Pull Up Elbow Pain: Common Reasons Explained

Despite the relatively low impact of the conventional pull-up, there are actually quite a number of different things that can go wrong when the exercise is being performed incorrectly.

Whether it be due to excessive volume, poor form adherence or simple incompatibility with the pull-up itself, it is important to cease performing the exercise and to investigate any symptoms of pain that may be felt.

Elbow pain during or after a set of pull-ups can be indicative of soft tissue injuries or physiological conditions involving irritation of the elbow’s tendons. In more serious cases, pain and numbness along the elbow can also indicate compression of the ulnar nerve that runs through the elbow joint.

What is a Pull Up?

The pull-up is a closed kinetic chain compound exercise with the entirety of resistance derived from the lifter’s own body weight.

It is most often performed for high volume sets by more advanced lifters, but is otherwise accessible to individuals of all levels of training experience.

The pull-up is known as an effective method of targeting muscle groups throughout the back and arms, with muscles like the latissimus dorsi, biceps brachii and deltoids being the primary sources of force within the exercise.

How to Perform a Pull Up Properly

To perform a repetition of the conventional pull-up, the exerciser will hang from a pull-up bar with their hands wider than shoulder-width apart and their grip in an overhand stance.

From this position, they will draw themselves upwards by contracting the latissimus dorsi muscles and pulling the elbows backwards, stopping once the pull-up bar is below their head.

The chest should remain upright and pushed forward throughout the movement.

Then, the exerciser will allow themselves to slowly descend back into the original position, avoiding any sort of swinging whatsoever. 

Once they have returned to the dead hang position, the repetition is complete.

How to Program the Pull Up

Programming a set of pull-ups is quite simple; the exerciser should aim for volume-induced fatigue, but not so much that they have reached the point of failure repeatedly within a single workout.

For most novice or intermediate level lifters, this could mean stopping one repetition short of full muscular exhaustion, while more advanced lifters may see better results from performing as-many-reps-as-possible (AMRAP) sets once or twice per training session.

Alongside programming the rep scheme of pull-ups, it is important to also factor in other exercises within the workout. 

Weighted compound movements like the barbell row, chin-up or other types of back muscle exercises should take priority over the pull-up, placing it later within the workout.

The exception to this, of course, is if these exercises are meant to function as an accessory to the pull-up, like the lat pulldown machine.

Tennis Elbow and Pull Ups: The Risks

The most common cause of elbow pain from pull-ups is a repetitive-use condition known as tennis elbow (or golfer’s elbow, depending on the tendon) - characterized by irritation and swelling at the tendons connecting the muscles of the forearms to the elbow joint.

This can often present as pain, swelling and general discomfort when performing actions that involve a pronated or overhand grip, such as pull-ups or barbell rowing exercises.

The main cause of tennis elbow is insufficient recovery, wherein the exerciser has either failed to alot sufficient recovery time to their elbow tissues, or otherwise has performed the same action to excess over the course of multiple instances.

For the pull-up, this could mean either too much volume per training session, or too great a training frequency within the workout program itself.

Rarely is poor form the cause of tennis elbow, though there are a few common mistakes that can increase the risk of strain being placed on the forearm tendons.

Common Mistakes That Cause Elbow Pain From Pull-Ups

While the majority of cases of elbow pain from pull-ups are due to poor programming or training habits, executing the movement improperly can also cause excessive strain to be placed on the soft tissues of the joint - leading to a faster development of irritation and other conditions that can present pain.

Hands Placed Too Close Together

Placing the hands too close together can cause the resistance of the pull-up to translate through a different path, leading to a greater risk of the elbows flaring alongside excessive strain taking place on the shoulder joint.

Furthermore, placing the hands too far apart can also have a similar effect of straining the elbow joint, forcing them to rotate under an excessive load.

Ideally, the hands should be spaced wider than shoulder width along the bar, with enough space for the torso to rise between them without any need to shift backwards.

Poor Grip Form of Wrists

Whether it be due to a lack of thumb usage or excessive bending in any particular direction, gripping the bar with the wrong form can put strain on the muscles of the forearm, which will in turn strain the tendons that connect to one end of the elbow joint.

This can often present as pain and weakness, but may not be noticed until damage and irritation has already occurred.

The wrists should be within a parallel plane with the rest of the forearm as they grip the pull-up bar in a pronated form, with no excessive bend to either side.

This will ensure that the full force produced by the body is translated through the wrist, rather than damaging it.

“Kipping” Upwards

Kipping or otherwise swinging so as to produce momentum during a pull-up repetition can be quite dangerous, especially in regards to the joints of the shoulders and elbows, which will bear much of the force of drawing the body upwards alongside translating the momentum of the swing.

This can easily lead to tears in the soft tissue of the elbow, as well as potentially lead to dislocations or damage to the bones in more extreme cases.

Every repetition of the pull-up should be performed in a slow and controlled manner, with the torso relatively rigid and parallel with the legs throughout the movement.

If the lifter is having trouble controlling the swaying of their lower body, they must learn to contract their abdominal muscles properly.

Pulling the Elbows Towards the Midline Rather Than the Side

Another common mistake during pull-ups that can potentially lead to elbow pain is that of pulling the elbows improperly.

During the initial phase of a pull-up repetition, the elbows are meant to be drawn backwards and down, as if tucking them into the sides of the torso.

The error becomes visible when, rather than tucking the elbows towards the sides, the exerciser will pull them towards one another as if drawing them towards the center of the torso instead.

This will place a great amount of the body’s weight on the elbows alone, leading to a far more rapid development of strain-related conditions, tennis elbow being the most likely among them.

Correcting this mistake is as simple as practicing pull-ups with careful attention being paid to form, as it is most likely just an issue of mistaken muscle memory rather than any other cause.

Other Issues That Lead to Elbow Pain

A Lack of Mobility and Warm-Up Work

Failing to stretch the elbows properly and otherwise not warming up prior to a set of pull-ups can lead to pain and damage to the various soft tissues of the body.

To avoid this, perform a dynamic mobility routine before beginning your workout, taking extra care to fully stretch the elbows through their entire range of motion.

Remember that if you are already experiencing pain, it is best to cease performing pull-ups temporarily so as to allow for the elbows to recover.

A Rapidly Increased Intensity of Training

The body requires time to adapt to a certain level of training intensity, regardless of whether the exerciser is a lifetime athlete or a complete novice to resistance exercises.

As such, suddenly returning to full training intensity after a period out of the gym or otherwise switching to a far more advanced program without a ramp-up week can easily lead to conditions like tendinopathy and tennis elbow.

In order to allow the body enough time to adapt, it is important to begin every new training program with a somewhat lower intensity than is intended - slowly increasing the intensity until it has reached your desired level over the course of several sessions.

If the Elbow Tissues Haven’t Adapted to Strain 

Quite similar to a rapidly increased training intensity, if the elbow tissues have not been properly adapted to the rigors of resistance training, it is possible for them to become damaged or otherwise irritated by pull-ups.

While this rarely occurs and is naturally avoided by following a proper training program, individuals jumping straight into resistance training from a sedentary lifestyle are the most likely to suffer from this problem.

To help reduce the intensity of the symptoms, following a proper training program specifically geared towards novices or returning athletes is the best way to ensure that the elbows are given ample time to adapt.

How to Rehabilitate Elbow Pain From Pull Ups

Stop Training Temporarily

Once you have established that your elbow pain is indeed caused by pull-ups, it is important to cease performing any activities that can further interrupt your recovery. 

Ensure that - even outside of the gym - the afflicted elbow does not bear any resistance whatsoever.

Rest, Ice, and Compression

The old adage of “RICE” still very much applies to elbow pain caused by pull-ups, albeit without the need for elevation (the last "E").

Apart from allowing the affected elbow to rest and generally avoiding any sort of strenuous activities involving the joint, symptoms may be further controlled by carefully compressing the joint and applying ice so as to reduce swelling that may worsen the injury.

It is also possible to make use of pharmaceutical means to reduce the incidence of symptoms, mainly through non-steroidal anti-inflammatory drugs - though it is best to speak to a physician prior to doing so.

Perform Elbow Tendon Rehabilitation Movements

Just like in most other cases of physiological injury, performing rehabilitative stretches and no-impact strengthening exercises will greatly speed up the recovery of the injured area, as well as ensure that it retains full physical function once actually recovered.

Some possible rehabilitative movements for conditions like golfer or tennis elbow are; grip strengthening exercises, dumbbell wrist supinations, wrist extensions and wrist flexions.

Note that performing physical rehabilitation without prior approval of a physician can lead to the injury in fact worsening, and it is best to wait for a full examination prior to attempting any sort of active recovery measures yourself.

Do Not Train Through the Pain

As a general reminder, it is important to avoid “training through the pain” whatsoever. 

Many individuals will simply ignore the pain in their elbow from pull-ups, especially if the symptoms are relatively mild in intensity and only occasionally occur.

This is a mistake, and will likely evolve into a larger problem if left untreated.

When to See a Doctor for Your Elbow Pain

If the pain is sharp and consistent, or otherwise is accompanied by other symptoms of tingling, numbness, discoloration of the affected area or a general loss of stability and strength in the joint - it is best to consult a medical professional, as more serious conditions could be present.

Frequently Asked Questions (FAQ)

Why Do My Elbows Hurt When I Pull Up?

Elbow pain during a pull-up can be indicative of poor programming or poor form adherence, and it is generally a good idea to reexamine your form and workout plan if pain of any sort is triggered by exercise.

Should I Do Pull Ups With Tennis Elbow?

No - as much as possible, avoid any sort of exercise that can affect the tendons of the forearms and elbow joint if you have a condition like tennis elbow.

Instead, follow a physical therapist’s recommendation, and maintain the full capabilities of your elbow through careful mobility work and sufficient rest.

Can Pull Ups Cause Elbow Tendonitis?

Any sort of repetitive strenuous movement can lead to tendonitis, which perfectly fits the bill of high-volume pull-up sets. 

In order to reduce the strain placed on the elbow during a pull-up repetition, ensure that proper form is followed, and that each training session involving pull-ups is followed by at least one day of recovery so as to avoid overtraining and irritation of the elbow’s connective tissues.

In Conclusion

While it is unlikely that you have incurred any sort of serious injury to your elbow, there is nonetheless a risk of your current condition worsening if left untreated.

Stopping the problem before it develops further will allow you to return to training at full intensity as soon as possible.

References

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2. Buchanan BK, Varacallo M. Tennis Elbow. [Updated 2022 Nov 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/

3. Stien, Nicolay & Saeterbakken, Atle & Id, Saeterbakken & Hermans, Espen & Vereide, Vegard & Olsen, Elias & Andersen, Vidar. (2019). Comparison of climbing-specific strength and endurance between lead and boulder climbers. PLoS ONE. 14. e0222529. 10.1371/journal.pone.0222529.