Elbow pain when straightening your arm: causes and what helps
Pain at the back of the elbow when you straighten your arm, or a click or pop at full extension, is less common than tennis or golfer's elbow, but it's familiar to lifters, throwers, grapplers and people who lean on their elbows.
What causes elbow pain when straightening the arm?
Common causes include irritation of the triceps tendon where it attaches at the back of the elbow, olecranon bursitis, pinching at the back of the joint at full extension (posterior impingement), a hyperextension injury, and arthritis or loose fragments inside the joint.
Triceps tendon pain
Pain at the point of the elbow with pressing movements, dips, push-ups and skull crushers, or when straightening against resistance, often comes from the triceps tendon. A review notes that distal triceps tendinopathy is rare and the published evidence on treatment is limited (Donaldson et al., Shoulder & Elbow, 2014). In practice, it's managed like other tendon problems: load changes and progressive strengthening.
Pinching at the back of the elbow
A sharp pain at the back of the elbow at the very end of straightening, sometimes with a click, can come from the bones at the back of the joint pinching soft tissue. It's seen in throwers, tennis players, gymnasts and lifters who lock out hard.
Olecranon bursitis
A soft swelling on the point of the elbow is usually bursitis. A systematic review found non-surgical management was more effective and safer than surgery for most cases (Sayegh and Strauch, Archives of Orthopaedic and Trauma Surgery, 2014).
See our post on elbow bursitis.
After an armbar or a fall
A hyperextension injury, from an armbar, a fall onto the hand or a bad lockout, can sprain the ligaments and bruise the back of the joint, making straightening painful.
See our post on BJJ elbow injuries.
Why does my elbow click or pop when I straighten it?
Painless clicking is common and usually harmless, often from tendons moving over bone. Clicking with pain, catching or locking can mean a loose fragment or a problem with the joint surfaces, and should be assessed.
Can't fully straighten your elbow?
Loss of full straightening after an injury, with swelling, needs an X-ray to rule out a fracture. A gradual loss of extension with stiffness can be arthritis or loose bodies in the joint.
What helps?
Reduce the movements that hurt for a couple of weeks, especially heavy pressing, dips and hard lockouts. Use a slightly softer lockout, adjust grip width, and swap skull crushers for cable pushdowns. Ice can ease pain after activity. Avoid leaning on the elbow if the point is sore.
See our post on elbow pain from lifting.
What exercises help?
For tendon pain: static holds with the elbow slightly bent, then slow triceps extensions with light weights or bands, building to heavier pressing over weeks. Include shoulder and upper back strength to share the load.
How long does it take to settle?
Mild irritation often settles in two to six weeks with changes. Tendon problems that have built up over months can take two to three months.
When is it serious?
See a doctor promptly after a fall with swelling and inability to straighten the elbow, or for a sudden pop at the back of the elbow with weakness straightening the arm, which can be a triceps tendon tear. A hot, red, swollen elbow, or numbness and tingling in the hand, also need assessment.
Is it tennis or golfer's elbow?
Probably not, if the pain is at the back of the elbow. Tennis elbow causes pain on the outside of the elbow with gripping, and golfer's elbow on the inside. The review mentioned above notes golfer's elbow is up to six times less common than tennis elbow.
See our posts on tennis elbow and golfer's elbow.
Should I keep training?
Usually, with changes. Keep training the movements that don't hurt, use lighter loads and stop just short of full lockout on pressing for a few weeks. In BJJ, tap early to armbars and avoid posting on a straight arm. Pain that's mild during training and settles by the next day is generally acceptable.
Does a brace help?
A counterforce strap is designed for tennis elbow and usually doesn't help pain at the back of the elbow. An elbow sleeve can feel supportive for some lifters and grapplers. Padding protects a sore bursa from pressure. None of these replace adjusting load and strengthening.
How can an osteopath help?
We examine the elbow, shoulder and neck to identify the source, treat hands-on, adjust your training, and build a progressive strengthening plan. We'll refer you for imaging if a fracture, loose body or tear is suspected.
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.
Sources
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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