Pushups are a basic calisthenic exercise that strengthens the chest, shoulders and arms. Pushups can elicit elbow pain for two main reasons: The elbows are straight and supporting the weight of the upper body in the upper position and the elbows move through a large range of motion from the lower position to the upper position. Poor technique, over-training, weak stabilizer muscles and inflexibility contribute to elbow pain induced by pushups.
Elbow pain associated with pushups is usually either medial epicondylitis or tricep tendonitis. Medial epicondylitis, nicknamed golfer's elbow and stair-climber's elbow, is pain, weakness, tenderness and fatigue on the inner, or medial, aspect of the elbow. Tricep tendonitis is inflammation of the tendon that attaches the triceps muscle to the bone. Pain from tricep tendonitis is felt in the back of the arm, just above the elbow, and is described as deep and aching.
Over-training is the most common origin of pushup associated elbow pain and easiest to correct. Over-training is performing too much too soon with inadequate rest between training sessions. Start at a level appropriate for you and increase in gradual increments with the number of sets and reps. If muscle soreness or fatigue still exists from your previous pushup workout, rest for another day or two to allow your body time to adapt, heal and grow.
Poor technique is a major source of pushup related elbow pain. Improve your technique by planting your hands directly beneath your shoulders; with your fingers pointing forward or slightly in. Once you have found your ideal hand position, make sure you distribute the weight evenly across your palms. Most exercisers place too much bodyweight on the thumb side of the palm which can lead to wrist, elbow and forearm pain.
Weakness in the core muscles leads to fatigue and sloppy pushup technique. Your upper body and lower body should be in a straight line while executing pushups. If you are unable to maintain correct body alignment while performing pushups, you increase the risk of elbow injury, due to the greater amount of stress placed on the joints. Performing a well-rounded core-strengthening routine helps improve your pushup technique, while reducing the possibility of injury and maximizing benefit.
Inflexibility contributes to a large number of injuries including tricep tendonitis and medial epicondylitis. Perform a thorough warm-up and cooldown that contains static stretches and dynamic range of motion exercises targeting the entire upper extremity to increase muscles flexibility and joint range of motion to help prevent injury. Stretching expert and author of the book "Stretching," Bob Anderson recommends holding a comfortable elbow behind the head stretch for 15 seconds to stretch the triceps muscles.