The push-up is a foundational bodyweight exercise that builds strength in the chest, shoulders, and triceps, but it frequently causes elbow discomfort. This pain signals that the joint’s tissues are being overloaded, often due to underlying irritation or flaws in movement mechanics. Understanding the precise location of the ache helps determine which anatomical structure is stressed, guiding necessary adjustments for pain-free training. This common issue is usually manageable through simple form corrections and temporary modifications.
Pinpointing the Source of Elbow Pain
The specific location of the discomfort provides immediate clues about the irritated tissue, helping to distinguish between common overuse injuries.
Pain located on the back of the elbow, near the bony point, often signals triceps tendinopathy or olecranon bursitis. Triceps tendinopathy involves irritation of the tendon connecting the triceps muscle to the elbow bone, typically worsening when the arm is fully straightened, such as at the top of a push-up repetition. Olecranon bursitis is the inflammation of the fluid-filled sac over the bony tip, which can cause swelling and tenderness, particularly when pressure is applied to the area.
Discomfort centered on the outside of the elbow is commonly known as Lateral Epicondylitis, or “Tennis Elbow.” This condition involves strain on the tendons of the forearm extensor muscles, which attach to the lateral epicondyle of the humerus. The pain is often aggravated by the hyperextended wrist position required in a standard push-up, which transmits tension up the forearm to the elbow joint.
Pain on the inside of the elbow is typically associated with Medial Epicondylitis, or “Golfer’s Elbow.” This involves the tendons of the forearm flexor muscles, which attach to the medial epicondyle. Excessive flaring of the elbows during the downward phase of the push-up can place undue valgus stress on this inner joint structure, contributing to this type of irritation.
Mechanical Errors in Push-Up Technique
Beyond underlying tissue irritation, several common execution flaws mechanically overload the elbow joint.
One of the most frequent errors is excessive elbow flaring, where the elbows point straight out to the sides, creating a T-shape with the body. This position stresses the shoulder capsule and places significant valgus strain on the medial structures of the elbow joint.
Hand placement also plays a significant role in distributing stress across the joints. Hands positioned too far forward or too wide/narrow relative to the shoulders force unnatural angles at the wrist and elbow. For instance, a narrow or “diamond” hand position greatly increases the load on the triceps tendon and the inner elbow, triggering pain in susceptible individuals.
The angle of the wrist is another factor, as a standard push-up requires a high degree of wrist extension, or bending backward. This acute angle translates stress up the forearm and into the elbow, especially if the wrist extensor muscles lack strength or mobility.
Finally, “locking out” the elbows by hyperextending them at the top transfers the load from the working muscles directly onto the joint’s ligaments and bones. This abrupt, forceful extension repeatedly jars the elbow, leading to irritation over time.
Immediate Steps for Pain Management
If elbow pain is experienced during push-ups, the first step is to temporarily cease the aggravating movement to prevent further tissue strain. Modifying the push-up technique allows for continued training while the irritated structures recover.
Performing push-ups on an elevated surface, such as a sturdy bench or wall, decreases the percentage of body weight supported by the arms, reducing the overall load on the elbow joints. A simple way to alleviate wrist and elbow discomfort is to maintain a neutral wrist position by using equipment like dumbbells, kettlebells, or parallettes. Holding the handles keeps the wrist straight, eliminating the forced hyperextension that translates stress up the arm. Another modification involves reducing the depth of the push-up, which limits the total range of motion and decreases the maximum bend the elbow must achieve under load.
For acute soreness, applying the RICE principle—Rest, Ice, Compression, and Elevation—can help manage immediate symptoms. Applying ice packs to the painful area for 15 to 20 minutes can reduce localized swelling and discomfort. However, these steps are aimed at symptom relief and must be paired with addressing the underlying mechanical cause to prevent the pain from returning.
Recognizing When to Consult a Doctor
While most elbow discomfort during exercise is resolved through rest and form modification, certain symptoms suggest a more significant injury requiring professional medical assessment. Persistent pain that lasts for more than one or two weeks, despite consistent home care and activity modification, should be evaluated by a healthcare provider. Pain that occurs even when the arm is completely at rest is another indicator that the tissue damage is beyond a simple exercise-induced irritation.
Specific physical symptoms serve as red flags that warrant immediate attention. These include visible swelling that is worsening or a noticeable deformity around the joint, which could indicate a fracture or dislocation. Sharp, sudden pain, especially if accompanied by a snapping or cracking sound, also requires prompt medical attention. Furthermore, any sensation of numbness or tingling extending into the hand or fingers suggests potential nerve involvement, such as cubital tunnel syndrome, and should not be ignored.