Tennis Elbow (Root Cause & Fastest Way To Fix)

You've come to the right place if you experience elbow discomfort and pain from exercising, such as tennis elbow (pain on the outside part of the elbow). For years, I struggled with outer elbow pain during my workouts. I fixed my tennis elbow. I will show you how to do the same. Let's begin!

Pain in the outer elbow while lifting weights can have several causes. These include restricted triceps and forearm muscles, inadequate warm-up of these muscle groups before exercise, excessive resistance, incorrect form or lifting technique, and sudden increases in training volume. All these factors, alone or in combination, can lead to pain in the outside part of your elbow. However, the primary cause is restricted (shortened, tight, and tense) triceps and forearm muscles.

To alleviate and prevent outer elbow pain, prioritize proper form, gradually increase weights, allow for adequate rest periods, and, most importantly, maintain pliable triceps and forearm muscles through self-myofascial release (SMR) exercises. These exercises can help relieve muscle restrictions and minimize the risk of injury, overuse, and inflammation.

Tennis elbow, also known as lateral epicondylitis, is a type of elbow tendonitis where pain occurs outside the elbow. It can develop gradually over time (chronic) or occur suddenly (acute) during weight lifting. What causes it?

Short answer: The tendon on the outer part of the elbow (extensor tendon) becomes overstressed and inflamed. This inflammation causes pain (sharp or dull) on the outer part of the elbow.

Long answer: The triceps and forearm muscles can become restricted when you lift weights over an extended period. This restriction occurs as the muscles shorten, tighten, and tense up due to muscular contraction, overuse, and a lack of myofascial release. These tight muscles can then overstretch, strain, and inflame the extensor tendon and the surrounding tissues around the elbow. As a result, you may experience pain on the outside part of the elbow during exercises such as bench presses, push-ups, pull-ups, overhead presses, and tricep pushdowns.

Important: Apart from musculoskeletal injuries (muscle and tendon-related pain), other medical conditions can contribute to outer elbow pain during weight lifting. These include nerve entrapment and compression, bone fractures and dislocations, and arthritis, which causes joint inflammation, pain, and stiffness. If your condition is medically related, it's essential to consult your healthcare provider to ensure no structural issues with your elbow.

Image source: Google Images

Yes, you can develop tennis elbow from lifting weights. However, it's essential to understand that lifting weight is not the underlying cause of this condition. Instead, lifting can trigger acute tennis elbow or worsen chronic pain. The root causes of tennis elbow from lifting include chronic inflammation, magnesium deficiency, and muscle restriction.

For a comprehensive article on the root causes of elbow pain from weight lifting, which covers different types of elbow tendonitis (including golfer's elbow and triceps tendonitis), elbow bursitis, chronic versus acute elbow pain, and the fastest way to cure elbow pain, read this complete how-to guide.

The bench press and push-ups do not cause tennis elbow when performed correctly. However, they can trigger or worsen the condition. "Push" exercises such as bench presses and push-ups engage the triceps and forearm muscles, which can become tight and shortened over time, reducing flexibility. This tightness and lack of elasticity can overload the muscles and place excessive tension on the tendons during bench presses and push-ups. When the forearm and triceps muscles are overloaded, it can stress and inflame the elbow/triceps tendons, leading to acute elbow pain (sharp pain) or exacerbating chronic elbow pain (dull pain).

Nurudeen performs a barbell bench press during a chest workout at the gym (2021). The bench press is highly effective for building upper body strength and targeting the chest muscles. It primarily engages the pectoral, shoulder, and triceps muscles. It's important to note that "push" exercises like the bench press can trigger or worsen conditions such as tennis elbow, golfer's elbow (pain at the inner elbow), and triceps tendonitis (pain at the posterior elbow).

The muscle conditions that lead to outer elbow pain develop gradually and cumulatively over time. The triceps and forearm muscles can become restricted through repetitive use, causing them to shorten and lose elasticity. This process of muscle restriction can take months or even years to develop.

When these muscles have become restricted for months, gripping objects tightly, engaging in workouts, and lifting weights can suddenly trigger elbow pain without apparent cause. Unfortunately, most individuals are often unaware of the restricted state of their forearm or triceps muscles until they experience this sudden onset of elbow pain during these activities.

Here are 12 signs and symptoms of tennis elbow from weight lifting:

1. A burning sensation or pain on the outer part of the elbow after lifting (e.g., overhead press, push-ups, bench press).
2. Tenderness, swelling, and soreness in the elbow after lifting.
3. Dull pain and aching in the elbow when lifting weights.
4. Sharp, shooting, sudden, and severe pain on the outside part of the elbow while lifting.
5. Pain and difficulty bending and straightening the arm after working out.
6. Weak grip strength when lifting dumbbells or barbells.
7. Pain or discomfort when gripping objects, such as weights or exercise equipment.
8. Difficulty performing activities that require wrist extension, such as opening jars or turning doorknobs.
9. Pain that radiates from the outer elbow down the forearm.
10. Increased pain when applying pressure to the affected area.
11. Stiffness and limited range of motion in the elbow joint.
12. Pain that worsens with repetitive movements or gripping activities.

Nurudeen performs push-ups during a workout session at the gym (2021). Push-ups are a versatile and practical exercise for building upper body strength. They primarily engage the pectoral, shoulder, and triceps muscles. Push-ups can trigger or exacerbate tennis elbow and triceps tendonitis (posterior elbow pain).

Yes, tennis elbow is common among athletes who lift weights. According to the National Health Service, tennis elbow is the most prevalent cause of persistent elbow pain, accounting for two-thirds of cases.

Various exercises commonly performed by athletes and weight lifters, including bench press, shoulder press, push-up, pull-up, tricep pushdown, tricep dips, machine chest press, wide-grip lat pulldown, and barbell upright row, can contribute to the development of tennis elbow. In addition, improper technique during movements like reverse curls can strain the tendon, increasing the risk of tennis elbow.

It depends on the severity of the pain. If the pain is mild, you can use conventional pain relief remedies such as sports or kinesiology tape, elbow sleeves, braces, or straps to reduce discomfort during exercise. However, suppose the pain is chronic or severe or causes sharp or shooting sensations during physical activity. In that case, fix the underlying cause of the injury before resuming weight lifting or intense training.

Nurudeen performs wide-grip pull-ups during a back workout at the gym (2022). Wide-grip pull-ups are a variation of the pull-up exercise that primarily targets the upper lats muscle while also engaging the deltoids, biceps, and triceps. Wide-grip pull-ups can overload the forearm extensor muscles and trigger or worsen tennis elbow and triceps tendonitis (pain at the back of the elbow).

The acute symptoms of tennis elbow can go away unaided with rest. However, the underlying factors contributing to this condition, such as restricted and tense forearm muscles, do not resolve unassisted. In fact, for many athletes and weight lifters, it often worsens over time.

Here's why: the root causes of weight-lifting tennis elbow include chronic inflammation, magnesium deficiency, and muscle restriction.

Firstly, once a muscle becomes restricted and dysfunctional, it tends to remain in that state or worsen unless specifically addressed. Secondly, muscle dysfunction is often associated with magnesium deficiency. "The Magnesium Miracle," a scientific reference on the health effects of magnesium, highlights that around 40% of magnesium in the body is in the muscles. A significant portion of the population is magnesium deficient. Heavy exercise, physical activity, and various factors like caffeine, stimulants, diuretics, stress, and dehydration can deplete magnesium levels in athletes. These factors are one reason why restricted muscles persist and worsen.

Thirdly, chronically restricted muscles eventually become dysfunctional and stop working correctly. This condition leads to repeated injury and stress on the extensor elbow tendon, resulting in chronic tendonitis (i.e., chronic tennis elbow). When the injury occurs, the extensor elbow tendon experiences micro-tear damage, known as tendonitis. As weight training continues, the tendon condition deteriorates and degenerates, known as tendinosis. The National Health Service reports that tennis elbow is the most common cause of persistent elbow pain, accounting for two-thirds of cases.

Therefore, it is crucial for athletes recovering from tennis elbow to replenish magnesium actively and maintain pliable triceps and forearm muscles through self-myofascial release (SMR) exercises. While resting the elbow (taking a break from physical training) may temporarily relieve symptoms, it will not address the underlying cause of the pain.

Nurudeen performs tricep pushdown during a workout session at the gym (2023). The tricep pushdown is a common exercise that targets the triceps muscles, effectively strengthening and toning the back of the arms. While it benefits triceps development, similar to other "push" exercises, it can trigger or worsen tennis elbow and tricep tendonitis.

By combining post-workout treatments such as RICE therapy (to relieve burning pain), magnesium supplementation (to reduce inflammation), and self-myofascial release (to alleviate sharp, shooting, and dull aches), it is possible to treat and heal tennis elbow within 7-10 days. It will involve performing self-myofascial release (SMR) on the triceps and forearm muscles at least 2-3 times daily.

While resting the elbow (taking a break from physical training) may provide temporary relief, it will not address the underlying cause of the pain - restricted triceps and forearm muscles that place excessive strain on the elbow tendons.

Avoid "pressing" or "push" exercises that place excessive strain on the forearm extensor muscles and exercises that require an overhand bar grip. Here's a list of 10 exercises to avoid if you have tennis elbow, along with alternative exercises you can perform (see #12 below):

10 Exercises to Avoid

1. Bench Press
   
2. Shoulder and Overhead Press
3. Push-Ups
4. Pull-Ups
5. Tricep Dips
6. Tricep Pressdown
7. Reverse and Hammer Curls
8. Heavy Upright Rows
9. Lat Pulldowns (overhand grip)
10. Overhead Tricep Extensions

Check out this 2023 video of Nurudeen performing the wide-grip cable lat pulldown (with palms facing in) during a back workout at the gym. The wide-grip cable lat pulldown is a targeted exercise focusing on the latissimus dorsi muscles, also known as the lats. These muscles are essential for developing a wide and powerful back. Wide-grip lat pulldown, specifically with an overhand grip, can strain the forearm extensor muscles excessively and trigger or worsen tennis elbow.

If you're weight training while still recovering from tennis elbow, there are a few essential things to remember.

1. Replace "push" and "press" workouts with "pull" and "fly" exercises.
2. Opt for resistance band or cable machine variations of exercises instead of using barbells, dumbbells, and stationary machines.
3. Consider performing partial reps, where you don't fully contract or extend the arm during the exercise. This modification can help reduce tension in the forearm and alleviate pain in the elbow.
4. Use less resistance and focus on performing more repetitions.

Here's a list of 26 upper body exercises you can try if you have tennis elbow. These exercises put less strain on the forearm extensors while effectively engaging the upper body muscles.

Back Exercises

• Lat Pulldown (using Resistance Band)
• Wide-Grip Lat Pulldown (with Palms Facing In)
• Rows (using Resistance Band)
• Machine Assisted Pull-Up (using Hammer Grip)
• Full Cobra (Supermans)
• Back Hyperextensions
• Machine-Assisted Dead Hang Stretch
• Back Fly (using Resistance Band)
• Dumbbell Reverse Fly

Shoulder and Arm Exercises

• Machine Deltoid Raise
• Cable Upright Row
• Dumbbell Shrugs (lower weight, higher reps)
• Lateral Raises (with a Resistance Band)
• Front Raises (with a Resistance Band)
• Close Grip Dumbbell Press
• Machine Tricep Extension
• Machine-Assisted Tricep Dips
• Cable Kneeling Tricep Extension
• Bicep Curl

Chest Exercises:

• Cable Chest Fly
• Cable Chest Crossover
• Chest Fly (using Resistance Band)
• Wall Push-Up or Kneeling Push-Ups (with Wide-Arm)
• Dumbbell Pullover (with Straight Arm)
• Machine Inner Chest Press (with Palms Facing In)
• Machine Fly (using Pec Deck Machine)

Nurudeen performs the seated barbell shoulder press during a shoulder workout at the gym (2019). The seated shoulder press is a variation of the shoulder press. It is known for its effectiveness in building upper body and shoulder strength. This exercise primarily targets the deltoids, upper pectoral, and triceps muscles. "Push" movements like the seated shoulder press can trigger or worsen tennis elbow, golfer's elbow (pain on the inside part of the elbow), and triceps tendonitis (pain at the back of the elbow).

If left untreated, tennis elbow can progress and lead to degeneration of the elbow tendon. The extensor tendon in the elbow can deteriorate and weaken over time, increasing the risk of tendon tears or ruptures, known as elbow tendinosis. Additionally, untreated tennis elbow can contribute to the development of autoimmune conditions such as elbow arthritis.

Furthermore, when restricted muscles in the forearm are left untreated, they become dysfunctional and cause pain in the forearm and wrist. Therefore, seeking appropriate treatment or incorporating regular self-myofascial release (SMR) exercises is vital to prevent further complications and maintain optimal elbow and forearm function.

Yes, tennis elbow can cause permanent damage to the elbow. This condition is known as elbow tendinosis. The degeneration of tendon collagen indicates tendinosis. Over time, tendinosis can lead to a loss of strength in the tendon and may result in tendon tears or ruptures. Therefore, addressing the condition's root cause is crucial to prevent the risk of permanent elbow issues.

Nurudeen performs the barbell incline bench press at the gym (2021). Click the photo above to watch the video. The incline bench press is a variation of the traditional bench press exercise. It targets the upper pectoral and deltoid muscles. The incline bench press can aggravate tennis elbow, golfer's elbow, and triceps tendonitis in athletes.

Yes, elbow compression sleeves, such as elbow wraps, straps, and support braces, can alleviate outer elbow pain felt during exercise. However, it's essential to consider the pros and cons of using elbow sleeves to manage tennis elbow.

Pros: Elbow compression sleeves provide compression, which improves blood flow, enhances joint position awareness (proprioception), and offers support to the muscles and tendons surrounding the elbow joint. The compression promotes better circulation, stabilizes the joint, reduces swelling, alleviates pain, and can help prevent further damage during intense workouts.

Cons: There are drawbacks to relying solely on elbow compression sleeves, especially for individuals with multiple chronic elbow injuries such as tennis elbow, golfer's elbow, triceps tendonitis, or elbow bursitis. Relying only on sleeves for pain relief can mask the underlying problem, allowing athletes to continue lifting without addressing the root cause of their pain. This masking will further perpetuate the injury and potentially lead to long-term degenerative conditions in the elbow.

Athletes need to seek treatments that address the underlying causes of their elbow condition rather than relying solely on compression sleeves. This approach ensures long-term joint health and helps prevent further injury.

To stop your elbows from hurting, you have two options: utilizing short-term pain relief methods for temporary relief or addressing the underlying cause of the pain to avoid its recurrence.

Option #1: Short-term relief remedies. These include:

• Using joint supplements and vitamins.
• Taking anti-inflammatory painkillers (NSAIDs).
• Undergoing physical therapy.
• Incorporating stretching exercises.
• Applying ice and resting the affected area.
• Wearing elbow braces or straps.
• Using kinesiology tape.
• Applying topical anti-inflammatory solutions such as oils and creams.

Option #2: Fix the root cause. To cure and prevent tennis elbow from interfering with your workouts, fix the root causes. These include chronic inflammation, magnesium deficiency, and muscle restriction. The TitaniumPhysique Program can help you accomplish this.

Nurudeen performs tricep dips during a workout session at the gym (2020). Tricep dips are a common exercise that targets the triceps muscle, effectively strengthening and toning the back of the arms. While tricep dip benefits triceps development, it can overload the forearm extensor muscles and tricep tendon. Like other "push" exercises, tricep dips can trigger or worsen tennis elbow and triceps tendonitis (posterior elbow pain).

The exercises below can help you relieve acute or chronic tennis elbow (outer pain), golfer's elbow (inner pain), or triceps tendonitis (posterior pain). Note - To prevent elbow problems, use a holistic approach and treat the entire forearm and triceps muscle group.

You will need a peanut ball and a lacrosse ball, found on Amazon or your local sporting goods store.

If your elbow pain is acute (causing burning pain after working out), you can put a cold compress on the elbow when you are not using the massage ball. Suppose your elbow pain is chronic (causing dull or achy pain during/after working out). In that case, you can supplement it with magnesium to heal and decalcify the elbow tendons.

Important: Restricted muscles that cause elbow pain develop over many years, so using the correct treatment strategy is necessary, for example, including magnesium supplementation therapy to get faster results.

For a step-by-step, easy-to-follow video-based guide to cure and prevent elbow pain, try the TitaniumPhysique Program today. Take advantage of our special promotion and get it at 50% off for a limited time.

Here is how to quickly relieve elbow pain:

To fix tennis elbow (outer elbow pain), use a peanut ball to massage the forearm extensor muscles (click the link to see photo). Lean against a wall and place the peanut ball on the forearm extensor muscles. Roll out (massage) the muscles with the peanut ball for 3-5 minutes. Stretch the forearm extensor muscles. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.

Nurudeen demonstrates how to fix tennis elbow using a peanut ball to massage the forearm extensor muscles.

To fix golfer's elbow (inner elbow pain), use a peanut or lacrosse ball to massage the forearm flexor muscles (click the link to see photo). Sit on a chair next to a table. Place the ball on the table and position your forearm flexor muscles on top of it. Roll out (massage) the muscle with the ball for 3-5 minutes. Stretch the forearm flexor muscles. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.

Nurudeen demonstrates how to fix golfer's elbow using a lacrosse ball to massage the forearm flexor muscles.

To fix triceps tendonitis (posterior elbow pain), use a peanut ball to massage the triceps muscle and tendon (click the link to see photo). Sit on a chair next to a table. Place the ball on the table and position your triceps muscle on top of it. Roll out (massage) the triceps muscle and tendon with the ball for 3-5 minutes. Start near your armpit and roll to the triceps tendon above the elbow joint. Stretch the triceps muscle. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.

Nurudeen demonstrates how to fix triceps tendonitis using a peanut ball to massage the triceps muscle.

Firstly, it's important to note that part of avoiding chronic elbow pain is preventing acute pain. Reduce the resistance if you experience pain on the outside of your elbow while lifting. If the pain persists, discontinue the exercise and focus on training another body part that doesn't involve your arm and elbow. Pushing through the pain will only exacerbate acute inflammation after your workout, worsen the pain symptoms, and prolong elbow recovery.

To avoid tennis elbow from weight lifting, follow these steps:

1. Before exercising, stretch your forearms and triceps. Check out these forearm stretches at RedBoxFitness or the overhead triceps stretch.
2. Warm up your elbow tendons with resistance band pull-apart or other suitable exercises.
3. If you plan on lifting weights heavier than usual (e.g., power training), gradually increase the weight to avoid sudden strain on the forearm extensors and triceps muscle/tendon.
4. Learn and consistently utilize proper form and technique. Check out the Exercise Database & Library from the American Council on Exercise for guidance.
5. Be mindful of the number of sets you perform and gradually increase your training volume.
6. Supplement with magnesium to counteract inflammation and decalcify the elbow tendons and joints. Magnesium also relaxes muscles to reduce pain.
7. Incorporate self-myofascial release (SMR) exercises into your recovery routine. Perform SMR on the forearm extensors, forearm flexors, and triceps muscle/tendon at least twice a week to keep the forearms and triceps pliable and healthy.

If you want a step-by-step, easy-to-follow video-based guide to cure and prevent tennis elbow, try the TitaniumPhysique Program. Take advantage of our special promotion and get it at 50% off for a limited time.

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Written by: Nurudeen Tijani

Nurudeen (aka T.J.) is passionate about helping people build the body they desire through weight training. He is a physique and fitness trainer, nutritionist, yoga instructor, vegan natural bodybuilder, National Physique Committee (NPC) competitor, and founder at TitaniumPhysique. Nurudeen is a member of the International Association Study of Pain (IASP) and the American Chronic Pain Association (ACPA).

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