On Working Past Elbow Tendonitis – Training Around Angry Elbows
In 2006, I was experimenting with Boris Sheiko’s Powerlifting programs. The programs emphasize submaximal volume, and allow a trainee to increase their lifts by at least 4-10% over the course of the year, in a predictable fashion. Although famously tough, they are effective strength programs.
Something a good program can’t protect you from is bad technique, or misinterpreting form cues. In my case, I’d heard the cue “bend the bar” many times in the articles I’d read on benching. I’m a very literal person, so I actually tried to bend the bar, which, for the record, is not possible, at least for me! The action that is supposed to be cued, however, is “rotate the elbows under the bar”. This puts the elbows in a tucked position, at about 45 degrees to the torso, which is said to be safer for the shoulder, as it allows for a shorter lever arm, and more support from the back and scapula muscles.
After doing this wrong for a while, I noticed soreness in my elbows. I’m an experienced trainee, and I’m used to being sore, so I ignored it at first, but after a while it became clear that this issue was here to stay. Whether you call it tennis elbow, golfer’s elbow, tendonitis or epicondylitis, I had “it”.
Although my response was a bit delayed, I did get treatment. But I had to continue to get treatment off and on – the elbow pain and inflammation would flare up from time to time, and it was pretty frustrating, I have to admit.
Treatment options for this sort of injury is often along the lines of; “Stop doing the thing that’s hurting you. Let the inflammation settle down. Take NSAIDs. It should go away.”
The problem is, more than a few of the things that irritate my elbows are also the exercises that are considered to be the best for developing strength and muscle. Things like bench pressing or overhead pressing with a straight bar, doing chinups or pullups (or even bicep curls) are exercises that I can only handle in limited quantities. The trouble is, like I mentioned, they are more or less a staple in serious exercise programs geared towards getting stronger and bigger, which was my primary reason for training for many years. So, it’s hard to take the well-intentioned advice of “Stop doing that” when it comes to those effective exercises so cherished by the fitness community.
The question becomes, how can you continue to exercise with enough intensity to make improvements, without irritating the existing issue of elbow tendonitis?
Here’s a few ideas that I’ve found very helpful in my own training, and in training my clients:
*Use neutral grip barbells if available – elitefts has a great one: https://www.elitefts.com/elitefts-swiss-press-bar.html
*Use individual handles – dumbbells and cable exercises
*Don’t be dogmatic about your exercise choice
You can see some video demonstrations of these ideas here:
Using a neutral grip for many different exercises has been touted as a shoulder saver. People talk about it feeling more “natural”. My own criteria for using neutral grip is that it doesn’t irritate my elbows or shoulders. After a lot of trial and error, I’ve started used neutral grip for most chest, shoulder, triceps and back exercises. This allows me to train mostly pain-free. Experiencing pain while training inhibits full muscular contractions, and also slows you down mentally – it’s tougher psychologically to push through that pain, as you don’t feel confident in the integrity of the area.
This has meant swapping my barbell bench press, barbell overhead press, straight bar chin-ups/rows, and barbell tricep extensions for exercises like the 1 arm incline dumbbell press, the alternating overhead dumbbell press, 1 arm pull downs with the D handle, 1 armed rows with dumbbells or cable attachment, and tricep work with dumbbells or rope attachments. The result has been steady progress on those exercise, very little pain in the elbows, and some pleasant changes to my upper body as a result of being able to work it hard without having to take breaks for injury.
Here’s the thing – even though it works to swap out your straight bar exercises for exercises that allow you to use a neutral grip, you might be tempted to not do so. The siren call of exercises like bench press, overhead press, and chin-up variations is very hard to ignore, especially when you see other people who are awesome at them! Youtube and Instagram make it seem like everyone in the world can bench big, overhead press their body weight, and do chin-ups all day long. But the immediate connectivity of our digital age has shrunk the world down to a size that tends to prevent a healthy perspective. We can see genetically elite (and possibly PED using) people in their prime ALL THE TIME now. And that’s not a normal representative of human experience. Like Bill Murray recently said, “Every Olympic event should include one average person competing for reference”.
So, don’t be dogmatic about your exercises. They might be awesome exercises for certain people, or even for you when you are totally healthy again. But until then, you may have to be a bit ruthless about chucking out the exercises that are causing you irritation, and open-minded about what to replace them with. I hope I’ve given you a few ideas about that here! It’s certainly helped keep my training fun and productive to not have to fight through pain at each workout. And remember, the main thing is to follow your doctor’s suggestions, so if they say take a break, take a break! The weights will still be there when you get back.
Ron Dykstra
Iron Lion Training
October 5, 2016
