Elbow pain from lifting: pull-ups, curls and rows
Elbow pain is a common complaint among lifters and grapplers, usually from a combination of heavy pulling, gripping and sudden increases in training. Steven lifts and trains BJJ, and sees plenty of sore elbows. Here's what's usually going on and how to keep training.
Why do my elbows hurt when lifting?
Most lifting-related elbow pain is tendon pain. Pain on the outside of the elbow, worse gripping, carrying or doing reverse curls, is usually lateral elbow tendinopathy (tennis elbow). Pain on the inside, worse with curls, pull-ups and gripping, is usually medial elbow tendinopathy (golfer's elbow). Pain at the back of the elbow during pressing and skull crushers often comes from the triceps tendon. Pain at the front of the elbow with heavy curls or chin-ups can involve the biceps tendon.
See our post on tennis elbow vs golfer's elbow for how to tell the two apart.
Why do my elbows hurt during pull-ups?
Pull-ups and chin-ups load the forearm muscles, biceps and the tendons on the inside of the elbow, especially with a fixed, straight bar. A sudden increase in volume, lots of grip-intensive work, or doing pull-ups on top of climbing or grappling is a common pattern. Rings or a neutral-grip handle let your forearms rotate naturally and are often much more comfortable.
Which exercises should I avoid with elbow pain?
You rarely need to avoid exercises completely, but you may need to change them for a few weeks. Swap straight-bar curls for dumbbell or hammer curls, use straps on heavy pulls to reduce grip demand, try a neutral grip on rows and pulldowns, and replace skull crushers with cable pushdowns if the back of your elbow is sore. Reduce total pulling and gripping volume rather than stopping.
What helps tendon pain in the elbow?
Progressive loading is the key. Gentle static holds can help settle pain early, followed by slow wrist curls, reverse curls, forearm rotation and grip work, then a return to heavier pulling. Tendons adapt slowly, so steady progress over weeks matters more than doing a lot at once.
Physiotherapy-style treatment has good evidence for tennis elbow. In a trial comparing treatments, a program of hands-on treatment and exercise outperformed wait-and-see in the first six weeks and gave better long-term results than a corticosteroid injection (Bisset et al., BMJ, 2006).
Should I get a cortisone injection for elbow pain?
Be cautious. For tennis elbow, a large trial found a corticosteroid injection led to worse outcomes at one year than a placebo injection, with recurrence in 54% of people who had the steroid compared with 12% who had placebo (Coombes et al., JAMA, 2013). Injections can give short-term relief, but they tend to be a poor long-term choice for tendon pain.
Do elbow straps or braces help?
A counterforce strap worn just below the elbow can reduce pain during gripping for some people. It's a useful short-term tool, but it doesn't replace progressive strengthening.
How long does elbow pain from lifting take to heal?
Mild tendon irritation often improves over a few weeks with changes to training. Established tendinopathy commonly takes two to three months of consistent loading, and longer-standing cases can take longer. Most people can keep training throughout with smart exercise choices.
Is it safe to train through elbow pain?
Training through mild tendon pain is often fine, and loading actually helps tendons recover. A useful guide is that pain during exercise should stay mild, and your elbow should feel no worse the next morning. If pain is sharp, building session to session, or your elbow is worse the day after, reduce the load or swap the exercise for a while.
Can an osteopath help elbow pain from lifting?
Yes. We work out which tendon or structure is involved, check your neck, shoulder and grip, treat hands-on and sometimes with dry needling, and build a progressive loading program that fits around your training. We'll also help you choose exercise swaps so you can keep lifting.
Does grip width affect elbow pain?
Yes. Very narrow or very wide grips, and a fixed straight bar, can increase strain on the elbow tendons. Using a grip at roughly shoulder width, switching to a neutral grip or rings, and using an EZ bar for curls often eases pain during pulling and curling.
When should elbow pain be checked?
Book in if pain isn't improving after a few weeks, or is affecting your training or work. See a doctor promptly for a sudden pop at the front of the elbow during a heavy curl or chin-up, especially with bruising or a change in the shape of your biceps, as a biceps tendon rupture is best repaired early. Pins and needles or numbness in your fingers can come from a nerve at the elbow or neck.
See our elbow and wrist pain guide. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
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Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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