Lateral epicondylitis, commonly known as Tennis Elbow, affects the tendons on the outer side of the elbow. It involves the degeneration or micro-tearing of the common extensor tendon, particularly the Extensor Carpi Radialis Brevis (ECRB) muscle, where it attaches to the lateral epicondyle bone. Weightlifting can cause this condition, as the repetitive strain and high forces involved in training frequently lead to this overuse injury. This condition is not exclusive to racket sports athletes and causes discomfort for many regular weightlifters.
How Weight Training Causes Lateral Epicondylitis
Weight training provokes lateral epicondylitis by placing excessive and repetitive strain on the forearm’s extensor muscles. These muscles are responsible for extending the wrist and fingers, and they are constantly engaged during gripping and stabilizing movements. The injury often begins not from an acute tear but from chronic micro-trauma, where the tendon tissue cannot repair itself fast enough between training sessions.
This mechanism is pronounced during exercises demanding a heavy or sustained grip, such as deadlifts, rows, or pull-ups. In these movements, the forearm extensors work intensely to stabilize the wrist and prevent it from dropping into flexion against the weight’s pull. This isometric contraction overloads the ECRB tendon at its attachment point on the elbow.
The eccentric, or lowering, phase of many lifts also contributes to the breakdown of the tendon structure. For example, during a bicep curl, the forearm extensors work to maintain wrist position as the weight is slowly lowered, creating a high-tension scenario. Poor wrist alignment, such as extending the wrist during pressing movements like the bench press, channels undue strain directly to the extensor tendon origin.
Using an improper grip, such as one that is too narrow or too wide, can alter the biomechanics of the forearm muscles, placing a non-optimal load on the extensor tendons. High-volume training, insufficient recovery, and technique faults push the tissue beyond its capacity for adaptation and repair. This chronic overload leads to a degenerative process within the tendon, resulting in the pain characteristic of lateral epicondylitis.
Identifying the Symptoms of Tennis Elbow
Identifying Tennis Elbow involves recognizing a specific pattern of pain centered around the outer aspect of the elbow. The primary symptom is localized pain and tenderness directly over the lateral epicondyle, the bony bump on the outside of the elbow joint. This discomfort can often radiate down the forearm toward the wrist or up the arm toward the shoulder.
The pain is typically aggravated by activities that involve gripping, twisting, or extending the wrist and fingers. Simple daily actions like shaking hands, turning a doorknob, lifting a coffee cup, or carrying a heavy bag can trigger a sharp increase in pain. Many people also report decreased grip strength, making it challenging to hold onto dumbbells or barbells during a workout.
It is important to differentiate Tennis Elbow from Golfer’s Elbow (medial epicondylitis), which affects the inner side of the elbow. Tennis Elbow involves the wrist extensor muscles, causing pain upon wrist extension, while Golfer’s Elbow involves the wrist flexor muscles and causes pain with wrist flexion. If the pain is exclusively on the outside of the elbow, it points strongly to lateral epicondylitis. If pain is persistent, severe, or accompanied by numbness or tingling, seeking a medical assessment is advisable.
Treatment and Safe Return to Exercise
Initial treatment for Tennis Elbow focuses on reducing irritation and promoting healing. This phase often involves resting the affected arm by temporarily avoiding activities that cause pain, which for a weightlifter means modifying or stopping specific exercises. Applying ice to the outer elbow for fifteen minutes several times a day can help manage localized discomfort.
Physical therapy is a fundamental component of recovery, concentrating on restoring the tendon’s tolerance to load. This typically includes gentle stretching of the wrist extensor muscles and, later, incorporating specific strengthening exercises. Eccentric strengthening, where the muscle lengthens under tension, is often prioritized, such as slowly lowering a light weight during a wrist extension exercise.
Returning to the gym requires a deliberate and gradual progression to prevent re-injury. Weightlifters should temporarily avoid high-risk movements like heavy deadlifts, cleans, or exercises requiring a fixed, heavy grip. Modifying technique by using a neutral grip (palms facing each other) on certain dumbbell exercises can significantly reduce strain on the extensor tendons.
Assistive devices are beneficial in managing the load on the healing tendon. Wearing a counterforce brace or strap just below the elbow can help disperse the force away from the injured attachment point during lifting. As pain subsides, the load should be increased very slowly, ensuring that any new exercise or weight increase does not cause a flare-up of symptoms within the subsequent 24 hours.