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The triceps extension is a popular exercise in gyms all over the world and is a favorite of many bodybuilders and powerlifters. As with most weight-training movements it does have a potential for pain and injury, however. The most common complaint associated with triceps extensions is elbow pain.
I addressed one source of elbow pain from triceps training in a July 1980 issue of IronMan - "Triceps Training and Elbow Pain" - specifically how the position of the wrist reduces the stress on the wrist flexors, which are the origin of the forearm muscles, at the inner side of the elbow, the medial epicondyle.
Trainees who add substantial weight to the bar when they do lying triceps extensions usually experience elbow pain in both the inner side of the elbow and at the triceps insertion. The added weight is necessary for the powerlifter to strengthen the triceps and for the bodybuilder to add intensity to his workout, but the pain always seems to derail those idealistic intentions.
There is a training flaw that permeates the workout programs of many recreational trainees and that is central to this discussion. This flaw is the mistaken notion that all exercises must be performed in a linear and perpendicular manner - that everything must be done at 90-degree angles for the movement to be correct. Unfortunately, the body does not always work that way, and this rigid adherence to what is believed to be "doing it right" and "strict form" can lead the body into a movement that is entirely unnatural and that can produce injuries.
Patients at the Soft Tissue Center who suffer from elbow pain usually describe their performance of lying triceps extensions in one of several ways. The trainee lies on a bench with a bar supported over his or her torso. Then the trainee either 1) lowers the bar to the nose, 2) lower it to the forehead, 3) lowers it behind the head or, 4) drops it back in a pullover type movement.
These variations are listed in decreasing order of elbow pain; that is, the bar lowered to the trainee's nose causes the most pain and the pullover-type movement causes the least. This makes sense when you consider the bar-to-the-nose method usually involves the elbows being "held high? or at right angles, "pointing to the ceiling," to make the movement "strict." This torque and leverage are where the problems begin.
The alternative triceps extension performance has an interesting history . . .
The World's Strongest Man competition was first held in 1977, and in '79 one of the contestants was World Super-heavyweight powerlifting champ Don Reinhoudt. During the precontest television coverage Reinhoudt used a form of lying triceps extension that I had never seen before, and he was doing easy reps with 315 pounds. Bill Kazmaier, who was the World Super-heavyweight champion after Reinhoudt, wrote articles for Iron Man in which he discussed a movement similar to the one that I saw Reinhoudt perform. Kaz reported that by doing the modified triceps extension he was able to progress from 200 pounds for reps to the nose with "screaming elbows" to 425 for reps with no elbow pain. Kaz also wrote several pamphlets on training, and the one titled "Bill Kazmaier & the Bench Press" features this modified exercise, which he called the lying triceps push.
Keep in mind that Reinhoudt bench-pressed 600 pounds, and Kazmaier did 663.
Former powerlifting world record holder in the 275-pound class David Shaw says, "I have used this movement since 1979. I wanted to experiment with a triceps exercise that would not place the joint in a precarious position, because exercises like the French press gave me elbow pain. I was looking for something besides the close grip bench press, and I chose the modified triceps extension due to the fact that it was easier to handle with an EZ-curl bar.
"Elbow pain had been a problem early on in my career, but that stopped with the change in the exercise. I would do one set of 8 reps with a 45 on each side, one set of 6 with two 45's on each side, one set of 5 with two 45's and a 25 on each side, and finally two sets of 5 with three 45's a side. The only difficulty with this exercise is getting that much weight into position if you train alone. I had a bench with narrow uprights, and this worked well."
If you train in a gym or with a partner, get a lift into the starting position.
Three things are evident from this history. First is the interesting idea that three world class powerlifters came upon this modification of the lying triceps extension at approximately the same time but completely independent of each other, and it enabled them to handle heavy weights without excruciating pain.
Second is the tie-in to periodization, a subject that I recently discussed in the May 1992 issue of Iron Man. In the article I talked about training for a total of 24 to 36 reps per exercise and no more. David's workout on the modified triceps extension is made up of 29 reps including the warmup. In last month's column, "The Reverse Grip Bench Press"
another world class powerlifter, Steve Miller, said that his bench press routine totaled 39 reps including warmups. Both Shaw and Miller lift well over 500 pounds in the bench press. The point is that Shaw and Miller were not trying for a specific rep total, and they didn't know they were going to be asked about it or have their routines analyzed. The effective total rep range appears to be 24 to 36.
It's actually very easy to perform the modified triceps extension. The movement is a combination of the standard lying triceps extension and the close grip bench press.
Hold the bar overhead as if you were going to perform a lying triceps extension. Lower the bar over your upper chest, allowing your elbows to drop somewhat, but don't let them go below the bench, the way they would if you were doing a close grip bench press. The elbows do not drop below the height of the bench.
You may touch your chest, however, the movement is still effective if you stop the bar several inches above your chest.
Finish the movement by pushing the bar back up in a steady, even manner.
Allowing your body to move in a more natural manner is not "cheating," and keeping your arms perpendicular is not more "strict" or "right." The elbows will be fully bent in the bottom position and fully straight in the top position. The only way the elbow can straighten out like this is if the triceps extend the elbow; there is no other muscle group that can do this in the described position. The triceps does the job and receives the stimulus, which is why you can stop the bar in the bottom position while it's still several inches from your chest.
Note the full bend in your elbow when you try the movement.
When you begin any new exercise, or try a new tweak on any exercise, use a light weight to learn the unfamiliar motor patter and let your body adapt to the new demand. You'll find that you'll adjust to this movement quickly. Likely you'll soon be using twice as much weight as you did in the standard lying triceps extension - and without elbow pain.
Remember that if your elbows are bent and then you straighten them, the triceps have performed their work. The slight movement of the shoulders that occurs will make the movement much more comfortable and also something of an accessory movement to the bench press.
This exercise is a healthy alternative to the standard lying triceps extension, and it is quite effective for strength building as well as bodybuilding.
Let go of the concept that weight exercises must be so linear - your body knows how to move, and it's much wiser and more efficient to let it find its most effective way to do it.
Give the modified lying triceps extension a try, and see if your poundages don't increase substantially.
Enjoy Your Lifting!