As an orthopedic surgeon, I can tell you that elbow pain while lifting is a very common problem.
On this site we focus on weight lifting and exercise, but you can also get elbow pain while lifting at home or work. Typing, loading freight, and using hand tools are all very common ways to develop elbow pain. And if you combine a job like this with weight lifting, you are at an even greater risk for elbow pain while lifting.
Common Causes of Elbow Pain While Lifting
The most common causes of elbow pain when lifting are different kinds of tendinitis including:
- Tennis Elbow
- Golfer’s Elbow
- Triceps Tendinitis
- Biceps Tendinitis
Tennis Elbow hurts on the outer side of the elbow, while Golfer’s Elbow hurts on the inner side. Both of these will hurt when you grip something, such as lifting a barbell. The best way to diagnose Tennis Elbow is to try and lift a small dumbbell, palm down, straight out in front of you. Does your elbow hurt while lifting that lightweight? You probably have tennis elbow. Triceps Tendinitis causes pain posteriorly, near the bony point on the back of the elbow. Does your elbow hurt when pushing or pressing? That’s probably Triceps Tendinitis. And Biceps Tendinitis causes pain deep in the front of the elbow. The biceps will hurt when you flex the elbow or do a curl. And don’t be fooled by pain that shoots down into the forearm: These problems can all radiate pain down that way.
Wear And Tear
Other common causes of elbow pain when lifting include damage to the interior of the joint like:
- Olecranon Bursitis
- Osteochondritis Dessicans (OCD)
- Stress Fractures
Elbow arthritis is much less common than hip or knee arthritis in general. But it is much more common in my patients that do powerlifting; it is usually marked by a loss of motion in the elbow. Olecranon bursitis is easy to identify. There is a large, easily visible swelling on the back of the elbow. Check out the picture below to see how notable it can be. Osteochondritis Dessicans (OCD) and stress fractures are typically something that affects throwing athletes, especially young baseball and softball pitchers. So if your kid starts getting elbow pain while weight training in the off-season, this could be a concern. (PS- it is a good idea to have your kids hit the weight room between seasons. Check out our article on How Weight Training Prevents Sports Injuries in Kids.)
Repetitive flexion of the elbow when lifting can lead to peripheral nerve injuries such as:
- Pronator Syndrome
- Cubital Tunnel Syndrome
Pronator Syndrome is caused by compression of the median nerve in the forearm and it causes pain in the forearm and front of the elbow. It can be caused by weightlifting exercises such as pull-ups or rowing. While the condition itself is rare, I do see it more commonly in avid weight lifters. Cubital Tunnel Syndrome is caused by compression of the ulnar nerve behind the elbow. If you’ve ever hit your “funny bone” you actually struck your ulnar nerve. This causes elbow pain as well as numbness in the hand. You may notice the symptoms actually get worse when you are sleeping rather than just during exercise.
What Is Tendinitis?
Tendinitis is by far the most common cause of elbow pain when lifting. Your tendons are made up of many microscopic protein fibers all bound together, kind of like a rope. Tendinitis is caused by repetitive stress that causes breaks in those microscopic tendon proteins.
Of course, those little injuries can heal. But your body can only do so much healing in a day. If weightlifting and other activities cause more damage than you can heal, the small tears become bigger tears. And eventually, the tissue of the tendon can start to break down and cause pain.
If you would like to know more about this problem, you can check out our article “What is Tendinitis?”
Treating Elbow Pain From Working Out
Most of the time, simple remedies stop elbow pain while lifting. These treatments work best early though. It is vital to address your elbow pain before it becomes a problem that might need surgery. My top recommendations for early treatment of elbow pain include:
- Reduce Painful Activities
- Brace The Elbow or Wrist
- Apply Moist Heat
- Stretch The Arm
- Shoulder and Forearm Strengthening
- Relieve Grip Tension
And if all else fails, see an orthopedic surgeon!
Reduce Painful Activities
The first step toward recovery is to give your body a chance to heal. Decrease the number of reps you do at the gym and find ways to decrease gripping and twisting motions with your hands at work. Stop performing lifts that hurt. You can still do exercises that don’t cause pain. Just lay off of anything that produces elbow irritation, like barbell exercises and pull-ups. And don’t use the bench for curls, it’s a common cause of olecranon bursitis.
Brace The Elbow or Wrist
A tennis elbow brace can really help relieve pain from an overworked tendon. It helps to redirect the forces toward the healthy portions of the tendon. Also known as a counterforce brace, this strap is designed to reduce the stress on your elbow during daily activities. If you want to try it, this inexpensive but effective tennis elbow brace is available on Amazon. Here’s a quick video on how to use it.
In severe cases, we sometimes prescribe a wrist brace also. This helps to reduce stress on the forearm muscles that are involved in Tennis Elbow and Golfer’s elbow. We generally recommend something like this cockup wrist splint.
Apply Moist Heat
Most of the time, elbow pain while lifting is caused by some kind of tendinitis. And tendinitis usually responds better to heat than ice. The ice may cause relief in the short term, but heat seems to be better at helping these tissues heal. The heat relaxes the muscles and tendons, increases the blood flow, and helps the muscles recover from exercise. That’s why it works better longer than icing does. If you’d like to know more about the debate on heat vs ice, read our previous post “Ice or Heat: Strategies for Treating Delayed Onset Muscle Soreness”
Stretch The Arm
Stretching is a great way to relieve pain in just about any joint and that applies to the elbow too. Stretch the muscles that cause Golfer’s Elbow and Tennis Elbow by working at the wrist. Those tendons start at the elbow but go all the way to the hand. Stretching in both directions at the wrist can relieve tension and decrease pain. But don’t stop there! Pain at the elbow can be due to loss of mobility in the shoulders, so make sure that you keep them limber too.
Shoulder and Forearm Strengthening
I know we spent most of this post talking about decreasing the load on your elbow. But there are some very specific exercises that can help heal tendons instead of damaging them. These are called Eccentric Exercises. Eccentric strength training is where you slowly resist a force working against you. You can purchase some inexpensive eccentric elbow strengthening bands easily, on Amazon. Just click this link! And don’t forget the shoulder rehab too! Studies have shown that strengthening the rotator cuff can help reduce elbow pain too.
Relieve Grip Tension
If you notice that you have elbow pain with barbell exercises, try switching to dumbbells. A dumbbell doesn’t lock your elbow into an awkward position like a barbell might. That reduces strain on the elbow and decreases pain. A larger point of grip can relieve the strain on your elbows too. So look for equipment with a fat handle or bar. That can help keep you working out with less pain. And consider using Grip Wraps like these for deadlifts and other heavy lifts. They can transfer strain away from the painful elbow areas.
When to see a doctor about your elbow pain
If you have tried these changes without seeing any relief over the course of several weeks, it is probably time to see a professional. That way you can get a proper diagnosis and be sure of exactly what you should do to fix it. Some problems, like tendinitis, may take up to 6 months to get completely better.
Your doctor may offer injections of steroid, anti-inflammatories, or Platelet Rich Plasma to help relieve the pain and speed healing. Or they may refer you to physical therapy for treatments like dry needling, soft tissue mobilization (Graston or IASTM), cold laser, ultrasound or other methods to help heal the elbow. And in severe cases, surgery may be needed to get relief from pain.
If you live in Maryland, Virginia, or West Virginia and have persistent problems with your elbow pain while lifting please call my office for an evaluation and treatment!
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Dr. James Larson is an orthopedic surgeon, trained and specializing in sports medicine and arthroscopic surgery. He started the LSO website to educate the functional fitness community of coaches and athletes. His mission is to help people understand their bodies and the sport of fitness so that they can stay healthy and prevent injuries.