Don Ross, Serge Nubret
Training With Sore Elbows
The three most common injuries to the elbows are joint injuries from hyperextending the elbow, tennis elbow, and sore tendons in the back of the elbow [though not listed, golfer's elbow is my personal least-favorite, most-frustrating].
Generally, avoid lockout movements in triceps exercises and full extension during biceps curls when training with an elbow injury.
This section deals with a common injury experienced by most trainees at some point, tendinitis at the triceps attachment. It starts with tenderness at the elbow after triceps work. This gets progressively worse as you continue to work out, until the elbow twinges with constant pain. This pain can be severe enough to wake you in the middle of the night.
The major cause of sore elbows is triceps extensions where the elbows are extended away from the sides of the body. When you raise your arms with elbows bent, muscles and tendons are tightly stretched and taut. This, combined with pressure during heavy triceps presses puts tremendous tension on the tiny tendon connecting the powerful triceps to the elbow.
Triceps exercises that don't tend to hurt the elbows as frequently are those where your upper arms remain in line with your body, such as pulley pushdowns and bent-forward triceps kickbacks. This eliminates those exercises considered to be mass builders, including standing and lying triceps extensions and wall pulley extensions. Even pushdowns and kickbacks done with heavy weight will contribute to the problem.
Pre-exhaust the muscle with the pyramiding method. This will thoroughly warm you up. It will pre-exhaust the muscles. For bodybuilding purposes here, weights too light to re-injure your elbows will have the same effect on the muscles as a heavy weight through increased workout intensity. Do the same with bench and overhead presses, or any exercise that causes elbow pain. This will build strength and size, giving you a good muscle pump without heavy weights.
Begin with triceps pushdowns on the overhead pulley. Do these movements very strictly and slowly. Keep your body back and your elbows at your sides. Never lean into the bar or raise your elbows up to gain leverage to swing the bar back down. Begin with a very light weight. Do 10 strict, slow pushdowns, then stop, even though you could do 30 or more reps with that weight. Quickly increase the weight 10 pounds and push out 8 more reps. Continue increasing in 10-pound increments. Don't rest at all between sets. Make the weight change and keep going. As you continue, you will no longer be able to complete 10 reps, but do as many as possible. Once you have increased (without rests) to a weight where you can only do 2 or 3 reps, start decreasing the weight with each set. Continue performing as many reps as possible until you are back down to your starting weight. By this time, that light weight will feel like a ton to your muscles.
Complete your triceps work with 3 or 4 sets of kickbacks. Use light dumbbells that you can do 20 reps with. Do all of your sets with the same weight. Do each until no further reps can be performed. Take only a few seconds rest between sets.
Training Around Tennis Elbow
Twisting movements while supinating heavy dumbbell curls or heavy reverse curls are a frequent cause of so-called tennis elbow. This can also happen while using a screwdriver, throwing, or swinging a racket. Referred to by physicians as "medial epicondylitirais," this injury is an inflamed, irritated tendon that attaches to the upper bone on the outside of the forearm.
You will experience extreme pain during any exercise where your lower arm twists, or your wrist flexes backwards. Exercises done with your palms down, including side lateral raises and front raises for your shoulders, will hurt the injury.
Train around this injury by altering all your exercises to avoid pressure on the area. All lateral exercises to avoid pressure on the area. All lateral exercises, including front raises should be done with a thumbs-up grip on dumbbells, or with a parallel grip curling bar. Do all chinning and lat exercises with a palms-away grip. Eliminate supinating and reverse grip arm exercises through the duration of the injury. Do all curling movements with palms facing each other or palms down. Refrain from all reverse grip direct forearm work (especially reverse wrist curls).
Pyramid on your arm exercises, as described above. When training your shoulders or doing incline presses or dumbbell chest exercises, have the weights handed to you. Don't clean the weights to your shoulders, as this requires a heavy reverse grip movement. Generally speaking, continue to train, but eliminate or modify any exercise that causes irritation to the area.
Biceps Training With Sore Tendons
Biceps tendon paths should be taken very seriously. Whether the pain is in the crook of your arm, the back of your forearm, or deep in the front of your shoulder, give it immediate attention. These pain are often isolated in a small area and can be mistaken for deltoid or forearm injuries. If ignored, you may be in the middle of a hard biceps exercise, feel and pop and see your biceps muscle roll up or down your arm like a window shade. Surgery would then be necessary.
When you experience pain in any of these areas, test your biceps to see if it is a biceps tendon. Do this by curling against resistance applied by the opposite arm and see if the pain increases. If it does, lay off of all biceps work as well as upper back work and dumbbell cleans. When the pain subsides, continue these exercises, but do it in the pyramiding fashion described earlier. If you experience moderate pain in those areas nd decide to continue to train, use light weights. Do sets of 20 reps.
If the pain is in the lower biceps tendon, eliminate preacher bench curls. Do light vertical curling exercises. If the pain is in the upper tendon, exercises for the biceps that provide maximum tension at the point of complete contraction. This includes vertical or spider bench curls. Stick to light, high-rep, vertical curl exercises. Beware of heavy upper back work during the injury, including heavy lat pulldowns and chinups. Limit biceps exercises to those that affect the injury least. Ice the area afterwards. An elastic elbow brace can be worn during workouts to further support the area.
Enjoy Your Lifting!