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Solutions for Elbow-Pain

I’ve addressed training-related inner- and outer-elbow pain several times in past columns. Inner-elbow pain often occurs at a bony prominence known as the medial epicondyle. Triceps training often causes it. When the wrists are bent back in extension, the tendons of the wrist flexor muscles of the forearm pull on the medial epicondyle. The pain can be significant and cause you to stop training your triceps.

What can you do to return to triceps training or to reduce the elbow pain during training? The first remedy is to keep the wrist straight during triceps exercises. If you are performing pushdowns, your palms will face your thighs as you complete the exercise instead of having your palms face the floor. The same applies to lying triceps extensions. Don’t use the traditional “nose breaker” technique, with your wrists bent back as you reach your nose or forehead. Rather, keep your wrists straight and let the backs of your hands touch your nose or forehead.

When performing standing triceps extensions with a cambered bar or with two hands on one dumbbell, your palms should face forward at the top of the movement, not face the ceiling. All of the above techniques will keep your wrists in the straight, or neutral, position, which reduces the stress on the elbow during triceps training.

It would be advisable to reduce the amount of weight you are using on all of your triceps exercises until you get used to the movement. Increase the weight gradually over a number of workouts. The transition period for the new technique won’t take long.

It’s also a good idea to strengthen your wrist flexor muscles. You can do that a couple of ways. The first and most common exercise is wrist curls, which you can perform with a dumbbell. Place the length of your forearm along your thigh with your palm facing up. Allow your wrist to drop downward, and then bend, or curl, it up. You can also hold a barbell, placing the lengths of your forearms along the tops of your thighs or on a bench. Let the wrists bend and straighten as you would for any wrist curl. If traditional wrist curls cause pain, you can try standing wrist curls with a close grip and your hands behind your back. Bend your wrists upward as high as they will go without pain, and then lower back down to neutral, or straight. Perform two to three sets of wrist curls.

If you can find a dumbbell handle that you can adjust to have the weight at one end only, or if your gym has specialized dumbbell handles that are similar, you can perform pronation and supination exercises. Hold the dumbbell handle at the empty end with the weighted end farthest away. Place your forearm on top of your thigh with the dumbbell handle pointing straight up and the weighted end at the top. Let the weight fall to one side so your palm faces up, and then twist it (pronate) back to neutral (straight up). Repeat. This strengthens an important elbow muscle known as the pronator teres.

Pain on the outer elbow usually occurs at the bony prominence called the lateral epicondyle. It comes from overuse and chronic strain from the wrist extensor tendons. The lay term for it is “tennis elbow,” but tennis is only one way to develop it. Strengthening the wrist extensors can reduce the pain. This time place the length of your forearm on top of your thigh with the palm facing down. Allow the wrist to slowly bend downward and then bend it back up—a traditional reverse wrist curl.

You can also perform supination exercises with the dumbbell handle described above. The weight is at one end with your forearm on top of your thigh and the handle pointing straight up. This time turn the handle until your palm is facing down and then bring it back up to vertical. That will strengthen the supinator muscle.

The modifications to exercise technique and the additional forearm exercises described above should reduce your elbow pain and keep you in the gym.

Train smart, then train hard.


Editor’s note: Visit for reprints of Horrigan’s past Sportsmedicine columns that have appeared in IRON MAN. You can order the books, Strength, Conditioning and Injury Prevention for Hockey by Joseph Horrigan, D.C., and E.J. “Doc” Kreis, D.A., and the 7-Minute Rotator Cuff Solution by Horrigan and Jerry Robinson from Home Gym Warehouse, (800) 447-0008 or at


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