Elbow Pain from Overhead Presses
Written by: Nurudeen Tijani (Wellness and Pain Relief Fitness Coach)
Quick Answer to Your Questions
Can overhead presses cause elbow pain?
Yes, overhead presses (OHP) can cause elbow pain—but the exercise itself is rarely the true problem.
Why do my elbow hurt from overhead presses?
In most cases, elbow pain during overhead presses shows up because the muscles and tendons involved are already stiff, overworked, or lacking proper pliability. This makes the elbows less able to tolerate stress during repeated pressing overhead.
Why pain persists: With overhead presses, elbow pain is rarely just about the elbow itself. It often comes from how pressing overhead overexerts the arms, how restricted muscles and irritated tendons handle stress during repeated presses, and compensation patterns that develop over time.
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Overhead Press Mechanics That Can Contribute to Elbow Pain
I’ve been lifting for over 10 years and have personally experienced—and resolved—elbow pain from overhead presses.
The overhead press mechanics and factors below are important to understand because they can contribute to elbow discomfort. However, they are not the root cause of elbow pain during overhead pressing.
This page explains the real cause.
Grip Type and Wrist Alignment
Overhand Grip
Creates additional tension on the forearm extensors, which can stress the elbow tendons.
Neutral Grip
Often reduces elbow stress by promoting a more natural wrist and forearm alignment.
Overhead Press Variations Based on Stability
Standing Overhead Press
Requires core engagement but may overload the elbows if alignment is poor or weight is excessive.
Seated Overhead Press
Provides stability but can increase elbow tendon pressure due to restricted movement.
Smith Machine Overhead Press
Guides the motion but may increase elbow strain because of the fixed bar path.
Shoulder Press Machine
Reduces stabilization demands but can overemphasize joint pressure at the elbows.
Complex and Dynamic Overhead Press Variations
Push Press
Uses explosive movement that can strain elbow tendons if not well controlled.
Clean and Press
High technical demand may lead to compensations at the elbows when form breaks down.
Behind-the-Neck Press
High risk of poor joint alignment, increasing stress on the elbows and shoulders.
Kettlebell Press
Challenges stability but may be less taxing on the elbows when performed with proper form.
Bar, Handle, and Grip Design
Barbell
A common choice but the fixed grip can increase elbow tension.
Swiss Bar
Encourages a neutral grip, helping reduce elbow tendon stress.
Bar Thickness
Bars that are too thick or too thin for hand size can cause grip instability and compensation at the wrists and elbows.
Type of Resistance and Equipment Used
Resistance Bands
Provide variable resistance with minimal joint stress.
Kettlebells
Offer improved grip dynamics, often reducing forearm and elbow strain.
Dumbbells
Allow independent arm movement, reducing compensatory stress.
Barbell
Fixed grip and heavy loading can increase the risk of tendon irritation.
Machine Type and Movement Path
Cable Machines
Offer smooth, adjustable resistance that reduces tendon stress.
Stationary Machines
Stabilize movement but may increase elbow tension depending on alignment.
Smith Machine
Fixed bar path can force compensatory joint movement and increase strain.
Bar Path and Alignment
Bar Path
An improper bar path can force the elbows into unnatural positions, increasing joint pressure.
Uneven Hand Position
Misalignment on the bar leads to compensatory loading and uneven tendon stress.
Misaligned Weights
Uneven loading destabilizes the press and increases strain on the elbows.
Load Management and Tendon Stress
Overall Tendon Stress
Gradual progression is essential. Rapid increases in weight can overload the elbow tendons.
Weight Load and Joint Compensation
Excessive weight often leads to form breakdown and compensatory movements involving the elbows and shoulders.
Elbow Position and Range of Motion
Degree of Elbow Bend
Over-bending increases tendon pressure, while locking the elbows transfers stress directly to the joint.
Range of Motion
Excessive or limited motion creates uneven tendon loading and discomfort.
Wrist Control and Muscle Restrictions
Overload of the Wrist Extensors
Heavy pressing can overload these muscles, leading to tightness that affects elbow tendons.
Overly Extended Wrists
Excessive wrist extension transfers tension directly to the elbow tendons.
Wrist Stability
Unstable wrists cause compensatory elbow movement and increased tendon stress.
Triceps and Elbow Referral Pain
Overstretching of the Triceps
Tight triceps can cause discomfort at the back of the elbow during pressing movements.
Pain at the Front Crease of the Elbow
Often related to irritation of the brachialis or lower biceps tendon from poorly controlled motion.
Alternative Exercises to Avoid Pain During Overhead Press Workouts
This section provides alternative exercises to the overhead press that target similar muscles while minimizing elbow tendon discomfort, allowing you to build shoulder strength and stability while giving your tendons time to recover.
You can find instructions of the exercises below on the JEFIT exercise database.
- Lateral and Front Raise (Dumbbell, Cable, or Machine): These exercises isolate the shoulder muscles, reducing strain on the elbow by eliminating pressing movements.
- Dumbbell Shrugs: Focuses on the traps and upper shoulders without involving the elbow tendons, making it a low-impact alternative.
- Cable Rope Face Pull: Strengthens the rear deltoids and traps while promoting healthy shoulder mechanics, minimizing elbow stress.
- Cable Upright Row: Targets the shoulders and traps with a controlled range of motion, reducing unnecessary tension on the elbows.
- Dumbbell Reverse Fly: Works the rear delts and upper back while avoiding excessive strain on the elbow joints.
Additional Helpful Tips to Avoid Pain:
- Incorporate Stretching: Perform stretches between sets, such as overhead tricep stretches and forearm stretches, to maintain flexibility and reduce tension. This YouTube video demonstrates forearm stretches.
- Use Self-Myofascial Release (SMR): Incorporate elbow SMR exercises into your recovery routine to prevent and counteract injuries.
- For a full lifter’s guide, including FAQs, see: Lifting with Elbow Discomfort.
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