When it comes to experiencing pain while bench pressing, elbow pain is one of the more common issues that powerlifters (along with regular gym-goers) tend to face. Thankfully, it’s oftentimes rather straightforward to rectify. There’s just a few key concepts you need to be aware of, and by the end of this article you’ll know exactly what they are, how to implement them and how to get back to bench pressing without any elbow pain.
Elbow pain occurring with bench pressing is most often the result of overuse of the forearm tendons and technique errors throughout the movement. These issues are fixed by ideal loading parameters, raising movement awareness and changing up your technique.
So, how do you fix elbow pain when bench pressing? Here’s the 7-step process:
- 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
- Fix your barbell placement consistency
- Ensure movement symmetry from side to side with each rep
- Change your grip width
- Find a coach to help you perfect your technique
Let’s cover each of these steps in further detail!
This article is part of our series on How To Avoid A Powerlifting Injury.
Understanding Your Pain & Causes Of Elbow Injury While Benching
It’s pretty hard to fix a problem when you don’t know exactly how or why it’s occurring.
Not only that, but if you think you understand it when you actually don’t, then you’re just not going to get better, at least not all that quickly.
This inability to properly understand the nature of your pain while simultaneously trying to treat it is often termed “chasing pain”, where treatment and remedies go after the symptoms of the pain rather than its root cause.
In the following section I’ll be presenting two key areas/reasons as to why you could be experiencing elbow pain while bench pressing.
As you read through this section, ask yourself which of these two categories you might fall into.
As well, keep in mind that it’s entirely possible for pain to be arising due to more than just a single category. In fact, I often see a combination of these categories creating pain in the lifters I treat in the clinic.
Once I’ve quickly outlined the main two categories in which elbow pain can arise from and you’ve got an idea of which category/categories your pain best fits into, I’ll then spend the rest of the article discussing the most common sources of elbow pain within each of these categories AND the best approaches to take for eliminating them.
If your biceps hurt while benching (not your elbows), then be sure to check out my other article on How To Fix Bicep Pain While Bench Pressing.
Why You Get Elbow Pain While Bench Pressing
When it comes to categorizing elbow pain that arises with bench pressing, we can classify the pain as either coming from high, repetitive training volume, which places excessive demands on structures around the elbows (causing them to get sore), or we can classify the pain as coming from poor technique. The inability to produce proper movement technique is often termed a motor control issue.
Spoiler alert: This is the most common reason for elbow pain in bench pressers and weightlifters due to the intense, repetitive and frequent demands they place on their forearm tendons (which cross the elbow joint). 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.
Motor Control Issues
Motor control simply refers to our ability to volitionally and intentionally coordinate and carry out specific movements. 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. Think of it as your bench technique.
Poor technique is often a cause of elbow pain when bench pressing since it can place excessive, uneven demand or torque on the joint.
There’s 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.
The same is true when lifting heavier weights; poor motor control with light weight isn’t nearly as concerning or injury-inducing as poor motor control with heavier weight.
If you also get elbow pain while squatting, make sure to read my article on How To Fix Elbow Pain During Squats.
Identifying The Most Common Conditions Causing Elbow Pain And How To Fix Them
With all the pain classification out of the way, let’s now discuss the most common overuse causes of elbow pain when benching and how to go about addressing them.
Issue #1: Tendinopathies Of The Forearm Tendons
Results from: High volume/high loading & repetitive tissue demands of the forearm tendons
Remember when I said that this was the most common issue in lifters? There’s a perfect reason as to why:
In the context of this article, tendinopathy refers to a generalized breakdown of the tendons around the elbow. In a simple context, it’s the painful condition that follows after you get tendonitis, which is the initial stage of tendon irritation.
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. Any time you’re squeezing the bar or holding onto a weight, you’re using those tendons to get the job done.
You may therefore be experiencing elbow pain during your bench press, but the cause may well be in fact from other combined aspects of your training regimen; if your training involves a lot of repetitive arm movements, wrist movements, excessive amounts of all-out gripping, etc. then your poor elbows and the tendons crossing your elbows might simply be the victims when it comes to experiencing elbow pain when benching.
In other words, the culprit may very well be other aspects of your training.
Tendinopathy isn’t something you just get overnight – it’s a condition that occurs over a length of time and with an accumulation of training hours. 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 golfer’s elbow).
How To Tell If Your Elbow Pain Is From Tendinopathy
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. If you’re finding that the pain only really occurs during your workouts (and aches for an hour or so afterwards), or it’s especially bothersome with lots of gripping/holding onto heavier barbells, weights and/or with heavy volume or loads, this is your first clue.
Unhealthy tendons oftentimes don’t produce a lot of pain until their loaded past the demands of what they can tolerate, hence why this type of elbow pain often doesn’t occur until you start benching (or potentially doing other exercises) with moderate resistance.
Pain location is also a really good clue for elbow tendinopathy.
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, there’s a good chance that this is the source of your pain.
Pain in this location essentially means that your forearm extensor muscles (which cross the elbow joint) are irritated and need some attention. This is a common condition known as lateral epicondylitis, also referred to as tennis elbow.
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 golfer’s elbow. The forearm flexor tendons are the issue here. These are the tendons that help to flex your wrist and squeeze your hand into a fist.
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. 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 you’re 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 golfer’s elbow.
If you put your arm into the position shown above and the pain that you’re 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.
How To Fix Tendinopathies Of The Forearm
Unfortunately there’s no real quick-fix here if it’s truly a tendinopathy that you’re dealing with. You’ll 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 tendinopathies is done by loading the affected tendons appropriately; not enough load and they don’t get better but too much and you make it worse.
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).
Perform the exercise for about three sets of ten reps with the elimination of that pain occurring while under load.
If you’re in the right loading stimulus for the tendons, the discomfort should actually be gone by the end of your third set. Repeat this a few times per week. Keep upping the load as the weeks go on so that you stay in this pattern. Be patient. I sometimes refer to this as being in “tendon purgatory” when treating lifters for tendinopathy in the clinic.
If you want to expedite the recovery, you can look to outside treatment adjuncts from qualified healthcare practitioners. Extracorporeal shockwave therapy (EST) is the gold standard for treating tendinopathies when followed up with appropriate loading right after being performed.
When it comes to your workouts, you may want to try a counterforce brace, which is a strap you wear around your upper forearm. This can greatly help take tension off the irritated portions of tendons. You can also spring for some neoprene elbow sleeves. Neoprene sleeves won’t do anything from a structural standpoint, but the added compression and warmth that they provide can have pain-relieving effects for lifters with tendinopathy in their elbows.
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.
One exercise that might allow you to train around your elbow pain is the Reverse Grip Bench Press. Check out my complete guide to learn more.
Issue #2: Bursitis Of The Elbow
Results from: Excessive or repetitive pressure placed on the back of the elbow against a hard surface, such as when doing floor press.
Closely related to the category of tendinopathy is another condition known as bursitis. Our bodies are in fact filled with well over a hundred of little water balloon-like structures known as bursas. These little guys act as friction reducers for tendons, allowing tendons to effortlessly glide and move over other tissues without sustaining friction-induced irritation.
The problem is that these little water balloon-like discs can actually become irritated and inflamed themselves. When this occurs, pain usually shows up. In the case of elbow bursitis, a particular bursa pad, known as the olecranon bursa becomes inflamed and rather painful when performing elbow movements.
Olecranon bursitis is in fact the most common area in the body for bursitis to occur. It tends to look a bit more serious than it actually is, despite the pain it can cause. If you’ve ever seen the tip of someone’s elbow appear as if it had a soggy golf ball underneath the skin, you were likely looking at a case of olecranon bursitis.
Thankfully, it’s rather self-limiting and typically doesn’t require specific medical intervention, so long as the bursa itself doesn’t become infected.
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). It typically worsens with elbow movements and tends to be the result of sustained and receptive pressure placed on the elbow or high volumes of elbow movement against resistance.
How To Fix Olecranon Bursitis
Since olecranon bursitis most often occurs due to repetitive pressure on the back of the elbow, your first step should be to cut out any exercises that place pressure over that region, such as floor presses.
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). An over-the-counter or prescription anti-inflammatory medication is likely a good starting point if you’re trying to get rid of this condition as quickly as possible.
In addition to NSAIDs, gentle compression of the elbow may help reduce the excessive amounts of fluid within the area, so consider wearing an elbow sleeve during your workouts and throughout the rest of the day, so long as it doesn’t further irritate the bursa (which would cause more pain).
Unfortunately, there’s no magical exercises that work to “fix” the issue; it simply takes a bit of time for things to calm down and fully resolve. Your best bet is to reduce training volume and/or load for benching until it resolves.
Try to keep performing bench press or variations at loads that don’t seem to stir up the pain. So long as you stay below this threshold, benching should still be fine. If you really have to lighten up on your bench pressing for the next bit, consider this a good time to work on perfecting your technique.
You can also spring for other anti-inflammatory measures, such as ice, but in today’s scientific community, the verdict is still out as to whether or not this actually influences bursitis to any favorable extent or not.
Issue #3: Fixing Poor Bench Press Technique
Those who have never bench pressed before or those who haven’t pursued it in a serious manner oftentimes fail to understand the world of technique and subsequent motor control that goes into bench press.
Not only does flawless technique add serious weight to your one rep max, but it also drastically decreases the likelihood for pain flaring up in your elbows.
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 they’ve been at it.
You should do the same since consistent movement errors, even rather small ones, such as bar path, chest placement and grip width can all wreak havoc on the health of your elbows.
If you’re still not convinced, talk to any decorated powerlifter and they’ll lecture you about it likely even more than I myself would (which is really saying something).
How To Fix Poor Bench Press Technique
There are a few strategies to implement here. The main one is to simply video yourself going through your bench workout.
Video yourself while benching at different loads and see if your technique changes based on the load you’re using or how tired you’re getting. Make sure to film a few reps from the side and some from a straight-forward angle, as each view can offer valuable insight.
Once you’ve got some video footage and you know what you’re looking for, take some time to look it over and see what you can find. Don’t sweat it if you don’t know what to look for; I’ll give you some ideas in the section below.
Look For Bar Placement Consistency On Each Rep
If you’re inconsistent with your bar placement (some reps landing too low on your chest and/or other reps landing too high) then there’s likely unnecessary amounts of torque going into your elbow joints as a result. Remember, the heavier you go with your weights the greater the torque running through your elbows will be.
In other words: the heavier you go on your bench, the more pristine your form/technique needs to be on each and every rep, assuming you want to save your elbows from unnecessary pain.
Look For Asymmetrical Movement From One Arm To The Other
Bench pressing is a pretty symmetrical movement from one side of the body to the other, yet plenty of bench pressers unknowingly don’t hold their arms in symmetrical positions when benching.
Reasons for this occurring are typically from a lack of awareness (a motor control issue) along with joint mobility issues within the shoulder.
It may also be due to muscular strength imbalances throughout the shoulder and arm as well. The result of all of this can be asymmetrical demands (forces) placed on an elbow joint.
When watching the video of your technique, look at the symmetry of your arms throughout the entire movement. Look to see if one arm is turned inwards more than the other and if one elbow flares out more than the other. These are commonly found technique issues in those experiencing elbow pain. Lifter’s oftentimes refer to this as “elbow flare”, and if your flare is different from one arm to the other, it’s a good indication that one of your elbows is enduring different and/or more biomechanical stress than the other.
When you examine your form from the side, look to see if there’s a difference in forearm direction (as in this picture above). This signifies that each one of your elbows is undergoing different torque demands as you bench, which could be leading to your elbow pain.
A side examination should reveal rather symmetrical forearm direction, indicating symmetrical torque and load running through your elbows as you bench.
You’ll need to determine why the asymmetry is occurring, which I can’t do for you, but consider examining your shoulder and wrist mobility as the starting point. If one is moving differently from the next, you’ll need to address that.
Otherwise, take time to practice your technique with just the barbell until you groove a new movement pattern into your muscle memory.
From the straight forward view, notice the difference in shoulder position from one side to the other, which greatly influences elbow stress. In this photo, the difference in elbow flare from one side to the other (highlighted with red angles and orange coloring) is what can result in abnormal stress on an elbow joint when benching.
You can read more about this in my article on Uneven Bench Pressing.
Look For Grip Width On The Barbell
Grip width is often overlooked in novice bench pressers and it considerably influences how elbow structures must adapt and tolerate loads as a result. Grips that are wider tend to place more structural stress and strain on the inside portion of the elbow, especially at the bottom position of the bench press.
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. The more stress you place on the triceps tendon insertional point, the greater the likelihood of incurring tendon-related elbow pain.
While you (or your coach) will need to determine which grip width is most ideal for you, it’s worth trying different widths to see how they impact your elbow pain (both while during the bench press itself as well as afterwards).
You may also want to avoid or incorporate certain grip widths based on what makes your elbow feel better and/or worse. If your current program calls for certain bench variations (narrow-grip bench, wide-grip bench, etc.), you may need to either avoid those variations, modify them, or even perform them more frequently based on how your elbow tolerates each one.
Check out my article on my top bench press accessories.
Consider Hiring Out A Coach To Help You Improve Your Technique
In order to fix your technique issues, you need to know what you’re looking for. If you don’t, then seeking out a coach who can analyze and critique your form is your best bet. It’s absolutely money well spent. You can work with them in person or send them videos of you benching and get their expert feedback. Remember, even the best bench pressers have coaches who help them continue to perfect their technique.
Once you’ve sought out a coach (or even if you already know what you need to work on), it’s time to devote some extra practice to cleaning things up. Don’t be afraid to put more technique-focused sessions into your training.
This will be extremely valuable since these sessions will be lighter in load, allowing time for your pain to settle down while correcting the issues that caused the pain in the first place. 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.
There can be numerous reasons as to why you can experience pain in your elbows when benching. 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.
Don’t be afraid to take some time to explore why you’re experiencing pain. If you’re stumped, get a qualified strength coach and/or healthcare practitioner to take a look at things – it will likely be money well spent. Above all else, don’t try to simply ignore the pain and push through it. Your elbows as well as the longevity of your lifting career will both thank you.
About The Author
Jim is a physical therapist, strength & conditioning specialist and former competitive powerlifter. 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.