I was pretty lucky during my college baseball career that I never suffered any of the “traditional” baseball injuries (rotator cuff, labrum, UCL, etc.). Minus a strained oblique during the first week of my senior season (an injury that is becoming more and more prevalent in extension-rotation based sports), I stayed pretty darn healthy despite a few years of less-than-adequate strength training.
Ironically, nagging injuries didn’t really pop up until lifting became my sport. Anyone with at least a few years in the iron game will tell you that it’s a battle. No matter how careful you are, heavy barbell work will beat you up and – if you’re not religious about warmups and prehab work – knock you on your ass.
Nagging injuries suck. I don’t know about you, but I love to train. If I can’t train, I’m not happy. So it’s in the best interest of my happiness to stay healthy. Most recently, my right elbow had been bothering me, especially during squats and curls. It got to the point where I couldn’t squat without my right elbow getting stuck in flexion for 30 seconds after each set. And I couldn’t do any curl variation without my elbows screaming, which wasn’t good for the state of my guns.
Keep in mind, I’m not a physical therapist, athletic trainer or orthopedist. Injuries are NOT my specialty and I DON’T know how to treat them, but I do know a bit about how to avoid them and train around them.
That said, here are 10 tips for avoiding or minimizing elbow discomfort during strength training. Nothing revolutionary here, but rather a compiled list of tactics I’ve learned from other coaches over the years.
1. Use Straps on Pulling Exercises
Here’s a controversial one right off the bat. Tough guys will tell you only wimpy spandex-wearing body builders use straps. Athletes and powerlifters are supposed to be hardcore and straps are NOT hardcore.
I got sucked into this mindset for a long time, but Jason Ferruggia recently changed my mind with a very convincing argument. The part about elbow pain is what resonated with me. Frustrated with the constant aching in my right elbow, I decided to give straps a chance. For the past six weeks, I’ve used them on almost all rowing exercises and a few lower body movements (dumbbell split squats, romanian deadlifts, etc.). Like magic, a majority of my elbow pain subsided.
You see, when we have to hold a heavy barbell, we have to squeeze the hell out of it lest gravity snatch it from our grip. And squeezing something really tight has a crazy effect called radiant tension. Crushing something in a clenched fist causes tension not only at the hand, but also at the wrist, elbow and shoulder. The tension radiates throughout the rest of the body. This is really useful when doing something like bench pressing, where strangling the bar keeps our upper back tight and helps the rotator cuff muscles fire and stabilize the shoulder. But when a bar is hanging from our hands, it can wreak havoc on other structures of the upper body.
Using straps takes that tension away from the grip and puts it where it belongs: on the upper back. Since using straps for heavy upper back work, my elbow pain has faded AND I’ve rekindled my relationship with the barbell row. I’ve already seen an increase in size and strength, and everybody knows a big, strong upper back is arguably the most useful physical trait of all time.
2. Do Direct Forearm Work
I can already hear people screaming at me. But if you use straps your forearms will shrivel up into pipe cleaners! I’m one step ahead of you.
Hitting some direct forearm work to put on size and counteract using straps is secondary. Forearm exercises are actually extremely beneficial for reducing elbow discomfort, as I’ve recently discovered. Many limb issues, such as biceps tendonitis and medial epicondylitis, can be traced back to weak wrist flexors, extensors, supinators and pronators. Charles Poliquin suggests hitting some high rep work to keep balance in the forearms which often don’t get worked dynamically with basic barbell lifts.
Steve Nickel of Xceleration Sports Training showed me a few quick exercises that I’ve now incorporated into a prehab series at the end of upper body days. Two or three sets of 10-12 reps of each movement usually does the trick. Check out the video below.
As you can see, I’m REALLY tight in my wrist extensors and supinators. I can hardly supinate my wrist (turn my palm up toward the ceiling) without compensating with movement at the shoulder. But the more forearm work I do, the more my elbows seem to “let up.”
3. Use Fat Bars or FatGripz for Presses and Curls
We just talked about radiant tension. That’s the key here. I want you to try something. Grab a pencil and hold it out at arm’s length with your palm facing down. Now squeeze as hard as you can. Did you feel the tension in your forearm and elbows? Now try the same thing with something wider, like a water bottle or coffee mug (make sure there’s nothing in the mug. Coffee stains don’t come out.) Squeeze with all your might. I’ll bet most of the tension that you felt in your elbow moved to your hand and forearm. Pretty cool, huh?
Opening up the hand takes a lot of tension off the elbows, wrists and shoulders. A ton of my athletes who complain of elbow or shoulder pain during regular dips or chinups can do thick bar dips and chins completely pain free.
The reason we do things like dumbbell presses and EZ bar curls with thick bars is because they aren’t grip intensive like a row or shrug. Some may argue that using a fat bar for a pressing or curling movement takes the focus off the working muscles (because the forearms are a smaller muscle group and will fatigue first), but if that’s the price you pay to keep the elbows pain-free, so be it.
Some coaches swear that thick grips result in greater motor unit activation, but the science is inconclusive. One older study showed that a regular Olympic bar enabled the subjects to lift more weight (and in theory recruit more muscle fibers) than a thin bar. The problem? They didn’t measure EMG activity. A more recent study found a standard bar elicited greater EMG activity in the pecs during the bench press than a thick bar. The problem? We’re not terribly concerned about activating the pecs when we bench with a thick bar, but rather overall neural drive to build pressing strength. So the scientific jury is out, but we’ll keep using thick bars and wait for the research to catch up.
At XST, we’re lucky enough to have several fat barbells and an entire set of thick-handled dumbbells. If you’re not that lucky, you can pick up a pair of Fat Gripz from EliteFTS and turn any bar into a fat bar in seconds.
4. Tuck Your Elbows on Pressing Exercises
This is kind of a no-brainer, but the more you flare your elbows during any pressing exercise (bench press, pushups, dips, etc.), the greater the varus stress. It’s like walking around bow-legged but for the upper body.
Anyone who knows anything about bench pressing knows that good benchers tuck their elbows. Rather than flaring the elbows and bringing the bar to the neck or upper chest, they keep the elbows close to the sides and bring the bar down to somewhere between the nipples and the upper abdomen. This does a couple things – it decreases the range of motion the bar travels and decreases the amount of internal rotation at the shoulder, allowing you to press more weight more safely. Sounds like a win-win.
But there’s more! Let’s talk about the elbows. Tucking the elbows keeps the bar aligned over the hand, wrist, forearm, elbows and triceps. This “stacks” the weight over a hefty totem pole of muscle and bone, allowing the structures to work together in moving the weight. When the elbows flare, stress is unevenly distributed and can lead to problems at any of the aforementioned parts. Dave Tate talks about this at about the 6:30 mark of his “Six-Week Bench Press Cure” video, which I highly suggest you watch start to finish.
Grip width can affect the amount of tuck you need as well. The closer the grip, the more you have to focus on keeping the elbows tight. Heavy close grip benching is one of the best ways to build massive triceps, but they can be hell on the elbows and wrists if you’re like most people and do them looking like Diamond Dallas Page flashing the diamond cutter. Use a grip no narrower than index fingers on the smooth part of the bar to minimize wrist strain.
The elbow tuck goes for bodyweight exercises like pushups and dips. But ESPECIALLY dips, which I’ll discuss in the next point. Jim Smith of Diesel Strength and Conditioning recommends squeezing your arms to your sides like you’re trying to hold a piece of paper under each armpit. This creates the same effect as tucking your elbows during the bench press.
5. Use Gymnast Rings for Dips and Pullups
This builds upon point number four. Parallel bar dips can really aggravate elbow and shoulder issues. Even pullups, especially the weighted variety, can shred your elbows if you do them heavy and often. The problem with the conventional versions of these exercises is that you’re locked into a fixed hand position. A neutral grip is usually OK for pullups, but fully pronated or supinated chins can be murder on the elbows.
One solution that I took directly from Jason Ferruggia’s Renegade Seminar was to do dips and pullups with gymnast rings. This allows you to naturally rotate the hands and wrists during each rep and takes a ton of stress off the joints. It also throws in a HUGE stability component that turns everything up a couple notches, forcing you to stay super tight and activate the scapular stabilizers, anterior core and glutes.
If the rings make dips and chins too difficult at first, you can start out with suspended pushups or inverted rows with your feet on the floor. Progress to feet elevated variations, and then graduate to full-blown ring dips and chins. It’s well worth the patience. I bought a pair of rings from Rogue Fitness immediately after using them at Renegade and was quickly doing dips and chins 100 percent pain free. Plus they’re super versatile and, if you’re good, you can do some pretty sweet party tricks on them.
Elbow issues can be extremely persistent and drastically reduce the quality of your training. Try any and all of these tricks to ease elbow issues while still training hard and smart. Stay tuned for five more tips in another post, coming soon!