: Encourages neutral wrist alignment but can lead to irritation if resistance is excessive. Straight Bar: May force the wrists and elbows into unnatural positions, causing discomfort. Neutral Grip Lat Bar: Provides ergonomic grip, minimizing tendon stress. V-Handle (Double D Handle): Promotes neutral alignment, reducing joint tension. Single D-Handle: Allows for unilateral training but requires control to prevent injury. V-Shaped Bar: May provide a comfortable grip but can lead to overexertion if the grip width is improper. Curl Lat Bar: Engages multiple arm muscles but can increase elbow pressure if used incorrectly.
Type of Machine or Resistance Used: Cable Machines: Provide smooth, adjustable motion, helping to reduce unnecessary stress on the elbows. Stationary Machines: Offer guided paths, which can either stabilize or inflame tendons depending on alignment. Resistance Bands: Allow for portable options but can create uneven tension, leading to irritation.
Type of Bar Used: Thick Bar vs. Thin Bar: Using a bar that is too thick or thin for your hand size can cause grip instability and compensation in the wrists or elbows. Thick bars may result in forearm tension and wrist discomfort, while thin bars can lead to instability and overexertion of the elbow tendons. Thicker bars are better suited for individuals with larger hands, while thinner bars are ideal for smaller hands.
Bar Path: Improper bar path can force the elbows into unnatural positions, increasing joint stress and discomfort.
Uneven Hand Position or Alignment on the Bar: Misaligned hand placement can cause one arm to overcompensate, leading to uneven pressure on tendons.
Overall Tendon Stress: Gradually increasing weight is essential. Rapid progression can overload the elbow tendons, leading to irritation and inflammation.
Overly Flexed Wrists: Keeping wrists neutral is critical. Excessive flexion can transfer tension to the elbow tendons.
Elbow Position and Degree of Elbow Bend: Over-bending or locking the elbows during the motion can lead to excessive strain on the tendons.
Weight Load and Joint Compensation: Excessive weight often leads to improper form, causing compensatory movements that inflame the elbows and shoulders.
Type of Workout Program: Overuse of the same lat pulldown variation or workout regimen can lead to repetitive stress injuries. Incorporating different exercises can help reduce tendon tension.
Range of Motion: Excessively stretching or limiting the range of motion can cause discomfort and uneven stress on the tendons.
Overload of the Wrist Flexors and Extensors: Improper load distribution can lead to tightness and irritation in these muscles, causing elbow pain.
Overstretching of the Triceps: Tight triceps can cause discomfort at the back of the elbow joint during arm-bending movements like pulldowns.
Pain at the Front Crease of the Elbow: This occurs when the brachialis or lower biceps tendon becomes irritated due to excessive or poorly controlled motion.
Tight Lats: Restricted lats destabilize the shoulder joint, forcing the arm to compensate during lat pulldowns, which indirectly increases elbow discomfort.

Tip: By improving muscle pliability with SMR exercises, most of these issues resolve themselves. The TitaniumPhysique program can help you achieve pliable muscle.

Ready to get started? Yes, I'm ready to eliminate pain .

Alternative Exercises to Avoid Pain

This section provides alternative exercises to lat pulldowns that target similar muscles while minimizing discomfort or irritation in the elbow tendons.

You can find instructions of the exercises below on the JEFIT exercise database.

Resistance Band Lat Pulldown: Resistance bands offer variable resistance and a smoother motion, reducing pressure on the elbow tendons compared to traditional lat pulldowns.
Machine-Assisted Pull-Up: This variation engages the lats with less strain on the elbow tendons by providing assisted weight support, making it easier to maintain proper form.
Machine-Assisted Pull-Up (Hammer Grip): Using a hammer grip reduces wrist and elbow stress by promoting a neutral hand position, minimizing tension on the forearms.
Leverage Machine Iso Row: A leverage machine row isolates the back muscles while providing support for the elbows and reducing joint compensation.
Dumbbell Pullover (Straight-Arm): This exercise strengthens the lats and chest while reducing strain on the elbows by using a controlled, straight-arm motion.
Cable Incline Pulldown: This alternative provides adjustable resistance and a natural range of motion, minimizing pressure on the elbow tendons.

Additional Helpful Tips to Avoid Pain:

Complement Your Routine: These alternatives can complement or replace traditional lat pulldowns in your workout routine. They help reduce the risk of injury while still building lat strength and muscle size effectively.
Incorporate Stretching: To avoid pain, stretch between sets to keep the triceps and forearm muscles relaxed. A quick 15–30 second stretch while resting between sets can improve flexibility and prevent tension in the elbow tendons. Recommended stretches include the overhead tricep stretch and forearm flexor and extensor stretches. Here's an example demonstrated by Hinge Health. However, keep in mind that stretching alone will not fix or prevent the underlying causes of elbow issues.
Use Self-Myofascial Release (SMR): Perform elbow SMR exercises the night before your lat pulldown workouts. SMR relaxes tense muscles, preventing and counteracting elbow injuries.

For a simple-to-follow video course to eliminate pain, check out the TitaniumPhysique program.

Ready to take the next step? Yes, I’m ready to eliminate pain .

Next Steps and Helpful Resources

Treatment Exercises: If you're looking for exercises to fix "elbow pain from lat pulldowns," check out this post and photos: Elbow Tendonitis Treatment and Relief Exercises. I demonstrate simple exercises using self-myofascial release (SMR), a highly effective method for addressing muscle and tendon pain.
Comprehensive Guide and FAQ: For a complete guide on elbow problems from lifting, check out this article. It covers the root causes of elbow pain, common injuries, elbow anatomy, exercise mechanics, treatment options, and a detailed FAQ section packed with valuable insights.
Tendon Recovery Program: For an easy-to-follow video course to fix "elbow pain from lat pulldowns," consider the TitaniumPhysique program. It’s the fastest way to eliminate and prevent elbow pain. In the program, I teach SMR techniques that provide instant relief. Trusted and used by athletes and bodybuilders, the program boasts a 98% satisfaction rate.

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

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