Lifter's Elbow: The Cause & The Cure

 

 https://www.t-nation.com/training/lifters-elbow-the-cause-the-cure

by Dr John Rusin  

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Soft-Tissue Techniques

HERE'S WHAT YOU NEED TO KNOW...

1. A weak grip can equal elbow pain. If you can't carry a load equal to your bodyweight in each hand for 15 meters, your grip sucks. Farmer's walks will help.
2. The false grip can boost your maximal strength numbers, but it reduces the capability of the neuromuscular system to produce force through the hands and wrists.
3. If your elbow hurts, use a neutral grip (palms facing each other) instead of a pronated or supinated position in your primary lifts.
4. If you've been making one of the above mistakes and have achy elbows, give self-myofascial release a shot.

Elbow Pain: Causes and Cures

If your elbows resemble a rickshaw more than a functional piece of bioengineering, here are three probable causes, along with some hugely effective self-myofascial release techniques.

1.  A Weak Grip

Without reliving the painful memories of the 1980's "grip trainers" that maimed more than their share of desk jockeys looking to Popeye-up their forearms, you must improve your grip strength to prevent or eradicate elbow pain for the long run.

A lack of functional grip strength not only limits your big-boy gym stats, but it can cause some horrific trauma to the deep finger and wrist flexors that adds up over time.

The test: If you think your grip is more than adequate, you're probably mistaken. The standards for a 15-20 meter carry are being able to lift and carry a load equal to your bodyweight in each hand.

Last time I checked, that's pretty damn heavy! At the very least, a functional carry should consist of 75% of your bodyweight in each hand. If you aren't here, it's time to just get better at the basics.

To enhance elbow health while increasing maximal grip force output, pick up the load on your carries in a linearly periodized progression. Keep the distance relatively short (10-15 meters) and treat your loads no differently than any other strength movement in your arsenal.

Related:  The fine points of the weighted carry

Program carries at least twice a week, making sure adequate rest periods are taken between sets. The goal is to increase your anaerobic capacity, not to walk around with 50 pounds in each hand for a half hour like you're a UPS deliveryman.

2.  Using a False Grip

Sure, the false grip can boost your maximal strength numbers. No argument there. Adding a few active muscle fibers firing at full capacity will obviously lead to greater force output. But can this technique sustain the chronic punishment imposed by your training? Probably not.

Unfortunately, the false grip does a few questionable things to the overall function of the upper body.

First, it reduces the capability of the neuromuscular system to produce force through the hands and wrists. The hand is the first link necessary to authenticate any movement of the upper body and shoulder girdle.

Without the ability to form a fist around your chosen training tool, you're more likely to overstress the larger joints up the chain like the elbow and shoulder.

While maximal tension can create PRs and boost your workout stats (along with your ego), high levels of mechanical tension can also cause an equally high level of soft tissue damage.

In the case of the false grip being used as a primary mechanism for movement, you exponentiate acute and chronic trauma to the elbow and surrounding tissues. The small forearm and wrist flexors - highly comprised of tendinous junctions with bone and muscle - are basically being torn to shreds secondary to your training.

Macro-tearing your tissues down multiple times a week is generally considered a bad thing. We can further limit this damage by simply ditching the false grip and wrapping your hand around the bar.

Train with the traditional grip until your elbows are supremely strong and healthy. Only then should you consider the false-grip alternative.

3.  Pushing and Pulling With a Pronated or Supinated Grip

The supinated (hands facing the body) or pronated (hand facing away from the body) grips used for pushing and pulling are standard operating procedure, but if your elbows hurt, start using a neutral grip. That means your palms will be facing one another.

This innocent rotation can enhance the way you move without the necessity of employing additional tactics in your activation and movement patterns that may take years to perfect.

The neutral grip allows a greater amount of shoulder joint centration along with decreasing the angle of the upper arm relative to the torso. Without torturing your with brain-numbing biomechanical analysis, the more centrally positioned we can place the shoulder, elbow, and wrist, the better those joints are going to naturally function.

Use the neutral hand position in your primary lifts whenever possible. This includes multi-joint pulling movements like the deadlift, row, and vertical pull. The use of readily available equipment like the trap bar and cable handles makes assuming a neutral hand position on your heavy pull days a cakewalk.

Things get a little more complicated for primary pressing movements such as bench variations and overhead pressing, especially if you're training at a commercial gym that frowns upon intelligently modified programming.

The football bar will provide the best training stimulus when concentrating on a neutral hand position. If you can find one, get to work. If not, your options are limited, and you may start to question that $10 per month gym membership.

Likewise, if you're crafty, the trap bar or Dead-Squat™ Bar can be a great way to vertical press if you can MacGyver a power rack setup.

Additionally, use dumbbell flat and incline pressing until you're sure your shoulders are strong enough to revert back to using supinated and or pronated grips.

Self-Myofascial Release Techniques

If you've been making one or all of the above mistakes and find yourself struggling with achy elbows, give these self-myofascial release techniques a shot.

Related:  More on self-myofascial release

The great thing about the elbow is that it's easily accessible to some serious soft tissue work. Start slow and reap the myriad of benefits of good ol' self-treatment!

Treating the pronator teres

Treating the medial wrist flexors

Treating the deep wrist extensors