What specific upper-body strength training (weight lifting) exercises should you stop, avoid – Or modify – when you have a Tennis Elbow injury?
Should you use dumbbells or is it better to use barbells? What about muscle isolation; is it better to do more general exercises and avoid getting too specific? More Tennis Elbow Exercise Posts
Podcast: Exercises To Avoid If You Have Tennis Elbow
Whether you listen to the podcast, watch the video or read the post, I’d love to hear from you in the comments below if there are any other exercises you’re wondering about – Or if there are any others that have caused or worsened your Tennis Elbow injury.
Here’s a slightly better-sounding, downloadable version of the podcast you can keep by clicking the “download” link under the player below – And please subscribe on your favorite platform:
Table Of Contents Of This Article:
(Links jump down to any section of this article)
- All-Or-Nothing Exercises
- Long-Lever (Straight-Arm) Exercises
- Cable Exercises
- Shoulder-Stability-Challenging Exercises, etc.
Before we can tackle the question of which exercises should be avoided, we should ask ourselves some preliminary questions:
Should you be exercising in the first place? – Be sure to watch this video / read this post first:
Should you be doing Tennis Elbow-SPECIFIC Exercises now? – What’s the right timing?
And what are the goals? – What Are The Goals of Exercise In Tennis Elbow Rehab?
These are not simple questions with easy answers, but if you do decide that it’s a good idea for you to continue doing upper-body strength training exercises, then here are some key considerations in order of importance:
- Whether you stop when it hurts!
- How much weight you use!
- Whether you warm up first!
- And how many sets you do per exercise.
Nothing really matters past this point if you ignore these basics. (It’s not going to matter that much which exercises you do)…
So be smart and warm up thoroughly with lots of cardio, use less weight (a lot less!) than you normally would, do fewer sets – And STOP if your Tennis Elbow starts hurting significantly! – Now with all of that in mind…
There’s one school of thought that basically says, “Do more multiple-muscle / multi-joint exercises – avoiding too much muscle isolation”
And another that says, “favor the barbell over dumbbells.”
I see the reasoning in this, as having a dumbbell in each hand (rather that one bar in both hands) to do say, biceps curls, will require the wrist muscles to do more stabilizing and work harder, which apparently is to be avoided in this view.
Perhaps this is correct, but then again, I think it may depend on what stage you are at in your recovery.
If you are already doing ‘Tennis Elbow-Specific’ Rehab Exercises that target the Wrist Extensor Muscle Group directly…
WHY would you avoid challenging these same muscles by asking them to stabilize your wrist as you use dumbbells to work other muscles like your Biceps, Triceps or Pecs?
On the other hand, if you’re not doing those Wrist Extensor Muscle-isolating rehab exercises YET and are holding off – (But are still working out doing upper-body strength training) I could see how it might make sense for you to avoid challenging or isolating those muscles for awhile. (And to favor the barbell over dumbbells.)
Still, I also see the reasoning in NOT having a barbell / fixed bar for a couple of reasons:
1 – You favor your weaker side when using a barbell or fixed bar in both hands on a cable.
This is utterly unavoidable. The stronger side compensates for the weaker through the bar. (More than you imagine.)
Is this a good thing when you have Tennis Elbow?
Maybe if your injury is on your weaker side, it will be smart to favor it in the short term, as your injury heals…
But what if your injury is on your stronger side?
Maybe it’s already overworked compensating for your weaker side! (Something to think about)
2 – You can also lift more weight with a barbell / bar than you can with dumbbells and that is not a good thing when you have Tennis Elbow.
Overall, I think “barbells or dumbbells?” is one of the less important questions and factors, (but still worth considering.)
I lean in favor of dumbbells and away from the barbell / single bar on a cable. (Except for, say, Lat Pulldowns, which is typically done with a single bar.)
For some more thoughts from a very knowledgeable trainer and Physical Therapist (who also recommends dumbbells when recovering from T.E.) see my G+ post and watch Jeff Cavaliere’s video in it below:
“When you return to lifting you are better off using dumbbells rather than barbells since you can’t hide the compensations of weakness as easily” – Jeff C. – In his video:
- Examples of improper exercise form
- The importance of a “Neutral” wrist position
- The importance of forearm stretching
- And the dangers of the chronic extended wrist position
My take is that it’s still much more important:
Whether you warm up first, whether you stop if it hurts or not, how much weight you use, how many sets you do (as stated earlier)…
And, finally, which specific exercises you do…
Push Ups, Pull Ups, Chin Ups and Dips are typically “all or nothing” in that you can’t vary the amount of weight (only the repetitions) because it’s normally your full body weight.
The point, of course, being that it’s important to be able to vary the amount of weight / resistance when you have Tennis Elbow:
- To start out with much less weight than you’d normally use,
- AND to adjust it as needed as you go through your routine.
Now, sure, if you have access to one of those “assisted” Pull Up / Dip machines at your gym where you stand on a platform that takes some or most of your body weight off, then fine. In that case it’s not “all or nothing.”
With Push Ups, if you’re okay with doing “girl” push ups with your knees on the floor (most guys won’t be caught dead doing these) AND that’s enough of a decrease in weight, okay (although that still equates to a fixed amount of weight you can’t reduce any further if you need to)
Better yet, if you feel the need to continue your push ups, try doing them on an incline – maybe at a 45 degree angle to start…
Especially if you can use the bar on a press/squat machine, or similar, so you can hold the bar and keep your wrists in a more neutral position and not fully flexed the way you typically do them on the floor.
OR skip the Push Ups for a while, do plank and a light Bench Press with a barbell or dumbbells instead.
Exercises done with your arms straight and elbows fully (or mostly) extended put the most strain on your Wrist Extensor Muscles (the Tennis Elbow muscle group)
They are inherently more challenging because the “lever” is longest with your arm straight; the weight either begins or ends held at max distance from your body.
AND since the elbow remains “locked” for most of these, instead of a multi-joint exercise (shoulder and elbow joints opening and closing, in say, a Lat Pull Down) it is more isolating (on the shoulder) and challenging because of the increased stability needed at the shoulder blade (longer lever = more counterweight and balance control needed on the other end)
I don’t even know what all of these exercises are called, but they involve a weight stack with cables that run through adjustable arms and pulleys, and you can attach handles and various other things on the ends of the cables.
You can do dozens of different exercises with these machines, including Pec Flys, Lat Pulldowns, Triceps Extensions and Biceps Curls many of which are completely fine.
The most potentially troublesome one is the “Cross-Over Lateral Raise and Shoulder Extension” (you basically start with straight arms crossed over your lower body and then go into an “X-like” position with arms over your head.
Followed closely by the ones that mimic a golf swing, or a tennis volley – One of which is called the “Wood Chop” – involving a lot of torso rotation and arms held mostly or fully extended and static.
Since, as a class, many of these exercises challenge your core and shoulder stability more than dumbbells and barbells do, you might be better off for reasons already stated to hold off on these altogether as well.
Also, avoid using this equipment to do the specific exercises described further down, like Deltoid Rasises.
(These specific exercises are also examples of “Long-Lever Exercises.”)
Long Lever Exercises are inherently more stability challenging, but there is another class that “raises the bar to another level” so to speak – Although this class of exercises is done without a bar.
TRX is the most popular example of this. These exercises, done using a pair of long straps, typically attached to a bracket in the wall or ceiling on one end – with handles on the other, require very high levels of stabilization.
It challenges your stability in your core / abs, and shoulders, and if you don’t have enough stability or strength – Especially in your shoulders – You’ll compensate with your forearm (Wrist Flexors and Extensors) and probably your upper arms muscles (Biceps, Triceps)
Novices tend to hold the handles in a “death grip” as a way of compensating, too, which is the last thing you need with Tennis Elbow.
If you haven’t been doing this kind of exercise, don’t even think about starting – Until your injury is a distant memory.
If you have been doing this kind of workout, I think it would be wise to stop until your elbow is better.
I don’t mean to knock this exercise. It’s great stuff. Really challenging and getting popular for good reason! (I’ve recently started doing some of these exercises myself.)
But I’m hearing that some of my members actually got their Tennis Elbow from doing TRX, so just be careful, and if and when you start, EASE into it!
This slideshow will give you a quick look at the worst exercises – It’s not the whole list, so keep reading for more. (The video at the end is the same as above.)
These are exercises primarily for the Deltoid Muscles of the shoulders. (Usually performed while standing.)
Lateral Raises can be done with your elbows fully extended (straightened) which is probably the most challenging upper body exercise for the Wrist Extensor Muscles…
Or they can be done with the elbow flexed to varying degrees – often at 90 degrees, which is a little less challenging.
The more the elbow is flexed (bent) the less load there is on the Wrist Extensors…
And, conversely, the more extended (straightened) it is the greater the load.
Anterior (forward) Raises (for your Anterior Deltoid) are usually done with elbows fully extended in front of your body, which makes them very challenging to the Wrist Extensors.
Posterior Deltoid There is also an exercise for the “back” part of the Deltoid Muscle, which is usually done with one arm and one knee supported on a low workout bench so your trunk is parallel with the floor. (Also with the active elbow fully extended.)
Although this exercise is less challenging to the Wrist Extensor Muscles it might be best to avoid it in the early stages of recovery.
Just do the classic “Bent Over Row” instead.
And then as you start making progress in your recovery, try adding the Posterior Deltoid exercise first, followed by the Anterior Deltoid Raise, and finally the Lateral Deltoid Raise.
The most challenging aspect of the Lateral Deltoid Raise is the fact that your palms must face the floor at the top of the motion where the resistance/weight is greatest.
This puts the maximum load and stress on your Wrist Extensors, because the back side of your wrist is facing the ceiling.
To attempt to modify your wrist position is unnatural in this exercise when doing it with flexed elbows, and I don’t think it makes sense to do it with extended elbows and a neutral wrist position (thumbs pointed up)
The Biceps Curl has quite a number of variations. Some are better than others when you have Tennis Elbow, but may still be OK to do…
As long as you avoid “Reverse” (palm-down grip) Biceps Curls at all costs! (with a bar or barbells.)
Here are the other, more common grips for doing biceps curls:
The palm-up grip with a bar whether a barbell or a bar on a cable,
The palm-up grip with dumbbells in each hand,
“Hammer Curls” – with dumbbells (starting and ending with thumbs facing forward and palms facing each other)
“Supination Curls” – with dumbbells (starting with thumbs facing forward and palms facing each other at bottom and then turning palms up as the weight is lifted) – my favorite.
And in general, (your experience may vary) that’s the order of difficulty when you have Tennis Elbow…
The palm up grip should be the least challenging, (slightly more with dumbbells) followed by Hammer and then Supination curls, with Reverse Curls being the most challenging and to be avoided.
The reason being that in the palm-down grip / Reverse Curl, your Wrist Extensors (“Tennis Elbow Muscles”) are under maximum load.
I have come across more than one weight lifter who got their injury from doing these.
Not that they are inherently negative and to be avoided indefinitely, they are simply very challenging to the Wrist Extensor Muscle Group (and somewhat unnatural if you think about it.)
If you’re doing this exercise already, my advice would be to stop it – And not just while you have Tennis Elbow – But forever.
(Unless, perhaps, you’re a teenager or a 20-something and a very serious bodybuilder.)
It’s a terrible exercise that jams the hell out of you’re A/C joint and serves no purpose that can’t be achieved with other exercises.
But for the purposes of T.E. it’s not ideal for the same reasons as Reverse Curls: Very heavy load on your Wrist Ext. Muscles.
In General, Don’t Just Train Your Major Muscles!
Since posting this article, I stumbled across a short article at LiveStrong.com and thought it was worth commenting on.
It reminded me of something that’s ordinarily so obvious to me that I didn’t think to include it! (I’ve been working out this way for a very long time.)
It’s very important to strengthen your supportive, smaller, “stabilizing” muscles – And not just your major muscle groups, like your quads, biceps, triceps, etc.
Otherwise, you can end up with all power and no stability; all force – and no finesse…
And when it comes to Tennis Elbow, I’ve seen many cases in my office where there is a lack of stability in the shoulder and scapular muscles (especially in the Rotator Cuff musculature)…
And compensation patterns for that weakness/instability that involve the Wrist Flexor and Extensor muscles (The “Golfer’s” and “Tennis Elbow Muscles”)
(This is more of a long-term suggestion, perhaps to think more about as you approach the latter stages of your recovery and beyond, but it could still be something to get started on right away.)
Is This Good Treatment And Exercise Advice?
And here’s another article on Tennis Elbow from a Doctor who authors a column on running, tennis and sports injuries.
Some of the advice is stellar, such as the admonition to avoid Cortisone shots! – And I love the admission that, “the conventional treatment works on the symptoms, not the cause.”
But I have to disagree with some of the exercises he recommends for rehab, (and the frequency = too often!!) first and foremost being Reverse Curls!
And another called “Unbalanced Rotation,” which involves holding the end of a small dumbbell at arms length, with full elbow extension, and then making circles with it.
I like the idea of doing these with the elbow flexed (bent) at 90% – Just not with a fully extended arm (which is the same position you use for the Anterior Deltoid Raise I warned against earlier.
Here’s my G+ “mini post” commentary on it:
So those are the big ones in my mind. Are there any other exercises I should add to the list? Comments, anyone? (Scroll down a bit for the comment section.)
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