Q: I’m having a continuing problem with elbow pain. I’m wondering if you’ve experienced this and, if so, what you did to alleviate it. To be more specific, the pain is on the outside of my elbow and just above the joint. You and I are close in age. I know you’ve been lifting for decades, so I’m hoping you have a solution. I don’t want to stop lifting!
A: Yes, sir, I have experienced that sort of elbow pain! In fact, I don’t know of anyone who has been a serious lifter for decades who hasn’t—especially guys our age.
I’m guessing that it hurts when you do pullups, bench presses and curls (especially reverse curls). And, if you’re doing overhead dumbbell presses or incline dumbbell presses, it hurts like hell when you’re swinging the weights into the pressing position and even worse when you’re putting them back.
While I’m discussing your issue, I’m going to add another common elbow problem that several people at the gym have asked me about recently—pain on the point of the elbow where the triceps tendon inserts.
First, if your elbow hurts constantly, if there is swelling, or if the pain is limiting everyday activities, see a doctor! If your elbow problem isn’t severe enough to warrant a doctor visit, there are a few things that are universally recommended regardless of where the elbow is hurting.
1) Rest. Okay, most of us aren’t going to do this, so I’ll have more recommendations below.
2) Ice. Apply a cold pack to the elbow for 15 to 20 minutes three times per day. Applying cold immediately after activity is crucial to limiting inflammation and swelling.
3) Compression. Apply a compression wrap or sleeve during and after activity to limit swelling.
4) Elevation. If you can elevate the injured elbow above the level of your heart, that will help facilitate blood and lymphatic flow away from the elbow and will help reduce swelling considerably.
The more that you can reduce swelling, the faster you will heal. Ultrasound therapy and active release therapy, or ART, can be very helpful in improving blood flow to the injured area as well as reducing scar tissue. You’ll need to see a health professional to receive those beneficial treatments.
Right now you’re probably thinking, “Dave, I learned about R.I.C.E in health class. As someone who, like you, doesn’t want to stop training, what can I do to keep training and help heal my injury?”
The first thing to do is make sure that you sufficiently warm up the area that’s causing you pain. If it’s the lateral aspect of the elbow, a couple of super-light sets of 15 to 20 reps of hammer curls should do the trick. Remember, the idea here is just to increase blood flow to the affected area. Don’t use a weight that is the least bit challenging, and don’t crank out reps to the point that you feel a burn. If your problem is the triceps tendon, use some very light dumbbells and perform a couple of sets of 15 to 20 reps on kickbacks. Keep the movement smooth, and don’t completely lock out the elbow at the top.
Once you are sufficiently warmed up, you will need to experiment with various exercises and some different angles to avoid feeling pain in your elbows. Years ago the incline dumbbell press was my staple for upper pecs. I had to abandon that exercise because getting the dumbbells into position and back down was killing my elbows. I had to opt for incline barbell presses or machine incline presses to avoid the lateral elbow pain.
The same thing applied to overhead presses. Although I prefer to use dumbbells, I had to move to barbell or machine presses until the inflammation cleared up. I was also experiencing a great deal of pain doing wide-grip pullups and wide-grip lat pulldowns. I had to change grip angles. I was able to perform close-grip pullups with palms facing inward or pulldowns with an underhand grip to keep training my lats.
The same thing applies to curls. A number of times over the years my elbows have started hurting while I was performing curls. In most cases all I had to do was change the grip angle or the grip width and I could do the curls pain free. There have been times that doing EZ-curl-bar curls hurt my elbows, and all I had to do was switch to straight-bar curls to alleviate the problem. Other times it was necessary to switch from a bar to dumbbells to get more freedom of movement.
For anyone who is experiencing triceps tendon pain at the tip of the elbow, changing grip angles can make all the difference. Recently, one of my clients was having a problem using a V-bar handle for pressdowns. All he had to do was change to a straight-bar handle and shorten his range of motion a bit, and the elbow pain disappeared.
Another fix for triceps-tendon irritation is staying out of the stretch position for a while, along with shortening the range of movement. I’ve found that when I’m having pain on the tip of my elbow, it’s always best to perform triceps exercises in which my arms are not extended away from my body. Exercises such as skull crushers and seated extensions, which put the triceps in a greater stretch position, will put a lot more tension on the tendon insertion. The best thing to do is stick with exercises in which your arms are close to your torso or a little behind; for example, pressdowns (you can use various handles and ropes), kickbacks or machine dips. Even on those exercises, limit your range of motion.
During times of elbow pain you don’t want to stretch the muscle too far or completely lock out the elbows. While it may feel kind of wimpy to lift that way, at least you’re still pumping your triceps and pumping much needed blood to the affected tendon without putting undue pressure on it.
It’s always a great idea to put an ice pack on your elbows after upper-body training. As the inflammation begins to subside, you can alternate cold compresses with hot compresses to speed the healing. Anti-inflammatory medications also help tremendously, but I would recommend consulting your doctor about your medication choices.
Always remember, if you’re feeling a sharp pain in your elbow while performing an exercise, you are doing damage. When you were younger, the minor injuries healed quickly. At our age they linger indefinitely. Adjust your training so that you can keep at it.
To review: Always warm up properly, and get some ice on your elbows immediately after training. Give my suggestions a shot, and let me know how you’re doing! I appreciate your confidence in me and in IRON MAN magazine.
Train hard, and eat clean!
Editor’s Note: See Dave Goodin’s blog at www.IronManMagazine.com. Click on Blogs in the top menu bar. Check out his new Web site at Shredderbuilt.com. To contact Dave directly, send e-mail to [email protected] IM