Why Your Elbows Hurt During Pull-Ups: Common Injuries and Mechanical Issues

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

Nurudeen performs pull-ups and chin-up in a gym

I've been lifting for ten years and have personally experienced and overcome elbow pain from performing pull-ups.

In this article:

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

Quick and Helpful Resources for "Pull-Ups Elbow Pain"

Treatment Exercises: If you're looking for exercises to fix "elbow pain from pull-ups," 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: For a complete guide on elbow pain related to weightlifting, read this article: Elbow Pain: A Helpful Guide for Lifters. 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.
Fast Relief Program: For an easy-to-follow video course to fix "elbow pain from pull-ups," 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 .

Injuries That Cause Elbow Pain During Pull-Ups

Here is a list of elbow and forearm injuries that can cause discomfort during pull-ups.

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.

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. This condition is common during chin-ups due to the underhand grip, which puts increased stress on the inner elbow, leading to discomfort. Learn more about golfer's elbow.
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. Standard pull-ups, especially with a wide grip, can exacerbate this condition due to excessive stress on the forearm extensors. Learn more about tennis 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.
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. Performing pull-ups with excessive weight or a poorly controlled range of motion 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 doing pull-ups without proper warm-up, causing pain at the elbow crease. Learn more about brachialis 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. Poor form or excessive load during pull-ups can strain this tendon, causing discomfort at the back of the elbow. Learn more about triceps 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 help fix and prevent elbow issues during pull-ups.

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

Pull-Ups Specific-Issues and Elbow Mechanics that Cause Pain

This section explains specific factors related to pull-ups that can contribute to elbow pain.

While the details below highlight 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: Wide Grip (overhand): A wide grip increases pressure on the outer elbow tendons, often contributing to tennis elbow, particularly when there is pre-existing tightness in the forearm extensors. Close Grip (underhand): A close, underhand grip puts more stress on the inner elbow tendons, leading to discomfort and a higher risk of golfer's elbow. Chin-ups commonly utilize this grip. Neutral Grip: A neutral grip (palms facing each other) often reduces stress on the elbow by promoting a more natural wrist and forearm alignment, minimizing the risk of irritation.
Pull-Up Variations by Support and Resistance Type: Weighted Pull-Up: Adding weight can overload the tendons and muscles, increasing the risk of injury, especially if progression is too fast or the supporting muscles are not sufficiently strong. One-Arm Assisted Pull-Up: This exercise helps isolate muscles but can lead to imbalance-related issues if not properly controlled. Band-Assisted Pull-Up: Bands provide variable resistance, but if overused or misused, they can lead to uneven muscle engagement and increase elbow irritation. Machine-Assisted Pull-Up: This variation provides support but may still lead to discomfort if the resistance isn’t properly adjusted or if form is compromised.
Pull-Up Variations by Grip Position and Technique: Standard Pull-Up: This common variation may lead to elbow discomfort, especially if there is poor form or a lack of flexibility in the upper body muscles. Chin-Up: Chin-ups place more emphasis on the biceps and forearm flexors, increasing the likelihood of golfer's elbow if the muscles are overly tight or not warmed up. Behind-the-Neck Pull-Up: This variation can increase shoulder and elbow stress due to the awkward positioning, increasing the risk of pain and injury.
Type of Attachment Used: V-Handle (Double D Handle): Promotes neutral alignment of the wrists, reducing tension in the elbow tendons. However, improper positioning can still lead to irritation. Tricep Rope: Encourages a neutral wrist alignment but can lead to elbow pain if the resistance is excessive.
Uneven Hand Position or Alignment on the Bar: Misaligned hand placement can cause one arm to overcompensate, leading to uneven pressure on the elbow tendons and increased risk of injury.
Type of Pull-Up 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.
Type of Workout Program: Overuse of the same pull-up 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, leading to elbow issues.
Tight Lats: Tight lats can indirectly contribute to elbow instability. When the lats are tight, they restrict shoulder movement, which in turn can destabilize the arm joint during pull-ups, leading to elbow discomfort.
Weight Load: Doing weighted pull-ups can overload and inflame the connective tissues. Gradually increasing the weight load is essential to prevent injury.
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, especially during overhand pull-ups.
Overstretching of the Triceps: Inelastic triceps can cause discomfort at the back of the elbow during arm-bending movements like pull-ups, due to excessive stretching.
Pain at the Front Crease of the Elbow: During pull-ups, the biceps' role in elbow flexion can lead to discomfort if the brachialis or lower biceps tendon is injured or overstrained.
Wrist Stability: Maintaining a neutral wrist position is crucial. Overly flexed or extended wrists can lead to excess tension on the elbow tendons, contributing to pain.

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 .

Pull-Ups Alternative Exercises to Avoid Pain

This section provides alternative exercises to pull-ups 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 pull-ups.
Machine-Assisted Pull-Up (Hammer Grip): This variation engages the lats with less strain on the elbow tendons by providing assisted weight support and promoting a neutral wrist position, which minimizes 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, making it a safe alternative to traditional pull-ups.
Dumbbell Pullover (Straight-Arm): This exercise strengthens the lats and chest while reducing strain on the elbows by using a controlled, straight-arm motion that doesn’t require elbow flexion.
Cable Incline Pulldown: This alternative provides adjustable resistance and a natural range of motion, minimizing pressure on the elbow tendons while effectively targeting the lats.

Helpful Tips to Avoid Pain

Tip #1: These alternatives can complement or replace traditional pull-ups in your workout routine. They help reduce the risk of injury while still building lat strength and muscle size effectively.
Tip #2: 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 forearm flexor and extensor stretches. Here's an example demonstrated on Hinge Health. However keep in mind that stretching alone will not resolve the root causes of elbow pain.
Tip #3: Perform elbow self-myofascial release (SMR) exercises the night before your pull-up 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 .

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