Elbow pain is a frequent barrier for lifters who prioritize the bench press, often leading to missed training sessions or reduced lifting weight. Moving beyond simple rest requires understanding the underlying anatomical structures and the specific mechanical forces generated by the movement. Identifying the root cause, whether biological or technical, is the first step toward a long-term, pain-free pressing routine.
Common Anatomical Causes of Elbow Pain
The elbow joint is a complex intersection where several muscle groups attach via tendons, which are susceptible to overuse injuries during heavy pressing movements.
Pain on the inside of the elbow is often classified as medial epicondylitis, commonly called “golfer’s elbow” or “lifter’s elbow.” This condition affects the common flexor tendon, the attachment point for forearm muscles responsible for gripping and wrist flexion. Repeated, uncontrolled loading can place excessive strain on this attachment site.
Discomfort localized to the outside of the elbow is known as lateral epicondylitis, or “tennis elbow.” This involves the common extensor tendon, which manages the muscles that extend the wrist and fingers. It can occur when the wrist is forced into an extended position under load, causing the extensor muscles to stabilize the joint. Both conditions are tendinopathies, representing a breakdown in the tendon structure.
A third source of pain is triceps tendinopathy, causing discomfort at the back of the elbow where the triceps tendon inserts into the olecranon process. This pain is often noticeable during the final phase of the press, known as the lockout. The triceps muscle is heavily recruited to extend the elbow against resistance, and sudden increases in volume or a narrow grip can quickly overload this tendon.
Bench Press Technique Flaws That Stress the Elbow
The way the bar is moved directly dictates the stress placed on the elbow tendons and joints.
A common mechanical error is excessive elbow flare, where the elbows travel perpendicular to the body instead of tucking toward the hips. This positioning forces the humerus into internal rotation, placing considerable torque and strain on the medial aspect of the elbow joint. Maintaining an elbow angle closer to 45 degrees relative to the torso helps stack the joints efficiently and distributes the load across the chest and shoulders.
Grip width also plays a role in determining which structures bear the most stress. An excessively narrow grip forces the elbows into deep flexion, significantly increasing the demand on the triceps and its tendon. Conversely, a grip that is too wide increases shearing forces on the elbow tendons. Finding a grip that allows the forearms to remain vertical at the bottom of the lift ensures optimal joint alignment.
The angle of the wrist is another factor in elbow health. Many lifters allow their wrists to hyperextend, or bend backward, under the barbell weight. This extended position places the wrist flexors and extensors, which attach at the elbow, under constant tension. Keeping the wrist straight and stacked directly over the forearm maintains a neutral position, reducing passive strain on the tendon attachments.
Finally, the bar path influences joint stack and elbow stress. An ideal bench press utilizes a slightly angled path, where the bar touches the lower chest and finishes over the shoulders. A purely vertical path, especially with flared elbows, moves the weight away from the body’s center of mass, increasing the moment arm and placing unnecessary strain on the elbow joint and stabilizing muscles.
Recovery Strategies and Load Management
Addressing elbow pain requires prioritizing tissue healing and load tolerance over immediate strength gains.
The initial step involves temporary modification of the aggravating activity, such as switching from a barbell to dumbbells, reducing volume, or implementing a “soft lockout.” The goal is to continue training below the threshold of pain (a discomfort level of three out of ten or less) to maintain tendon health without causing further irritation.
Targeted rehabilitation exercises focus on strengthening forearm muscles and increasing the load capacity of the affected tendons. Eccentric training, which involves slowly lowering a weight, stimulates tendon repair. Movements like slow wrist curls and reverse wrist curls, performed with light weight for high repetitions, build resilience in the flexor and extensor tendons. Low-load triceps pushdowns with a slow eccentric phase can strengthen the triceps tendon.
A comprehensive warm-up is an effective preventative measure that should precede every pressing session. This should include dynamic movements for the shoulder and light-resistance work for the elbow and forearm. Using a light resistance band for rotation exercises helps prime the shoulder stabilizers, contributing to better elbow control. Performing several sets of the main lift with light weight, focusing on perfect technique, prepares the tendons for the heavier load.
If pain is accompanied by acute swelling, joint instability, or numbness extending into the fingers, it may signal a more serious issue like nerve involvement. Consulting a physical therapist or a sports medicine doctor is advisable. A professional can provide an accurate diagnosis and prescribe a progressive loading program to safely guide the tendon back to full health.