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Elbow Pain and Squatting; What To Do

One of the biggest problems faced by lifters is the dreaded elbow pain. A nagging, persistent problem that is down right annoying. Sometimes it’s hard to put a finger on the mechanism of pain but as someone who has experienced it firsthand, I can tell you it can be quite debilitating. This article today explores what could be causing the pain, how to train around it as well as some methods of fixing the problem. I hope it helps.

What is causing the pain?

Like a lot of things when it comes to the human body it’s not always one thing in isolation but several things that could be contributing to your pain. Let’s go over them:

Bar position overloading the elbow itself – at times we see lifters place the bar too low on their back which causes the elbows to bear the brunt of the load. Ideally, we will create a shelf across our rear deltoids coupled with retraction of our scapula, and our upper back will hold the load rather than our wrist and elbow. This is a technical error which can easily result in overloading and irritation of the tendinous structures at the elbow which under heavy squat loads is a relatively small, weak joint with typically no protection in the form of a wrap etc

Limited external rotation at the shoulder – This is probably the most common problem area for most lifters, especially the big boys. Tight anterior musculature and/or internal rotators such as latissimus dorsi, pectoralis minor, biceps brachii and subscapularis may be limiting external rotation at the shoulder. Under heavy loads, in a stretched and less than optimal position this may create irritation and inflammation of a number of structures such as the anterior shoulder, long head of biceps and the elbow itself.

Loaded extended wrist position: With limited external rotation at the shoulder (as mentioned above) we may be forced into an loaded extended wrist when placing the bar in a low bar position. This may place the wrist flexors that originate from the medial epicondyle of the elbow to be stretched maximally and overloaded.

Training around the pain.

Luckily you aren’t the first person to have sore elbows from squatting and you won’t be the last. Awesome gyms like Smith’s Fitness have got you covered. In the event that you are experiencing the dreaded elbow pain you can still train your squat and you can still get stronger, here are your options:

Buffalo Bar – The buffalo bar, or bent barbell is the closest relative to a traditional straight bar squat. The bar can still be placed in the same low bar position but due to the bend in the bar the mobility demands are not as great. For me this is a great tool to use when lifters can feel the onset of elbow pain.

Safety Squat Bar – The SS Bar is a must have for strength gyms, a great tool in itself but also a great alternative for injured athletes and those with insufficient mobility. It will create a slightly different style of squat due to the camber of the bar creating a more anterior load. Regardless of this it’s still a fantastic tool.

Belt Squat – The Belt Squat completely takes out the need to hold anything. It allows you to train your lower body with high load and volume without stressing both the spine and shoulder complex at all. Great as a secondary exercise and great for those with upper limb injuries.

Fixing The Problem

Firstly, if this is a persisting problem please seek out a knowledgeable physiotherapist, hopefully someone with experience dealing with people who strength train.

Improve Shoulder External Rotation: There are a plethora of mobility exercises that will help improve your shoulder external rotation. From the simple door frame pectoral stretch to an assisted dowel front rack stretch. Find a couple that you feel work and complete them diligently throughout your training week.

Trigger point therapy on Infraspinatus: A study by J Kwon et al (not the rapper who sang Tipsy) investigated 380 Infraspinatus muscles with myofascial trigger points (a great sample size) finding that the most common area of referred pain was the antero-lateral aspect of the upper arm, right above the elbow. Referred pain is quite a complex issue, but just know, if you include some trigger pointing with a ball or whatever implement you choose, you may find some relief. At least, you’ll be covering your bases.

Isometric Bicep Curl: Again, we are covering our bases here. We know that isometric contractions have been shown to have an analgesic (pain relieving) effect on patients with patella tendinopathy. Whilst we should definitely not diagnose ourselves, it may be worthwhile performing some light isometric contractions before/after training sessions as it may elicit some relieving effects. I’d suggest starting light with 3 sets of 45 seconds at about 100 degrees of elbow flexion.

Try a thumbless grip: A thumbless grip might feel strange to begin with but like most changes you will get used to it over time. The thumbless grip allows you to maintain a straight wrist position which may alleviate the stress placed through the elbow flexors.

Finishing Up

Elbow pain sucks, believe me. As a powerlifter you should be proactively addressing these areas to ensure pain free lifting. At the end of the day, there isn’t one answer for all elbow pain, rather a number of things to try, experiment with and implement. Just know, there are ways to train around these issues and ways to address it.

Feel free to get in touch via social media to discuss any and all things strength & fitness.


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