There’s limited information out there about elbow health for the recreational trainee, but many people who train regularly – particularly with bodyweight exercise – find themselves limited by elbow problems.
Pain and tightness in the elbow when performing certain exercises is very common, but barring any known injuries, there are easy to apply solutions.
Many elbow problems are due to progressing too quickly, not allowing the muscles around the elbow a chance to get strong enough to handle the strain of bodyweight work. So, progressing at a slower pace is key, but there are also ways you can prepare your elbows to work through current issues or avoid future issues.
This post, rather than providing an encyclopedic instruction on elbow treatments, will give you an understanding of why you may be having elbow problems, and offers some strategies to work through them or, better yet, prevent them from occurring at all.
Public Service Announcement
Before we get into the nitty gritty, here’s an obligatory PSA: We’re not doctors, and this article and the suggestions below are no substitute for being seen by a real-live professional in person.
If you’re having ongoing aches and pains that don’t seem to improve with rest, you really should make an appointment to see a doctor or physical therapist as soon as possible.
Good, now let’s continue.
How the Elbow Works
The elbow is made up of two forearm bones – the radius and ulna – that form a hinge joint to the upper arm (humerus).
Its primary role is flexion and extension of the arm, so it is analogous to the knee joint. Unlike the knee though, it is primarily used in open chain movements for grasping and manipulation of objects vs. being fixed on the ground or other object as the knee is.
The elbow’s open chain movement may be one of the contributing factors to why people have problems when beginning bodyweight training.
The Elbow’s Role in Bodyweight Training
Just as in the hands and wrists, weight bearing and fixed grip activities can be very new and unusual, and not representative of what people are used to in their normal daily activities.
And really, the interconnectedness between the wrist and elbow can’t be overstated. In terms of active self care and exercise they really can’t be separated at all.
The stability of the elbow primarily comes from the depth of the hinge joint, along with the collateral ligaments on both sides. Sprains and dislocations occur with abnormal and excessive traction (pulling) forces either from falls or other violent stress, such as quick pulls or impacts to the forearm that pull on the elbow joint.
Baseball and other hard throwing sports can unduly stress the elbow joint if there are insufficient recovery periods relative to the player’s strength and work capacity.
So actions where there are stresses outside the “normal” plane of flexion and extension (bending and straightening) need to be approached carefully and progressively to avoid problems.
Again, this is not to say we should avoid these motions, but simply that they should be practiced and built up to deliberately.
The Areas that Need the Most Strengthening for Elbow Health
While we have the biceps, brachialis, brachioradialis, triceps, and anconeus, which cross from the upper arm to flex and extend, the primary muscles which need to be strengthened for improved elbow capacity in bodyweight exercises are actually more in the forearm.
There are quite a lot of forearm muscles for a healthcare provider to memorize to help patients, but for our purposes you just have to know the actions of wrist flexion, extension, and rotation (supination and pronation) and that the main groups of muscles perform those actions with common extensor and flexor attachments at the elbow.
Strengthening these actions, along with the grip, will do a lot to precondition your elbows and increase their activity tolerance.
What Causes Elbow Pain?
Like most other pathology classification, the conditions at the elbows are usually diagnosed by the affected tissue, whether it is tendonitis, muscle strain, bursitis, or even stress fractures.
But unless you had a particular trauma such as a fall or other impact injury, these diagnoses are more descriptive than very helpful.
For instance, the most prevalent overuse/repetitive strain pathologies are the lateral and medial epicondylitides, “Tennis” and “Golfer’s” elbow. Unfortunately these terms don’t tell us:
- why exactly you might have these problems when another person doesn’t, even with doing the same volume and intensity of activity
- or why you were fine with these same activities a year ago but now they are creating difficulties
The Specific Activity Isn’t the Problem
If they are true inflammatory issues then a rest period of 2-3 weeks should be enough to resolve the condition. Yet, most of us have to deal with pain and dysfunction lasting much longer than that, even after rest and what we think of as a gradual return to training.
It can lead us to think some activities are inherently bad or dangerous. Whether that is gymnastic ring training, particular barbell exercises, or any other specific physical activities.
While that may truly be the case for some people and their peculiar body structure, more often it’s a case of improper exercise technique and a poor adaptive capacity of the soft tissue for the chosen volume and intensity of exercise.
This doesn’t mean you are resigned to years of boring exercises before you are allowed to pull yourself up on the rings, instead it indicates that some additional preparatory training and a slower progression of the main activities may be necessary to keep your elbows healthy and able to adapt to your exercise sessions appropriately.
Exercises to Keep Your Elbows Healthy
The exercises and techniques I’ll show you below are good to practice a few times a week, as part of your warm-up for your regular training.
Practicing these often will help strengthen the muscles in your forearms and upper arms to support the elbows and keep them healthy.
Elbow Exercise #1 – Open Chain Rotations with Resistance
Wrist rotations with resistance are helpful for strengthening the forearms.
In this video I’m using a leverage handle with weight but you can use dumbells, dowels with weight or resistance bands to the same effect. Choose a resistance that you can perform at least 10-15 repetitions with, and perform these both with the elbow bent and with the elbow straight.
Do 2-3 sets of 15 repetitions of this exercise.
For wrist extension and flexion strengthening, see this previous video we shared.
Elbow Exercise #2 – Eccentric Band Elbow Flexion While Pronated
This is a combination exercise that strengthens your ability to keep your wrist strong in a neutral position (doesn’t break into flexion under weight), while controlling elbow extension under resistance.
In the video, I am using a resistance band for increased tension at the top of the movement, but a dumbbell or other weight is just fine.
Do 3-4 sets of 10 repetitions of this exercise.
Elbow Exercise #3 – Grip on Rope and Towel
Another combination exercise that works your grip and elbow muscle control in a useful way, holding on to a rope (or towel) helps you improve your strength in a unique way. You don’t have to handle your entire body weight for this exercise to be effective.
Keep your feet on the ground or other support, and shift enough weight to allow you to perform holds of 15-30 seconds at a time. Do these with the elbow straight and bent.
Do 3-4 sets of 15-30 seconds in each position for this exercise.
Elbow Exercise #4 – Pull-Ups on Rings (Neutral, Supinated at Top, Pronated with Elbows Out)
An unfortunately common complaint for people beginning to add more pull-ups into their training is medial elbow pain (the above mentioned “golfer’s elbow”). Though likely a primary problem of a lack of forearm strength to handle the stress of the pulls, another issue that contributes is inappropriate grip and elbow positioning during the exercise.
Here I demonstrate a neutral grip pull (palms facing each other) which can be less stressful on the forearms and elbows. Keep your wrist and elbows in a straight line, with your elbows tucked in to your sides.
As you improve in strength, you can add a supination (turn your palms to face you) at the top of the movement.
In the last variation for pulls with the wrists pronated (palms facing away from you), it’s important to have the ability to bring the elbows out so there is less stress on the inside of the elbow. Dr. Andreo Spina explains this well in this video.
If you don’t have the scapular strength and mobility to do this with your full body weight, you should do assisted pulls either with part of your body weight supported or use bands for assistance.
Elbow Exercise #5 – Elbow Extension Stretch with Weight
There are some people with tightness into elbow extension (straightening the elbow) which makes proper form in activities such as handstands more difficult to do. Be careful with this exercise as it’s easy to overdo.
The weight should be moderate and allow a relatively comfortable hold of at least 30 seconds. 3 sets of 30 seconds is more than enough and should be followed by active exercise.
A Note on Elbow Hyperextension
Hyperextension in the elbows is quite common, particularly amongst female trainees.
This is not “bad” and it does not mean something is “wrong” with your elbows. What it does mean is that you have to be a bit more aware of how your elbows are behaving and feeling in different exercises.
It’s common for people with elbow hyperextension to experience some discomfort when performing hand balancing exercises, particularly in the handstand.
One way to combat this is to contract the biceps slightly while in the handstand.
For people without hyperextension, a biceps contraction would bend the elbow, which is not what we want. But with hyperextension, a slight biceps contraction can correct the hyperextension in the handstand position, which can relieve some of that pressure.
The Elbow Bone’s Connected to the Shoulder Bone…
No body part or joint acts in isolation, and the elbow is certainly no exception.
The prior exercises are good local strengthening activities for the elbows, but there is an important interrelationship between the elbows, the wrists, the shoulders, and the neck.
Popular mobilizing techniques with bands and wraps are just temporary fixes if underlying causes are not addressed. This usually includes poor muscular capacity (grip, wrist extension, shoulder girdle) or impaired nerve conduction from plexus or cervical nerve root.
Relationship to the Shoulder
Lack of shoulder girdle strength and mobility can transfer undue stress to the elbows.
If you are unable to put your shoulder into proper position for a particular movement or exercise, that force will transfer to other parts of the body. Since the elbow is the next joint in the chain, it is often what takes the brunt of that force.
Click here to learn what could be wrong with your shoulders, and what to do to fix those issues.
Relationship to the Wrists
Similarly to the shoulders, if the wrists aren’t strong or mobile enough to handle pressure from hand balancing exercises or pressing movements, the elbows, as the next link in the chain, will often take more strain than they really should.
Especially when you’re just getting started with bodyweight training, this is something to be careful of.
Click here to make your wrists strong and mobile.
Relationship to the Neck
And because the nerves that supply the arm are made up of nerve roots that stem from the neck, if there is decreased nerve conduction from the plexus or cervical nerve root, you may experience pain, discomfort and decreased strength in any part of the arm (including the elbow).
Improving your neck function can go a long way to resolving issues throughout the arms (whether in the elbows, shoulders, or wrists).
Click here to learn how to improve your neck function.
If you’ve struggled with elbow issues in the past, working on improving your strength and mobility in these other joints might be a big part of the answer
Don’t Stop With Your Elbows!
If you’ve experienced pain and restriction in your elbows, you can probably imagine how great it will feel to move them freely and with total confidence again.
But the truth is that most people have aches and tight spots in more than just one part of their body.
Maybe your back gets a little sore at the end of a long work day. Maybe you feel a sharp pain in your knees sometimes when you’re climbing stairs.
Whatever your trouble spots are, these sorts of things keep you from doing all the things you want with your body.
That’s why we created our free Body Maintenance Guide. It zeroes in on the most common problem areas and gives you strategies to fix your aches and pains, loosen tight spots and restrictions, and move more freely throughout your body.
Free Your Body From Pains and Restrictions
Fix your aches and tight spots with our free Body Maintenance Guide so you can do more of what you love.
Whether or not you’ve had issues with your elbows in the past, you’ll benefit greatly from strengthening your body to give yourself the best chance of avoiding problems in the future.