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

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

Nurudeen performs push-ups in a gym

I've been training for years and have personally experienced and overcome elbow pain from performing push-ups.

In this article:

  1. I’ll explain why push-ups can cause elbow discomfort and offer strategies to address and prevent these issues.
  2. I’ll also share alternative exercises and a detailed program to fix and prevent elbow problems.


Injuries That Cause Elbow Pain During Push-Ups

The two primary injuries that cause elbow pain during push-ups are triceps tendonitis and tennis elbow.

Both conditions result from excessive stress or tension on the tendons, often due to restricted muscles. Below is a list of common elbow injuries and how they relate to push-ups.

Recognizing these injuries and addressing them early is crucial for effective treatment and prevention.

  1. Triceps Tendonitis (pain at the back part of the elbow): This injury involves inflammation of the tendon connecting the triceps muscle to the elbow. Overloading the triceps with repetitive push-ups or performing advanced variations like plyometric push-ups without proper conditioning can lead to irritation at the back of the elbow. Learn more about triceps tendonitis.
  2. Tennis Elbow (pain at the outside part of the elbow): Tennis elbow, or lateral epicondylitis, occurs when the tendons on the outer elbow are overloaded. Excessive pressure from improper hand positioning or wrist instability during push-ups can exacerbate this condition, causing discomfort. Learn more about tennis elbow.
  3. Golfer's Elbow (pain at the inside part of the elbow): Also known as medial epicondylitis, golfer's elbow results from inflammation of the forearm flexor tendons. Variations like narrow (diamond) push-ups place more stress on the inner elbow, potentially triggering pain. Learn more about golfer's elbow.
  4. Brachioradialis Tendonitis (pain at the outside of the elbow, near the forearm and triceps): This condition involves irritation of the brachioradialis tendon, often caused by excessive resistance or advanced push-up techniques. The discomfort is distinct from tennis elbow but occurs near the same area.
  5. Distal Bicep Tendonitis (pain in the lower biceps near the elbow): Inflammation of the tendon connecting the biceps to the elbow can arise from poor control or excessive speed during push-ups, particularly in explosive variations. Learn more about distal bicep tendonitis.
  6. Brachialis Tendonitis (pain at the crease of the elbow): This injury affects the brachialis tendon at the front of the elbow. It can result from inadequate warm-ups or overloading the arms during push-ups, causing discomfort at the elbow crease. Learn more about brachialis tendonitis.

Tip: A holistic approach to treatment, including addressing the muscles of the entire arm (triceps, biceps, and forearms), can help fix and prevent these issues.

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


Push-Ups Specific Issues and Elbow Mechanics That Cause Pain

This section highlights specific factors related to push-ups that can contribute to elbow pain.

While the issues listed below detail unique challenges, the underlying cause for most individuals is often restricted (tight, tense, or shortened) muscles.

Maintaining muscle flexibility and proper mechanics can significantly reduce discomfort.

  1. Hand Position During Push-Ups: Standard Push-Ups: Incorrect hand placement can create excessive tension in the wrist and elbow, leading to irritation. Wide Push-Ups: A wider hand position increases stress on the outer elbow tendons and shoulder joints. Narrow (Diamond) Push-Ups: This variation intensifies pressure on the triceps and inner elbow, potentially causing discomfort.
  2. Type of Push-Up Variation: Incline Push-Up: While this reduces resistance, improper alignment can still irritate the elbows. Decline Push-Up: The increased load on the upper body can stress the elbow tendons if not performed with control. Plyometric and Explosive Push-Ups: Variations like clap, superman, and chest slap push-ups place high impact on the elbows, making them more prone to inflammation. Unilateral and Uneven Push-Ups: Single-arm and uneven push-ups require greater stability, which can overload one elbow more than the other, leading to imbalance-related pain.
  3. Type of Weights or Resistance Used: Resistance Band Push-Up: Resistance bands add variable tension, which can lead to uneven stress if used improperly. Weighted Push-Up: Adding weight increases overall load, which, without proper form, can strain the elbow tendons.
  4. Type of Equipment Used: Push-Up Bar: Promotes wrist alignment but can stress the elbows if grip mechanics are poor. Medicine Ball Push-Up: The instability of the ball increases pressure on the elbows and wrists. Stability Ball/TRX Push-Up: These tools engage stabilizing muscles but may irritate the elbows if not used with proper form. Bosu Ball Push-Up: The added instability can overexert the elbow tendons, especially if alignment is off.
  5. Overall Tendon Stress: Gradually increasing intensity is critical. Rapidly progressing push-up variations or repetitions can overload the elbow tendons, leading to discomfort.
  6. Elbow Position and Degree of Elbow Bend: Keeping the elbows flared too wide or tucked too close can lead to uneven distribution of stress, increasing the risk of irritation.
  7. Weight Load: Body weight serves as resistance during push-ups. For advanced variations, improper distribution of this load can strain the elbow joints.
  8. Type of Workout Program: Overuse of push-ups or insufficient rest between sessions can lead to repetitive stress injuries. Incorporating rest days and exercise variety is essential.
  9. Overload of the Wrist Flexors and Extensors: Excessive load on these muscles, which stabilize the wrist during push-ups, can cause discomfort and inflammation at the outer elbow.
  10. Wrist Stability: Unstable wrists during push-ups transfer unnecessary tension to the elbows, contributing to pain and potential injury.

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

If push-ups cause elbow discomfort, consider incorporating the following alternative exercises.

These options target similar muscle groups while minimizing stress on the elbow tendons, making them suitable for recovery or injury prevention.

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

  1. Dumbbell Pullover (with Straight Arm): Strengthens the chest and lats with a controlled, straight-arm motion, reducing elbow strain.
  2. Machine Fly (using Pec Deck Machine): Provides a guided path to isolate the chest muscles without placing unnecessary pressure on the elbows.
  3. Cable Chest Fly or Crossover: Offers adjustable resistance and natural range of motion to target the chest while protecting the elbow tendons.
  4. Chest Fly: Using dumbbells or cables, this exercise isolates the chest with minimal elbow involvement.
  5. Wall Push-Up (with Wide-Arm): A low-impact variation of push-ups that reduces the load on the elbows and wrists.
  6. Knee Push-Up (with Wide-Arm): Decreases body weight resistance, making it easier on the elbow joints.
  7. Incline Knee Push-Up: Combines incline and knee variations for minimal resistance, reducing elbow and wrist tension.


Helpful Tips to Avoid Pain

  • Tip #1: Incorporating these exercises into your routine can provide relief while maintaining strength and conditioning. They are excellent options during recovery or when managing elbow pain.
  • Tip #2: To avoid pain, stretch the triceps, forearms, and shoulders between sets. Gentle stretches, such as overhead triceps and wrist flexor stretches, improve flexibility and prevent tightness in the elbow tendons. You can find examples of these stretches in this article by Hinge Health. However keep in mind that stretching alone will not resolve the underlying causes of elbow pain.
  • Tip #3: Use elbow self-myofascial release (SMR) exercises on your arms the night before push-up workouts. This method relaxes tight muscles, reduces tendon stress, and prevents injury.

For a step-by-step video course to eliminate elbow pain, check out the TitaniumPhysique program.   Yes, I’m ready to eliminate pain .


Next Steps and Helpful Resources

  1. Treatment Exercises: If you're looking for exercises to fix "elbow pain from push-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.
  2. Comprehensive Guide with FAQ: For a complete guide on elbow pain related to exercising, learn more in 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.
  3. Tendon Relief Program: For an easy-to-follow video course to fix "elbow pain from push-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 fitness enthusiasts, the program boasts a 98% satisfaction rate.

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

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