Elbow Pain When Lifting Weights: Causes, Fixes, and Prevention

Elbow pain is one of the most common complaints among lifters. It creeps in gradually, gets worse with certain exercises, and can derail your training if not addressed.

The good news: most lifting-related elbow pain is fixable without stopping training entirely. Here's what's causing it and how to fix it.

Common Types of Elbow Pain in Lifters

1. Lateral Epicondylitis (Tennis Elbow)

Where it hurts: Outside of the elbow, at the bony bump

What it feels like:

• Pain with gripping
• Aching on the outside of the elbow
• Worse with wrist extension movements
• May radiate down the forearm

Exercises that aggravate it:

• Reverse curls
• Pull-ups (especially with pronated grip)
• Rows
• Deadlifts (grip)
• Any exercise requiring strong grip

What's happening: The tendons that extend your wrist attach at the lateral epicondyle. Repetitive gripping and pulling overloads these tendons.

2. Medial Epicondylitis (Golfer's Elbow)

Where it hurts: Inside of the elbow, at the bony bump

What it feels like:

• Pain on the inside of the elbow
• Worse with gripping and wrist flexion
• May radiate into the forearm
• Pain when shaking hands or turning doorknobs

Exercises that aggravate it:

• Chin-ups (supinated grip)
• Bicep curls
• Heavy pressing (triceps connect nearby)
• Deadlifts

What's happening: The tendons that flex your wrist and fingers attach at the medial epicondyle. Curling motions and heavy gripping overload these tendons.

3. Triceps Tendinopathy

Where it hurts: Back of the elbow, where triceps attach

What it feels like:

• Pain with pressing movements
• Aching at the back of the elbow
• Worse at lockout
• May feel like a deep ache in the triceps

Exercises that aggravate it:

• Skull crushers
• Dips
• Close-grip bench press
• Overhead triceps extensions

What's happening: The triceps tendon attaches at the back of the elbow. Repetitive pressing, especially with elbow isolation, overloads this tendon.

4. Biceps Tendinopathy (Distal)

Where it hurts: Front of the elbow, in the crease

What it feels like:

• Pain when curling
• Discomfort when turning palm up under load
• May have localized tenderness

Exercises that aggravate it:

• Bicep curls (especially heavy)
• Chin-ups
• Rows with supinated grip

Why Lifters Get Elbow Pain

1. Too Much Volume Too Fast

The most common cause. You increased sets, reps, or weight faster than your tendons could adapt.

Tendons adapt slower than muscles. Your muscles might be ready for heavier curls, but your tendons aren't.

2. Grip-Intensive Training

Heavy deadlifts, rows, pull-ups, and carries all stress the elbow tendons through the grip. If you do a lot of pulling work, your elbows take a beating.

3. Repetitive Strain

Doing the same exercises, same grip, same angle repeatedly without variation.

4. Poor Warm-Up

Jumping into heavy weights without adequately preparing the tendons.

5. Weakness in Forearm Muscles

Weak wrist extensors or flexors transfer more stress to the tendon attachments.

How to Fix Elbow Pain

Step 1: Identify the Type

Use the descriptions above to determine which type of tendinopathy you likely have. This guides your treatment.

Step 2: Modify (Don't Stop) Training

Complete rest often makes tendinopathy worse. Instead, modify:

For lateral epicondylitis (outside pain):

• Switch to neutral or supinated grip for pulling (chin-ups instead of pull-ups)
• Use straps to reduce grip demands
• Reduce volume of direct forearm work

For medial epicondylitis (inside pain):

• Switch to pronated or neutral grip (pull-ups instead of chin-ups)
• Reduce curl volume
• Use EZ bar instead of straight bar for curls

For triceps tendinopathy:

• Reduce isolation triceps work
• Avoid skull crushers and dips temporarily
• Keep pressing, but reduce volume

For all types:

• Reduce weight by 20-30% on aggravating exercises
• Reduce volume temporarily
• Maintain pain-free movements

Step 3: Start Eccentric Exercise (The Key Treatment)

Eccentric exercise (controlled lowering) is the most effective treatment for tendinopathy.

For lateral epicondylitis:

1. Hold a light dumbbell (2-5 lbs) with palm down
2. Rest forearm on thigh or table, wrist hanging over edge
3. Use other hand to help lift the wrist up
4. Slowly lower the weight (3-5 seconds)
5. 3 sets of 15 reps, 2x daily

For medial epicondylitis:

1. Same position, but palm up
2. Slowly lower the wrist down
3. 3 sets of 15 reps, 2x daily

For triceps tendinopathy:

1. Light overhead triceps extension
2. Use other arm to help lift
3. Slowly lower (3-5 seconds)
4. 3 sets of 15 reps daily

Progress: Gradually increase weight as pain allows. Some discomfort (3-4/10) during exercise is okay; sharp pain isn't.

Step 4: Address Grip and Forearm Strength

Weak forearm muscles contribute to tendon overload.

Exercises to add:

• Wrist curls (light, high rep)
• Reverse wrist curls
• Finger extensions with rubber band
• Farmer's carries (when pain allows)

Step 5: Improve Recovery

• Ice after training if swollen (15-20 minutes)
• Consider a counterforce brace (tennis elbow strap)
• Ensure adequate sleep
• Address overall training volume

Exercise Modifications by Pain Type

Lateral Epicondylitis (Outside Elbow)

| Instead of | Try | |------------|-----| | Pull-ups (overhand) | Chin-ups (underhand) or neutral grip | | Barbell rows | Chest-supported rows | | Heavy deadlifts | Use straps, or trap bar | | Reverse curls | Regular curls |

Medial Epicondylitis (Inside Elbow)

| Instead of | Try | |------------|-----| | Chin-ups (underhand) | Pull-ups (overhand) or neutral | | Straight bar curls | EZ bar or hammer curls | | Heavy dumbbell curls | Cable curls (less stress at bottom) | | Close grip bench | Wider grip bench |

Triceps Tendinopathy

| Instead of | Try | |------------|-----| | Skull crushers | Cable pushdowns | | Dips | Close grip bench | | Overhead extensions | Pushdowns | | Heavy lockout work | Tempo pressing (no lockout) |

Sample Training Week With Elbow Pain

Here's how to structure training while managing elbow pain:

Day 1: Lower Body (No Direct Elbow Stress)

• Squats, leg press, leg curls, calf raises
• Can train normally

Day 2: Upper Body (Modified)

• Bench press (if pain-free, or reduce weight)
• Neutral grip pulldown (instead of chin-ups)
• Chest-supported rows with straps
• Face pulls (usually tolerated)
• Skip direct arm work

Day 3: Rest + Rehab

• Eccentric exercises: 3×15
• Light forearm work: 2×20

Day 4: Lower Body

• Deadlifts with straps (if grip is the issue)
• Romanian deadlifts, lunges, leg extensions

Day 5: Upper Body (Modified)

• Overhead press (if tolerated)
• Cable rows (neutral grip)
• Push-ups (often tolerated better than bench)
• Light triceps pushdowns
• Skip curls or do very light cable curls

Daily: Eccentric exercises, 2-3 sets of 15

Timeline for Recovery

Mild tendinopathy (caught early):

• Improvement in 2-4 weeks
• Full recovery in 6-8 weeks

Moderate tendinopathy:

• Improvement in 4-6 weeks
• Full recovery in 3-4 months

Chronic/severe tendinopathy:

• Improvement in 6-12 weeks
• Full recovery in 4-6 months or longer

Key insight: The longer you've had the pain, the longer recovery takes. Address elbow pain early.

Prevention: How to Avoid Future Elbow Pain

1. Progress Gradually

Increase volume and intensity slowly. The "10% rule" applies to tendons too.

2. Vary Your Grips

Don't do all your pulling with the same grip. Rotate between:

• Overhand (pronated)
• Underhand (supinated)
• Neutral

3. Manage Total Pulling Volume

If you do heavy deadlifts, consider reducing rows or pull-up volume. Your elbows only have so much capacity.

4. Warm Up Your Elbows

Before upper body work:

• Arm circles
• Light triceps pushdowns
• Light curls
• Wrist circles
• Band pull-aparts

5. Include Forearm Work

Regular, light forearm training builds capacity:

• 2-3 sets of wrist curls and reverse curls, 2x per week
• Light farmer's carries

6. Use Straps When Needed

If grip is failing on heavy pulls, use straps. Your grip will still get work from other exercises; no need to destroy your elbows.

When to See a Doctor

Seek professional evaluation if:

• Pain persists more than 6-8 weeks despite self-treatment
• You have significant weakness in the arm
• There's visible swelling or deformity
• Pain is severe or getting worse despite modification
• You felt a pop or snap followed by sudden weakness

Most lifting-related elbow pain responds well to the approach above, but persistent cases may need imaging or additional treatment.

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Related Articles:

• Tennis Elbow Exercises
• Golfer's Elbow Exercises
• How to Warm Up Before Exercise
• Why Am I Not Getting Stronger?