Elbow Pain While Lifting is a Problem!
If you experience elbow pain while lifting, there can be many reasons. Muscle strains, arthritis, or bursitis are possible sources of pain. But the most common cause is “tennis elbow.” This is also known as lateral epicondylitis, a kind of long-term strain of the tendons. Tennis elbow is a painful condition of the elbow caused by overuse. It is frequently a problem for people involved in popular high-intensity exercise programs. If your gym programs a lot of cleans, pull-ups, and toes-to-bar then you may be at higher risk of lateral epicondylitis.
While most exercise routines involve some discomfort and sore muscles, be aware of chronic issues. If your elbow, or anything else, is hurting while you exercise don’t ignore it. Pain the next day is an expected consequence of exercise. But pain during a workout should be addressed right away. Even if you can exercise with painful joints, it’s best not to ignore them for long.
What is Tennis Elbow?
Lateral Epicondylitis is the result of microscopic damage to the tendons on the outer side of your elbow. The forearm muscles that move your wrist and hand become damaged by overuse. Frequent lifting in the gym, combined with a sedentary job using a keyboard or register, is just the kind of overuse I mean. These activities lead to tiny tears in the collagen fibers of your tendon. When this damage builds up faster than you can heal it, you wind up with problems. Just like a rope slowly fraying, the damaged tendon is weak and won’t work well.
Anatomy of Elbow Pain
Many of the muscles that control your wrist and hand originate at the inner and outer side of your elbow. From there, they run down to your wrist and hand. You can feel a bony bump on each side of your elbow: those are called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle. That is why tennis elbow is also called to as lateral epicondylitis. That’s hard to pronounce so we just call it tennis elbow, after a common source of the problem.
Cause of Tennis Elbow
Tennis elbow is often due to a chronic injury of the extensor carpi radialis brevis (ECRB) muscle. This muscle attaches to the lateral epicondyle on the side of your elbow. It helps stabilize the wrist and is active during gripping. It is especially problematic when you are pulling something heavy. When doing HIIT WODs, people often end up hanging from a rig doing pull-ups or toes-to-bar. You may be doing EMOM of cleans. Or you may be gripping a kettlebell for twenty minutes at a time! We know those exercises cause some serious skin tears on your hands. Imagine what they could be doing to your tendons!
Symptoms of Tennis Elbow
The symptoms of tennis elbow develop slowly. You may notice a minor annoying pain in the elbow when gripping or lifting. Try holding a 5-10 pound dumbbell directly out in front of you with your arm straight and palm down. Does that cause pain? If so, you may have tennis elbow. In most cases, the pain begins as mild and slowly worsens. There is usually no specific injury associated with the start of symptoms.
Treating Elbow Pain From Working Out
Approximately 80% to 95% of people can stop tennis elbow problems with simple solutions. Adjusting your fitness activities and mobilizing your upper body can help prevent major problems. And if the issue becomes chronic, many treatments by a therapist or physician can be quite helpful.
Elbow Pain Treatment #1: Stretching
Ergonomics play a role in the development of tennis elbow because your equipment may not match your range of motion. That puts a strain on your extensor tendons. In this case, it is not just flexion and extension of the wrist but rotation as well. If you can’t turn your palm fully in both directions, gripping a barbell will cause elbow strain.
Stretching both sides of your elbow and wrist is essential. We frequently find that pain on one side of the joint arises when the other side is too stiff. Working against the tight antagonist adds causes more damage than usual. Actively stretching and loosening the opposing muscles can keep strain off the painful one.
Further up the chain, shoulder stiffness can cause elbow problems. If your shoulder range is limited, you’ll end up straining at the elbows to make up that range. I addition to the above forearm stretches, be sure to work on your shoulder mobility as well.
Elbow Pain Treatment #2: Rest
The first step toward recovery is to give your arm proper rest. This means that you will have to stop performing lifts that cause pain. You can still workout and do exercises that don’t cause pain. Just lay off of anything that produces elbow irritation.
Pushups and other presses are probably going to feel OK, and are usually safe to do. The exercises most likely to cause this problem are ones where you are pulling, and your hand is locked into an absolute position. These include rowing, pull-ups, cleans, and deadlifts.
Elbow Pain Treatment #3: Change Your Grip
The ergonomics of your daily activities can predispose you to lateral epicondylitis. Similarly, poor ergonomics can affect your risk of tennis elbow from your workout as well. Even if your workouts are constantly varied, there are still a lot of similar exercises that get programmed into most HIIT routines.
If you notice that you have elbow pain with barbell exercises, try switching to dumbbells. A dumbbell allows you to position the wrist in its natural range. This will produce less stress on your elbow and decrease pain.
One change that reduced the rates of lateral epicondylitis in tennis players was an increase in the thickness of the grip. So if you are a woman, consider using the 45lb barbell during your workouts. The increased bar diameter may reduce elbow strain.
Elbow Pain Treatment #4: Braces
A very common treatment for this problem is a tennis elbow brace. Also known as a counterforce brace, this strap is designed to reduce the stress on your elbow during daily activities. It may slip and slide too much to wear while working out. But using it during the day can reduce pain and help with healing. If you want to try it, this inexpensive but effective tennis elbow brace is available on Amazon.
Elbow Pain Treatment #5: Physical Therapy
Contrary to popular belief, physical therapy is not simply exercising. There are many different treatments that physical therapists can employ to help you heal. Certain types of exercise, especially eccentrics, can help tendons to heal. But dry needling, instrument-assisted soft tissue mobilization (Graston or IASTM), manual therapy, ultrasound and other methods will heal tennis elbow also. Sometimes rest alone isn’t enough to achieve tendon healing. Sometimes you need these treatments to stimulate the body to repair this chronic damage.
Elbow Pain Treatment #6: Eccentric Strengthening
One very simple method for preventing and treating elbow pain when lifting weights is to strengthen the tendons. High volume repetitive gripping of a narrow bar during workouts can cause damage to the tendons. But eccentric strengthening of those muscles can help build up the same tendons and fix your elbow pain. Eccentric strength training where you slowly resist a force working against you. An example of eccentric strengthening would be slowly lowering your body toward the ground from the top of a pull-up. The following video can show you how to use an inexpensive exercise device to perform eccentric elbow strengthening at home. You can purchase these inexpensive eccentric elbow strengthening bands easily, on Amazon. Just click this link!
Elbow Pain Treatment #6: See a Physician
Injections of the tendon can help relieve pain from tennis elbow. There is some evidence that the simple act of injecting fluid into the damaged area can help heal a tendon. It may not matter whether steroids, saline, or other medications are injected. Many medications may help the elbow feel better, but it’s possible that the long-term benefits arise from the shot alone.
The newest treatments being investigated include injecting a patient’s own plasma (PRP) or stem cells into the damaged elbow tendon. These treatments have the benefit of injecting growth factors or vigorous cells ready to heal. Hope is high that these injections may fix tennis elbow that won’t get better any other way.
If your symptoms do not respond after 6 or more months of other treatments, you may have to consider surgery. Tennis elbow surgery elbow involves removing damaged tendon tissue and repairing healthy tendon back to the bone. There are usually limitations to moving and lifting your arm for weeks afterward to allow for proper healing, but success is high.
Coaching Clients with Elbow Pain
As a coach or trainer be sure your athletes are using proper form when lifting. Today’s HIIT gyms often program many barbells and gymnastics into their WODs. These can lead to tennis elbow if you don’t have good form.
Teach your clients how to stretch the upper body properly and make sure they warm up well. An exaggerated kipping motion can lead to excessive stress on the elbow. Keep their swing under control to help save the shoulder and elbow.
Most people learning to do cleans will often generate force with their arms rather than the legs and hips. This pattern will cause elbow pain over time. Kettlebell swings can also cause tennis elbow if clients aren’t using the hip hinge to generate momentum.
Elbow Pain while lifting is a sign of overuse. It may be from too much time in the gym. But more often the cause is poor form, bad ergonomics, or deficient joint mobility. Fortunately, these are all problems that you can improve on.
I hope this article has helped you gain insight into the roots of elbow pain during your workouts. Hopefully, you found something that you can change instead of giving up on training entirely!
As a reminder, don’t let an internet search be the only thing you do if your elbow pain is significant or worsening. There are many other causes of elbow pain, and this is by no means intended to fully diagnose your problem. If you try these remedies for a short while without results, see a professional.
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.