Elbow Pain When Lifting? How to Fix Tennis Elbow

A sharp or nagging pain on the outside of your elbow when you grip a barbell, do rows or even carry groceries? That's usually lateral elbow pain, better known as tennis elbow, and it's incredibly common in lifters, climbers and anyone who uses their hands a lot.

What's going on

Tennis elbow is an overload problem in the tendon of the forearm extensor muscles, especially the extensor carpi radialis brevis (ECRB), where it attaches to the outside of the elbow. Like most overuse injuries, it usually develops gradually, often after:

• A jump in training volume (more pulling, more grip-heavy work)

• Grip or wrist mechanics that put extra strain on the forearm

• Strength imbalances between the forearm, shoulder and upper back

What it feels like

• Achy or sharp pain on the outside of the elbow

• Pain gripping, lifting or shaking hands

• Grip that feels weaker than usual

• Pain when you extend your wrist against resistance

Your three-phase recovery plan

Phase 1: Calm it down

A counterforce strap worn just below the sore spot can take some load off the tendon during lifting or repetitive tasks. Think of it as short-term support, not a fix.

Wrist extension isometric (2 to 3 x 30 to 45 sec)

1. Rest your forearm on a table, palm down, hand off the edge.

2. Hold a light dumbbell (or press up into your other hand) and keep your wrist still.

3. Hold at a tolerable effort, no more than mild discomfort.

Isometric holds have been shown to ease tendon pain in the short term in research on knee tendons, and I use the same idea at the elbow. Do them a few times a day during flare-ups.

Phase 2: Build it back up

Slow wrist extension (eccentric focus) (3 x 12 to 15)

1. Forearm supported, palm down, light dumbbell.

2. Use your other hand to help lift the weight up.

3. Lower it slowly on your own over 3 to 4 seconds.

Reverse curl (3 x 10 to 12)

1. Hold a light bar or dumbbells with palms facing down.

2. Curl up with control and lower slowly.

Phase 3: Get your grip back

Farmer's carries, fat-grip holds and towel hangs, progressing load gradually. Then work back into your full program.

Keep training, modified

Try a neutral or wider grip, straps for heavy pulls, and fewer grip-intensive sets for a few weeks. Most people never need to stop training completely.

A word on cortisone shots

Cortisone injections can reduce pain in the short term, but the long-term picture for tennis elbow isn't good. In a 2013 randomized trial in JAMA, people who got a cortisone shot were less likely to be fully recovered or much improved at one year than those who got a placebo injection (83% vs. 96%), and far more likely to have their symptoms come back (54% vs. 12%). The shot quiets symptoms without making the tendon stronger. Talk it through with your doctor, and consider building capacity first.

Key Takeaways

• Tennis elbow is a tendon overload problem, common in lifters.

• Calm it with isometrics and smart modifications, then rebuild with slow loading and grip work.

• A strap can help short term; progressive loading is the real fix.

• Cortisone may help briefly but did worse long-term than placebo in a major trial.

Frequently Asked Questions

Why does my elbow hurt when I lift?

Pain on the outside of the elbow during gripping, rows or pulls is most often tennis elbow, a tendon overload from a jump in grip-heavy work. Pain on the inside of the elbow is more often golfer's elbow.

How long does tennis elbow take to heal?

It varies, but many people improve over several weeks to a few months with a progressive loading plan. Staying consistent matters more than any single treatment.

Should I get a cortisone shot for tennis elbow?

It's a conversation to have with your doctor. In a major 2013 trial, cortisone gave short-term relief but worse one-year recovery and more recurrence than a placebo injection.

This article is for general education only and isn't a substitute for an individual evaluation. If you have severe, worsening or unusual symptoms, see a healthcare provider. In an emergency, call 911.