Powerlifting produces three distinct hand and arm injuries, one per lift, and they have almost nothing to do with each other.
- Bench is a wrist position problem.
- Squat is a shoulder and wrist position problem disguised as a bar placement issue.
- Deadlift is a grip problem with one genuinely serious risk attached.
Treating “wrist pain in the gym” as one thing is why people buy wraps and get no better.
Bench: the wrist
The bar should sit low in the palm, over the heel of the hand, with the wrist stacked straight over the forearm. Let it drift high into the fingers and the wrist bends backwards under load, which is where the pain comes from.
- Stack the wrist first, then consider wraps. Wraps support a good position; they do not fix a bad one
- Thumbless grip is where the bar drifts high and is worth abandoning for this reason alone, before the safety argument
- Back-of-wrist pain that persists past a deload is not a positioning problem any more — see gym and weightlifting wrist pain
Squat: the elbow and wrist
Low-bar squatting with tight shoulders forces the wrist into extension and the elbow to carry load it was never meant to. Most “squat wrist pain” is actually a shoulder range problem expressing itself two joints away.
- Widen the grip, use a thumbless-over-the-bar hold where safe, and work on shoulder rotation
- Keep the elbows under the bar rather than flared back
- Pain on the inner elbow after squat sessions is usually golfer’s elbow from gripping the bar hard to hold position
Deadlift: the grip, and the one real risk
Mixed grip — one palm up, one palm down — puts the supinated arm’s biceps tendon under a long lever at maximum load. A distal biceps rupture is the injury that ends deadlift seasons, and it happens overwhelmingly on the supinated side.
- Keep the supinated elbow straight. A bent elbow on a mixed grip is the mechanism. Never bend it to help the bar off the floor
- Use hook grip or straps for volume work, mixed grip only for heavy singles, and alternate which hand supinates
- A pop at the front of the elbow, then bruising down the forearm, is a rupture with a repair window of roughly two to three weeks. The arm keeps working well enough to talk you out of going, which is exactly the trap
- Calluses that tear are a maintenance issue: file them down rather than letting them build
The deadlift injury that costs you a year is not in your back. It is at the front of the elbow on the hand that was palm-up.
On wraps and straps
Wrist wraps are a support for near-maximal work, not a solution to daily pain.
Wearing them for every set means the wrist never develops tolerance, and the underlying position problem stays hidden.
Straps are a legitimate tool for building back volume without the grip failing first. They only become a problem if they let you load a wrist or elbow that was already telling you something.
When to stop training through it
- Any pop or tearing sensation, particularly at the front of the elbow
- Numbness or tingling during or after sets
- Wrist pain on rotation rather than on loading — that points at TFCC
- Pain present before the session rather than appearing during it
- Grip failing well below your normal working weight
- Elbow pain that has not changed across a full deload week
If your training also includes long carries and conditioning work, the fatigue pattern is different again: Hyrox hand, wrist and forearm injuries. And for elbow tendon pain, tennis elbow exercises and golfer’s elbow exercises cover the loading that actually rebuilds it.
Three lifts, three injuries, one bad habit each. Fix the position and most of this never happens.
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.