Why Your Elbows Hurt During Overhead Presses: Common Injuries and Mechanical Issues

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

Nurudeen performs a seated overhead press in a gym

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

In this article:

I’ll explain the causes of this issue and suggest alternative overhead press 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 Overhead Presses

Here is a list of elbow and forearm injuries that can cause discomfort during overhead presses.

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.

Triceps Tendonitis (pain at the back part of the elbow): Triceps tendonitis is the primary injury causing pain during overhead presses. It occurs when the tendon connecting the triceps muscle to the elbow becomes inflamed due to overuse. Improper form or excessive weight during the press can irritate this tendon, resulting in discomfort at the back of the elbow. Learn more about triceps tendonitis.
Tennis Elbow (pain at the outside part of the elbow): Tennis elbow, or lateral epicondylitis, is caused by tension and overexertion that lead to overload and irritation of the tendons on the outer elbow. During overhead presses, poor elbow alignment or compensatory movements can worsen this condition. 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 irritation of the forearm or wrist flexor tendons. A narrow grip or improper positioning of the wrists during overhead presses can increase stress on the inner elbow, causing pain. Learn more about golfer's elbow.
Brachioradialis Tendonitis (pain at the outside of the elbow, near the forearm and triceps): This condition affects the brachioradialis tendon and can occur with improper grip alignment or heavy resistance. It leads to pain near the outer elbow and is distinct from tennis elbow or triceps tendonitis.
Distal Bicep Tendonitis (pain in the lower biceps near the elbow): Distal bicep tendonitis stems from irritation of the tendon connecting the biceps to the elbow. A poorly controlled range of motion or excessive weight during overhead presses can contribute to this issue. 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 result from heavy resistance and insufficient warm-up, causing discomfort 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 overhead presses.

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

Overhead Press Specific-Issues and Elbow Mechanics That Cause Pain

This section explains specific factors related to the overhead press 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: Creates additional tension on the forearm extensors, which can stress the elbow tendons. Neutral: Often reduces stress on the elbow by promoting a natural wrist and forearm alignment.
Stability-Based Overhead Press Variations: These variations are categorized by the level of stability they provide, which can affect elbow stress. Standing Overhead Press: Requires core engagement but may overload the elbows due to improper alignment or excessive weight. Seated Overhead Press: Offers stability but can increase pressure on the elbow tendons due to restricted movement. Smith Machine Overhead Press: Guides the motion but may increase elbow strain due to a fixed bar path. Shoulder Press Machine: Reduces the need for stability but can overemphasize joint pressure.
Complexity-Based Overhead Press Variations: These variations involve dynamic or explosive movements that can increase elbow strain if performed improperly: Push Press: Involves explosive motion, which can strain elbow tendons if not controlled. Clean and Press: High complexity can lead to compensation in the elbows if performed incorrectly. Behind-the-Neck Press: High risk of improper joint alignment, causing elbow and shoulder discomfort. Kettlebell Press: Challenges stability but can be less taxing on the elbows when performed with proper form.
Type of Bar Used: Barbell: A common choice but can increase elbow tension due to its fixed grip. Swiss Bar: Promotes a neutral grip, reducing stress on the elbow tendons.
Type of Weights or Resistance Used: (Listed from least to most impact on the elbow): Resistance Bands: Provide variable resistance with minimal joint stress. Kettlebells: Offer better grip dynamics, reducing forearm and elbow strain. Dumbbells: Allow independent movement, reducing compensatory stress. Barbell: Fixed grip can lead to overload and irritation.
Type of Machine Used: (Listed from least to most impact on the elbow): Cable Machine: Provides smooth motion, reducing tendon stress. Stationary Machine: Stabilizes movement but may increase tension on the elbow. Smith Machine: Fixed path may lead to joint compensation and increased strain.
Bar Path: Improper bar path can force the elbows into unnatural positions, increasing joint pressure and discomfort.
Uneven Hand Position or Alignment on the Bar: Misalignment can lead to compensatory movements, causing uneven stress on the elbow tendons.
Overall Tendon Stress: Gradually increasing weight is crucial. Rapid progression can overload the tendons, leading to irritation and inflammation.
Degree of Elbow Bend: The angle at which the elbow is bent during overhead presses significantly impacts tendon stress. Over-bending the elbows can create excessive pressure on the tendons, while locking the elbows at the top of the press transfers tension to the joint.
Weight Load and Joint Compensation: Excessive weight often leads to improper form, causing compensatory movements that inflame the elbows and shoulders.
Type of Bar Used: 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.
Misalignment of Weights: Uneven loading can destabilize the press, leading to compensatory strain on the elbows.
Type of Workout Program: Overuse of the same overhead press variation or workout regimen can result in repetitive stress injuries. Alternating exercises can help minimize tendon tension.
Range of Motion: Excessive or limited range of motion can create uneven pressure on the tendons, causing discomfort.
Overload of the Wrist Extensors: Excessive weight during overhead presses can create undue pressure on the wrist flexors, the muscles responsible for bending the wrist. This overload can lead to tightness and irritation, which may indirectly affect the elbow tendons, resulting in discomfort or injury.
Overly Extended Wrists: Excessive wrist extension during the press transfers tension to the elbow tendons, leading to discomfort.
Overstretching of the Triceps: Tight triceps may cause discomfort at the back of the elbow joint during arm-lifting movements.
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.
Wrist Stability: Unstable wrists can lead to compensation in the elbows, increasing tendon stress.

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 the overhead press 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.

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:

Complement Your Routine: Incorporate these alternatives into your routine to give your elbow tendons time to recover while still building shoulder strength and stability.
Incorporate Stretching: Perform stretches between sets, such as overhead tricep stretches and forearm stretches, to maintain flexibility and reduce tension. This article on Hinge Health demonstrates forearm stretches. However keep in mind that stretching alone will not resolve the underlying causes of elbow pain.
Use Self-Myofascial Release (SMR): Incorporate elbow SMR exercises into your recovery routine to prevent and counteract injuries.

For a simple-to-follow video course to eliminate pain, get access to 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 overhead presses," 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 related to lifting, read 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 overhead presses," 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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