Reilly D, Kamineni S. Olecranon bursitis. Body Types: How to Train & Diet for Your Somatotype. By limiting movement-compensation at the shoulder, forearm, and wrist, in conjunction with medical intervention, if deemed necessary by the appropriate medical care provider, individuals with lifters elbow should be able to continue training and progress towards their fitness goals. Ideally, the hands should be placed in a manner that allows for a neutral wrist and the forearms to be perpendicular with the resistance, placing them over the chest (not the shoulders) for proper kinetic chain checkpoint alignment (Clark et al., 2018). If the client lacks mobility throughout the shoulder, forearm, or wrist, or is otherwise unable to stabilize the load, compensation will occur. Twice per week, do two sets of 10 reps each of the following exercises: Wall extensions: Stand with your back against a wall. If you were to make a fist with each hand, with your thumbs up, the thumb should remain in-line with the upper arm. Sure, some burning, aching muscles are to be expected, but recurring pain in a particular area of the body is not. Poor technique is often a cause of elbow pain when bench pressing since it can place excessive, uneven demand or torque on the joint. A barbell bench press should be performed with proper kinetic chain checkpoint alignment.
The more stress you place on the triceps tendon insertional point, the greater the likelihood of incurring tendon-related elbow pain. Clark, M. A., Lucett, S. C., McGill, E., Montel, I., & Sutton, B.
1. While the wrist flexors may be overactive, overactivity does not mean they are strong enough to maintain a neutral grip. Acute variables: Using cable or band resistance and bodyweight 10-15 reps with a 4-second eccentric, 2-second isometric hold at end range, and a 1-second concentric tempo. While you would not grip the bar or handle with your thumb out in this manner, the wrist and forearm orientation should be the same. When watching the video of your technique, look at the symmetry of your arms throughout the entire movement. This signifies that each one of your elbows is undergoing different torque demands as you bench, which could be leading to your elbow pain. Remember, even the best bench pressers have coaches who help them continue to perfect their technique. If you want to learn more about correcting upper crossed syndrome, check out Correcting Upper Crossed Syndrome by NASM Master Instructor Ken Miller. How can you prevent this from happening during your next bench press session? A quick way to test if your elbow tendons are the source of pain is to place them in a stretched position when the pain is present, which is typically during your workout. Adjusting your workout frequency may also help. Here is a sample warm-up routine following the NASM Corrective Exercise process : Foam roll or massage ball: Latissimus dorsi, pectoralis major, biceps brachii, wrist flexors, and forearm pronators. Youll need to determine why the asymmetry is occurring, which I cant do for you, but consider examining your shoulder and wrist mobility as the starting point. With all the pain classification out of the way, lets now discuss the most common overuse causes of elbow pain when benching and how to go about addressing them. Lifters elbow, perhaps more commonly known as golfer's elbow, is an overuse injury. (2018). Risk factors for tendinopathy include repetitive loading, excessive loading, as well as abnormal and unusual movements (Kaux et al., 2011). As the client develops and maintains greater stability and postural control while being exposed to progressive training loads, they will continue to progress towards their training goals while reducing overuse patterns within the forearm and elbow. Once youve got some video footage and you know what youre looking for, take some time to look it over and see what you can find.
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During the first stage, you might feel some discomfort that disappears after your warmup. Some people tuck their elbows because they feel it protects their shoulders, but the reason for that is usually poor range of motion in the shoulders. 2016;25(1):158167. This warm-up routine should be performed prior to the clients chest workout involving pressing exercises like the bench press and should take no more than 5-15 minutes to complete. Dont sweat it if you dont know what to look for; Ill give you some ideas in the section below. This Is Your 4-Step Guide to Fixing It, Built Lean: Top 7 Exercises to Increase Shoulder Flexibility. Since, as Matthews says, most elbow overuse injuries result from increasing your load too quickly, the first step is to dial it back. There are several other conditions that could potentially cause elbow pain when lifting, including: If you're not sure an overuse injury is what you're dealing with, or you have other symptoms not associated with an overuse injury, it's a good idea to make an appointment with your doctor. In proper bench press form, elbows should flare out so they're directly under the bar. This causes undue wear and tear on the elbow joints and surrounding tendons and muscles, resulting in inflammation and pain. The most common issues tends to be from excessive demands placed on the forearm tendons and technique errors, which greatly influence how the elbow has to move and tolerate loads. Lavallee ME, Balam T. An Overview of Strength Training Injuries: Acute and Chronic. It doesn't mean you can't do bench presses again, but replacing the exercise temporarily may help you heal your injury without having to stop chest pressing altogether. It may also be due to muscular strength imbalances throughout the shoulder and arm as well. Pull your shoulders down and back as you lift your arms up and overhead, keeping your elbows as straight as possible. Its pretty hard to fix a problem when you dont know exactly how or why its occurring.
How Effective Are Resistance Band Workouts? Retrieved from https://jssm.org, Andrew is an NASM Master Instructor with a masters in Exercise Science with emphasis on Rehabilitation and working on a doctorate in Health Science from CalU. Thankfully, its rather self-limiting and typically doesnt require specific medical intervention, so long as the bursa itself doesnt become infected. 
You can reach him at: Andrew.Mills@NASM.org, Fitness Never underestimate the importance of developing impeccable technique; even the best bench pressers and powerlifters in the world continually work to tighten up and perfect their technique, no matter how many years theyve been at it.
If you put your arm into the position shown above and the pain that youre familiar with is recreated or worsens on the outside portion of your elbow (red area), then you may likely be dealing with a case of lateral epicondylitis, often referred to as tennis elbow.
If you want to learn more about correcting upper crossed syndrome, check out. In later stages, the pain worsens with activity, and you may end up feeling pain or discomfort most of the time. Otherwise, take time to practice your technique with just the barbell until you groove a new movement pattern into your muscle memory. Even with treatment, the recurrence of symptoms is common. He loves treating lifters and other active individuals in the clinic and working with them in the gym in order to help them move better, feel better and maximize their training potential. This article is part of our series on How To Avoid A Powerlifting Injury. Acute variables: You should hold static stretches for 20-30 seconds. If the wrist flexors are shortened, they will not meet the wrist extension position's demand. Acute variables: 10-15 reps under control. Jim is a physical therapist, strength & conditioning specialist and former competitive powerlifter. No pain, no gain is the old adage bandied about the gym like ripe sweat towels.
Above all else, dont try to simply ignore the pain and push through it. Lifters elbow is an overuse injury in which the tendons of the wrist flexor muscles become inflamed due to abnormal loading patterns and overuse (Ambler-Wright et al., 2021).
If youre inconsistent with your bar placement (some reps landing too low on your chest and/or other reps landing too high) then theres likely unnecessary amounts of torque going into your elbow joints as a result. Perform the exercise for about three sets of ten reps with the elimination of that pain occurring while under load. If you're still in an early stage of an overuse injury, you can continue to work out, according to Russell. It is ok to place a step or similar platform under the feet to maintain a neutral, low back position for those with shorter legs. In such a state, the wrist flexor muscles and tendons may become unnecessarily strained, which may be especially true if the wrist flexors are overactive or shortened. Tendons behave in a very specific way when it comes to their pain patterns, which is helpful since it gives you more certainty as to whether or not this is the cause of your pain. Murtaugh B, Ihm JM. Tendinopathy occurs as a tendon experiences greater disrepair than it can recover from, possibly due to poor lifting biomechanics and other combinations of repetitive tasks, in this case, involving the wrist and forearm. Understand the basics of elbow pain & causes of elbow injury when benching, Determine if your pain is from overloading your elbow tendons or from poor technique, Load your elbow tendons appropriately if pain is from overuse, Ensure movement symmetry from side to side with each rep, Find a coach to help you perfect your technique, How To Fix Bicep Pain While Bench Pressing, Does Forearm & Grip Strength Help Bench Press? If one is moving differently from the next, youll need to address that. As an individual progresses to pressing heavier loads and greater training volume, the bench press resistance may begin to outpace grip strength, limiting the clients ability to maintain a neutral grip orientation, placing the wrist in extension during the press. If you also get elbow pain while squatting, make sure to read my article on How To Fix Elbow Pain During Squats. Theres nothing too catastrophic about having poor technique on the occasional rep, but the more frequently and consistently the poor technique is being performed, the bigger the problem can become. While you (or your coach) will need to determine which grip width is most ideal for you, its worth trying different widths to see how they impact your elbow pain (both while during the bench press itself as well as afterwards). She'll also be able to guide you in properly increasing your load once you get back to your normal bench-press program. Website: www.strengthresurgence.com. A barbell bench press is a closed-chain exercise not allowing the distance between the hands to change. If the pain is of the same nature but on the inside of your forearm, you might be dealing with a tendinopathic condition known as medial epicondylalgia, or more simply known as golfers elbow. Tendinopathy isnt something you just get overnight its a condition that occurs over a length of time and with an accumulation of training hours. Current opinions on tendinopathy. Its absolutely money well spent. Dont be afraid to take some time to explore why youre experiencing pain. Combine this with repeated and intense squeezing of the bar and you just might be staring down the barrel of a tendinopathic condition known as lateral epicondylitis, (AKA tennis elbow) or medial epicondylitis (AKA golfers elbow). You can also spring for some neoprene elbow sleeves. Bring your arms behind you as far as you can without causing pain; you may need to move your hands farther apart. Keeping the elbows tucked in rather than flared out puts the joints at an awkward angle, placing more stress on the tendons around the elbow joint.
However, in an ideal situation, modifications may be made enabling the. Unfortunately theres no real quick-fix here if its truly a tendinopathy that youre dealing with. Some of the benefits of a warm-up include increased heart and respiratory rate, increased tissue temperature, and increased psychological preparation for bouts of exercise. Going into the gym day after day and week after week, loading up the barbell and pressing away puts a lot of stress on your muscles and joints. If the pain is located over the outside region of your elbow and seems to only come on when squeezing the bar or pressing high loads or volumes, theres a good chance that this is the source of your pain. When the wrist is extended, the length-tension relationship between the wrist extensors and flexors becomes altered, limiting the wrist flexors' ability to produce force. Unfortunately, due to the required rotation of the forearm to grip the barbell, barbell bench pressing can exacerbate the lifters elbow symptoms by requiring greater range of motion from the shoulder, forearm, and wrist than the individual may possess. Youll have to be smart with your training and maybe make some specific changes for the time being (such as decreasing your overall training load and volume), but it beats the alternative of just trying to push through and only having it get worse. Fixing your elbow injury means you'll have to change up your training program for a while. A side examination should reveal rather symmetrical forearm direction, indicating symmetrical torque and load running through your elbows as you bench.
It is vital to maintain a neutral grip (i.e.
In: Shockwave Medicine. Client to achieve a stable lift with good technique and without compromising intensity while reducing the stress placed on the wrist flexors' muscles and tendons.
Lowering the intensity to match what the client can stabilize and control with proper technique is essential. Please note that if the client lacks shoulder stability, they may find that dumbbells provide too much freedom of movement and lack control to perform the dumbbell bench press without reducing the weight safely. She'll be able to pinpoint the problem and give you ways to work around the pain as well as exercises to strengthen or stretch any muscles that may be underworked or overused. Individuals with upper crossed syndrome may also present excessive thoracic kyphosis, scapular winging, and elevated, rotated, or abducted shoulders (Ambler-Wright et al., 2021). Not only that, but if you think you understand it when you actually dont, then youre just not going to get better, at least not all that quickly. Jones & Bartlett Learning. There can be numerous reasons as to why you can experience pain in your elbows when benching. You can find more information about the muscles involved with the bench press by following the link. Optimizing the forearm angle, promoting a neutral grip, and maintaining proper kinetic chain checkpoint alignment, can significantly reduce risk factors for elbow tendinopathy and lifter's elbow symptoms, or at the very least prevent the worsening of symptoms while continuing to train. Fixing tendinopathies is done by loading the affected tendons appropriately; not enough load and they dont get better but too much and you make it worse. So, how do you fix elbow pain when bench pressing? In the second stage, the pain may begin to show up after your workout. Any time youre squeezing the bar or holding onto a weight, youre using those tendons to get the job done. Curr Sports Med Rep. 2013;12(3):175182. Jandas upper crossed syndrome is an example of a postural distortion pattern that could compromise form and negatively affect the elbow during a bench press exercise.
Other modifications to your workout can include avoiding repetitive motions of the forearm and using lifting straps to decrease required grip effort for pulling-based exercises. There are many potential reasons for elbow pain after bench pressing, but if the pain occurs only after you stop bench pressing, the most likely cause is an incipient overuse injury. For proper form, the client should be lying on a bench with their back against the bench. A standing cable press or stability ball dumbbell chest press. then your poor elbows and the tendons crossing your elbows might simply be the victims when it comes to experiencing elbow pain when benching. You can read more about this in my article on Uneven Bench Pressing. Its Always Sunny-Ish: A Deep Dive Into Toxic Positivity, Some suggested bench press modifications to reduce symptom aggravation, A sample warm-up routine to prepare the upper body for loaded movement and promote recovery. In the following section Ill be presenting two key areas/reasons as to why you could be experiencing elbow pain while bench pressing. The isolated strengthening exercises were chosen to activate common underactive muscles that would lead to shoulder compensation during a bench press. And the longer you keep doing the same thing, the worse your injury will get. Conversely, grips that are too narrow can place extra strain on the insertion of the triceps tendon (which attaches right on the back of the elbow) at the bottom of the movement. Try to keep performing bench press or variations at loads that dont seem to stir up the pain. Proper mobility of the thoracic spine, scapular stability, and shoulder position are essential to the elbow and wrist's overall function. Pain location is also a really good clue for elbow tendinopathy.
The dumbbells provide more freedom of movement, especially allowing for a more neutral forearm position. 7. 
If you have trouble using proper form, you may need to work on shoulder mobility. Because bursitis is an inflammatory process involving the bursa, it tends to respond rather well to NSAID medications (note: see medical disclaimer at the beginning of this article). If your elbow hurts after bench pressing, it's a sign that something is not right. Bend your elbows to 90 degrees and press the backs of the hands into the wall. Karger Publishers; 2018:2741. Additionally, the standing cable press or stability ball dumbbell chest press is ideal for challenging the intermuscular coordination of the shoulder complex, forearm, and wrist throughout a pressing motion. Dont be afraid to put more technique-focused sessions into your training. Ko J-Y, Wang F-S. Extracorporeal shockwave therapy for tendinopathy. A more technical name for this condition is medial epicondyle tendinopathy. the muscles involved with the bench press, Everything You Need to Know About Muscle Memory. The main one is to simply video yourself going through your bench workout. How To Fix Tailbone Pain When Squatting (6 Solutions), Squat Walkout: 7 Common Mistakes Lifters Make. Check out my article on my top bench press accessories. The inability to produce proper movement technique is often termed a motor control issue. Adding too much weight too soon can cause elbow pain after bench pressing. The key is to perform exercises for those unhealthy tendons using a load that only stirs up the pain throughout the movement to a rating of 1 or 2 out of a scale of 10 (with 10 being the most excruciating pain imaginable). The tendons of the wrist flexor muscles become inflamed due to abnormal loading patterns and overuse (Ambler-Wright et al., 2021). It can occur for multiple reasons, but again, within the context of this article is most often due to high volumes of repeated movements or demands placed on those tendons. There will be a lot of information in this article as to how and why this occurs, as well as how to address it since it tends to run rampant in powerlifters along with other strength training athletes. The same is true when lifting heavier weights; poor motor control with light weight isnt nearly as concerning or injury-inducing as poor motor control with heavier weight.
You can also do cable presses, or try a chest press machine. Take a look at the following pictures and replicate the arm position when your pain is present: If you put your arm into the position shown above and the pain that youre familiar with is recreated or worsens on the inside portion of your elbow (red area), then you may likely be dealing with a case of medial epicondylitis, often referred to as golfers elbow. In addition to emphasizing exercise technique and the discussed modifications, a warm-up routine before lifting has many benefits. Our bodies are in fact filled with well over a hundred of little water balloon-like structures known as bursas. Integrated dynamic movement: A standing cable press or stability ball dumbbell chest press. Once youve sought out a coach (or even if you already know what you need to work on), its time to devote some extra practice to cleaning things up.
The feet should be parallel, pointed straight ahead, and the low back should be neutral. Theres a perfect reason as to why: In the context of this article, tendinopathy refers to a generalized breakdown of the tendons around the elbow. Accessed November 23, 2020. https://www.orthobullets.com/shoulder-and-elbow/3083/medial-epicondylitis-golfers-elbow. Of course, if your elbow pain persists even after you've made small changes, you may need to make larger modifications, including taking time off. Medial Epicondylitis (Golfers Elbow) Shoulder & Elbow Orthobullets. The problem is that these little water balloon-like discs can actually become irritated and inflamed themselves. Hold briefly, then return to the starting position.
Space your workouts evenly, which will give your elbow more time to recover between sessions. Weightlifting is a prime example.
Olecranon bursitis is in fact the most common area in the body for bursitis to occur. The Benefits of Flexibility: Why You Should Stretch More! 2010;9(5):7. Russell points out that in the early stages of an injury, pain may be the only noticeable indicator, but it doesn't mean these other symptoms aren't present: According to fitness expert and author Michael Matthews, overuse injuries from weightlifting are predominately caused by doing too much, too soon. The most widely reported description of pain when it comes to this condition is a burning or stinging-like sensation around the back of the elbow (right where the bursa is). If you've been feeling pain only after lifting, the good news is that your injury is not yet advanced. ), you may need to either avoid those variations, modify them, or even perform them more frequently based on how your elbow tolerates each one. Think of it as your bench technique. NASM essentials of corrective exercise training (2nd ed.) While there are many innovative grip tools in development to mitigate the barbell's complications, the CPT can utilize the barbell in their programming and reduce risks by ensuring optimal form and positioning throughout the exercise. Keep upping the load as the weeks go on so that you stay in this pattern. Accessed November 23, 2020. https://www.orthobullets.com/shoulder-and-elbow/3083/medial-epicondylitis-golfers-elbow. Read more: Treatments for Elbow Pain From Weightlifting. Accessed November 23, 2020. https://www.orthobullets.com/shoulder-and-elbow/3082/lateral-epicondylitis-tennis-elbow, Medial Epicondylitis (Golfers Elbow) Shoulder & Elbow Orthobullets. Hi! Check out my complete guide to learn more. In the case of bench press, our ability for how we coordinate the movement for a single rep from start to finish can be termed our motor control when performing the complete movement. Repeat this a few times per week. Make sure to film a few reps from the side and some from a straight-forward angle, as each view can offer valuable insight. You may also want to avoid or incorporate certain grip widths based on what makes your elbow feel better and/or worse. Remember, training and lifting is all about the long term approach; being myopic and simply trying to push through unnecessary pain is not a good long term strategy. Workout Plans, Bench Press Elbow Pain: Avoid Lifter's Elbow With These Modifications, Individuals with upper crossed syndrome may also present excessive thoracic kyphosis, scapular winging, and elevated, rotated, or abducted shoulders (Ambler-Wright et al., 2021). Results from: Excessive or repetitive pressure placed on the back of the elbow against a hard surface, such as when doing floor press. Because of the barbell bench press's closed-chain nature, the forearms may begin perpendicular to the bar but will change in angle at the top and bottom portions of the press.
