Cranky joints aren't just a sign that you're getting older. Something might actually be wrong, so don't simply work through the pain. Elbow injuries aren't as common as problems with the lower back or knees, but they can be difficult to deal with. Many require rest, physical therapy or even surgery.
What Could Go Wrong?
The elbow is similar to the knee joint. It isn't as variable and complex as the hip or shoulder joint. It essentially bends only forward and backward with some slight rotation. It's a hinge joint which means it's similar to the hinges on your doors.
Without much range of motion, there aren't many complicated problems for your elbow to face. For the most part, injuries from weightlifting will simply be overuse injuries, which aren't as serious as breaking a bone, but can take longer to recover from.
There are a few things that can cause elbow pain after a workout. You can damage tendons and ligaments, strain a muscle, compress nerves or irritate the bursa sac. If your elbow hurts, the first thing you should do is see a doctor, who can help you get to the root of the problem.
Even if you think you know what's going on with your elbow, a doctor can run the appropriate tests to determine the cause of your pain. It might be something benign that won't even interfere with your workout, or it could be something serious that forces you to rest. Knowing the anatomy of your elbow will help you understand what could be wrong.
Bones of the Elbow
Your elbow joint is made up of two main bones: the humerus and ulna. The ulna is a forearm bone that hooks around your humerus, which is the upper arm bone. That forms the pointy part of your elbow. The radius is the other bone in your forearm, which runs parallel to the ulna. It's connected to your humerus by muscles and ligaments.
Ligaments of the Elbow
While it's a fairly simple joint, there are a few ligaments and muscles running across your elbow joint. Ligaments hold your bones together. They're incredibly strong bands of connective tissue.
According to an article from Washington University Physicians, there's a lateral, or ulnar collateral, and medial, or radial collateral, ligament in your elbow that prevent it from moving too far to either side. The ulnar collateral ligament is on the inside of the elbow, while the radial collateral ligament is on the outside.
The third ligament is the annular ligament. It holds the radius against your arm bone, the humerus.
Ligaments in the elbow can be either sprained or torn, ranging from microtears to complete tears. Few weightlifting movements cause damage to your elbow ligaments. Side-to-side motions are the most dangerous, since that's the movement your ligaments protect the most.
UCL Ligament Tear
Although rare, it's possible to develop a ligament injury on the inside of the elbow from weightlifting. The ulnar collateral ligament runs across the inside of the elbow and prevents the joint from buckling in.
Baseball players commonly injure this ligament due to the incredibly high speed at which they throw. A quick throwing motion puts tremendous stress on the inside of your elbow. If you feel inner elbow pain while lifting weights, a UCL strain could be the cause.
If you actually tear your UCL, it requires something called Tommy John surgery, which is a baseball reference since the injury is common in pitchers. If you partially tear your UCL, you can try resting it.
Your doctor might recommend taking anti-inflammatory medication and icing the injury. Then, you'll go to physical therapy to strengthen the ligament and surrounding muscles so you don't run into the same problem again.
Very few weightlifting movements move your elbow laterally, so the radial collateral ligament is very rarely injured. The same goes for the annular ligament.
Muscle and Tendon Injuries
The biceps and triceps, the two biggest arm muscles, run across the elbow joint. They both cover the length of the humerus. The bicep is in front of the arm and the tricep is in the back.
The tendon of your bicep goes down into your elbow through the front of your arm. It connects through the elbow joint and into your radius bone. When you lift weights, your muscle contracts and pulls on your tendon. The tendon attaches to bone and actually moves the bone. That means all the force your muscles produce must go through the tendon.
Even though they're incredibly durable, tendons can come under too much stress. Sometimes they completely tear, but more often than not, they simply become inflamed. Inflammation of a tendon is known as tendinitis.
Bicep Tendon Tears
To treat bicep tendinitis, you should start by eliminating moves that involve the bicep. That includes curls, chin-ups and rows. Some sports like tennis can also aggravate the bicep tendon. You can also take anti-inflammatory drugs and ice the area to promote healing, according to an article from Intermountain Healthcare.
If the injury is severe enough, the entire bicep tendon can tear. In that case, you'll need surgery. As long as you have an operation within two to three weeks after your injury, you can fully heal the bicep tendon and get back to normal. However, it can take up to three months to heal completely even if you're doing physical therapy.
Tricep Tendon Injuries
A similar injury can occur to the tricep tendon, which runs down the back of your elbow. However, tricep tendon injuries are much less common than bicep tendon injuries, according to a 2014 paper published in the Clinical Journal of Sports Medicine.
Weightlifting movements that involve pressing, like the bench press, or even pushups, strain your triceps tendon. If you have inflammation and pain in the back of your elbow, it could be triceps tendinitis, which means that you have to avoid pressing movements and rest your triceps. A full tear of the triceps tendon requires surgery and months of recovery.
Tennis and Golf Elbow
Some of the muscles of your forearm also run across your elbow. The wrist extensor muscles that pull your hand back connect to the outside of your humerus. The wrist flexor muscles that pull your hand forward connect to the inside of your humerus.
Two of the most common elbow injuries are tennis elbow and golfer's elbow. The site of those injuries is where your forearm muscles attach to the humerus, on the epicondyle. If you straighten your arm, you can see two little points that jut out to either side of your elbow. The inside point is the medial epicondyle, which is the site of golfer's elbow. The outside is the lateral epicondyle, which is the site of tennis elbow.
Either problem could be the reason your elbow hurts after lifting weights. A few forearm muscles merge and attach into the epicondyle, and the area where they all meet becomes inflamed. Tennis elbow is inflammation of the extensor muscles, which pull the hand up. Golfers elbow is from the flexion muscles, which pulls the hand down.
Treating Elbow Tendinitis
To treat these forms of tendinitis, you should take time away from movements that hurt. Stay away from weightlifting exercises that use intense grip strength like dead lifts and pullups.
Simultaneously, you should take time away from sports like tennis and golf that exacerbate your injury. In addition to taking anti-inflammatory drugs, try icing and massaging the inflamed area. You can also stretch the forearm muscles that pull on the tendon by gently pushing or pulling your hand down toward your forearm.
Nerve Problems at the Elbow
Nerves make your muscles move, and there are three major nerves that cross the elbow joint. The ulnar, radial and median nerves collectively control the muscles of your forearm.
Since your nerves run through your elbow joint, they can be compressed by muscles, tendons or bones. If they're compressed, you might feel numbness or tingling in your forearm and hand, according to the University of Michigan Comprehensive Musculoskeletal Center.
You can take time away from weightlifting if this happens, which will reduce inflammation around your elbow. If that doesn't solve the problem, you might need surgery to relieve the pressure on your nerve.
Bursa Sac Inflammation
To protect your elbow, there's a bursa sac on the bone. This small sac of fluid can become inflamed and swell, which is concerning. Contact at the tip of the elbow, right where the bursa sac sits, is usually the cause of swelling. Rubbing or other inflammation in the area can cause the bursa sac to swell.
To treat bursitis, a medical professional will probably have to drain it with a needle, according to an article from Alberta Health. After that, you'll need followup injections to keep the swelling down.
Tendinitis or Tendinosis?
There are a few tendons around your elbow that can be inflamed. Tendinitis is a common elbow injury, but it's also often mistaken for a different problem: tendinosis.
If you have tendinitis for over two weeks, the injury slowly starts to change. Instead of swelling and inflaming the tendon, your body actually begins to break the tissue down. That means the tendon is slowly weakening.
The treatment options for tendinosis are different from tendinitis. Since your tendon is breaking down when you have tendinosis, taking time off from your activity might not help. You need to stimulate the tendon to grow again, just as you'd stimulate a muscle to grow by lifting weights.
For your elbow, that means doing light exercises that work the injured tendon. Arlington, Virginia's Nirschl Orthopaedic Center recommends starting your exercises with very light weights, between 1 and 3 pounds.
The goal is to stimulate the tendons to rebuild themselves, but too much weight can have the opposite effect. Exercises like wrist flexion and extension, shoulder presses, bicep curls and tricep extensions can help strengthen the tendons. You shouldn't return to your normal weights until you can go through daily life without pain.
- Washington University Physicians: The Anatomy of the Elbow
- Intermountain Healthcare: Inflammation of the Biceps Tendon at the Elbow
- Ortho Info: Biceps Tendon Tear at the Elbow
- Clinical Journal of Sport Medicine: Diagnosis and Treatment of Triceps Tendon Injuries
- Ortho Info: Tennis Elbow (Lateral Epicondylitis)
- University of Michigan: Michigan Medicine: Nerve Injuries of the Hand, Wrist and Elbow
- Alberta Health: Olecranon Bursitis (Popeye Elbow)
- Nirschl Orthopaedic Center: Elbow Tendinosis