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The Bar Didn’t Hurt Your Elbow. Your Grip Did.
Weightlifting causes tennis elbow through your grip. Every time you squeeze a bar, the forearm muscles that hold the wrist steady fire hard, and they all pull on one small spot on the outside of the elbow.
Rows, pull-ups, deadlifts and reverse curls load it most. Most lifters can keep training with grip changes. Expect 6 to 12 months for full settling, often less if you change the load early.
Where are you right now?
- Outer elbow sore after pull day: go to “What to change in the gym.”
- Pain on the INNER elbow: that’s golfer’s elbow. See golfer’s elbow.
- A pop and bruising at the front of the elbow during a lift: skip to the red flags now.
- It’s been months: read “If it isn’t going to plan.”
Why lifting causes tennis elbow
The muscles that bend your wrist back (the extensors) start from one tendon on the bony bump on the outside of the elbow.
You don’t need to bend your wrist back to load them. Gripping does it. When you squeeze, those muscles fire to stop the wrist curling under the weight.
So a heavy deadlift, a set of pull-ups and 4 sets of rows are all, quietly, a forearm workout…on a tendon that adapts slower than your muscles do.
Arnold built his forearms in an era before lifting straps. You don’t have to.
The lifts that load it most
- Overhand pulls: pull-ups, lat pulldowns and rows with a palms-down grip.
- Deadlifts and shrugs with a hard double-overhand grip.
- Reverse curls and wrist extensions done heavy.
- Farmer carries and heavy dumbbell work, where grip is the limit.
- Fat grips. Thicker handles make the forearm work harder. Great for grip. Not now.
Usually fine: squats, leg work, and pressing with a neutral wrist and a relaxed grip.
What to change in the gym
- Grip as hard as you need, not as hard as you can. White knuckles on a lat pulldown are wasted effort.
- Use straps for heavy pulls and deadlifts while it settles.
- Switch to neutral grips: hammer curls, neutral-grip pull-ups and rows.
- Halve your pulling volume for 2 to 4 weeks. Keep the rest of the program.
- Drop reverse curls for now. They come back later as rehab.
- A counterforce strap helps some people during the session. See tennis elbow strap.
Change the grip and you can usually keep the bar.
Tennis elbow from lifting, week by week
Pain during exercise should stay at 3 out of 10 or less, and settle by the next morning.
- Weeks 0 to 2 (OPEN): the grip changes above. Wrist isometrics: hold the wrist back against your other hand, about half effort, 5 holds of 30 to 45 seconds, once or twice a day.
- Weeks 2 to 6 (OPEN): slow wrist extensions with a light dumbbell, 3 seconds up, 3 seconds down, 3 sets of 15. Add weight as it stays comfortable.
- Weeks 6 to 12 (OPEN): heavier, slower wrist work, then grip work. Bring back overhand pulls a set at a time.
- Months 3 to 12 (CLOSING if nothing has moved): most settle in this window. If you’ve been in the rest-then-return loop for 3 months, the plan needs changing, not repeating.
The full exercise plan is in how long tennis elbow lasts.
Is this normal?
Usually expected:
- A tender spot on the bony bump outside the elbow.
- Pain lifting a full kettle, shaking hands or turning a stiff tap.
- An ache after pull day that’s better by morning.
Check with a doctor or hand therapist if the pain is lower down the forearm, aches at night, or the elbow locks or catches. Pain 5 cm or so below the bump can be radial tunnel syndrome.
If it isn’t going to plan
Three months in. You rest a week, it calms, you go back to rows…and it’s back by Thursday.
Rest calms the pain. It doesn’t make the tendon stronger. Every rest-then-return cycle sends a weaker tendon back to the same load, and the cycles get longer each time.
What fixes it is progressive loading of the tendon itself, with the gym load adjusted around it. If you’ve done 6 to 8 weeks of that and nothing has moved, get assessed by a hand therapist or sports doctor. See also wrist pain when lifting weights.
When can I…?
Typical ranges. Your body decides, not the calendar.
| Activity | Typical timing |
|---|---|
| Legs, pressing with a relaxed grip | Usually straight away |
| Neutral-grip pulls with straps | Usually within 1 to 2 weeks, if pain stays at 3 out of 10 or less |
| Overhand pull-ups and rows | Often 6 to 12 weeks, a set at a time |
| Heavy deadlifts without straps | Last. Often 3 months or more |
Get it checked today if
- You felt a pop at the front of the elbow during a heavy curl or deadlift, then bruising, and the biceps muscle bunched up. That can be a distal biceps tendon rupture, and repair works best within the first few weeks. See distal biceps repair.
- New numbness in the ring and little fingers.
Get it checked if
- No improvement after 6 to 8 weeks of load changes and exercises.
- Pain at night or at rest.
- You can’t lift a cup of coffee without pain.
Lifting gave you tennis elbow through your grip. Change the grip and the tendon gets its chance to catch up.
Related: tennis elbow from golf · table tennis elbow · wrist pain doing push-ups
Written by Nigel Chua, hand occupational therapist in practice since 2005. Thousands of hands, wrists and elbows assessed and treated. My credentials are here. This article explains; it doesn’t examine. If you felt a pop at the front of your elbow, get seen this week, not next month.
Part of: Hand, wrist and elbow pain by job, sport and hobby
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.