Push Up Elbow Pain: 8 Potential Reasons

published by: Debbie Luna
Last Updated:
January 19, 2023

Despite the popularity and relatively low impact of the push-up exercise, there are quite a number of instances where injury or pain has occurred as a direct result of the otherwise novice-level bodyweight exercise.

In most cases, this can be attributed to the exerciser performing the push-up with poor form, but a rare few may be making more severe mistakes in relation to their diet, lifestyle or approach to physical training in general.

Elbow pain from the push-up can usually be traced to poor wrist positioning or elbow flaring during the exercise, but may also be indicative of tendinopathy or poor recovery methodology - two commonly encountered mistakes among novice level exercisers.

What is a Push-Up?

The push-up is a compound bodyweight exercise most often performed so as to target the pectoral muscles, the triceps brachii, the deltoids and the muscles of the core - all with a novice-level pushing movement that is easily accessible to practically anyone.

push up

Due to its relatively low level of intensity per repetition, it is often performed for great volume in a single set - hence why many novice or beginner exercisers may begin to fail at proper form adherence or will otherwise irritate the connective tissues of their elbows when training at a high level of intensity.

How to Perform a Push-Up Properly?

In order to perform a repetition of the push-up exercise, the exerciser will enter the plank position with their feet set close together and the hands vertically parallel with the shoulders, elbows fully extended beneath them.

push up

Flexing the core and keeping the lower back neutral, the exerciser will then bend at the elbows, slowly lowering their torso to within a handbreadth of the floor. From this point, they will then push through their palms and chest, drawing themselves back upwards until the arms have returned to a state of full extension once again.

This completes the repetition.

Anatomy of the Elbow Joint in Relation to Push-Ups

The elbow joint is utilized to a significant extent during a push-up repetition, as it enters a state of both flexion and extension during the two phases of the movement.

From an anatomical point of view, the elbow joint is essentially the part of the arm where the muscles of the upper arm can translate force through the forearm and into the ground - meaning that much of the body’s weight is placed on the elbow, causing the smaller tissues of the extensor tendons to become irritated or otherwise tear at some level.

While regular excessive volume can trigger inflammation or other kinds of irritation in these tissues, more egregious mistakes can lead to more severe damage, often requiring medical attention or an extended period away from exercise.

Most Common Push-Up Mistakes That Can Cause Elbow Pain

Though there are indeed causes of elbow pain that are entirely unrelated to how the push-up itself is performed, the majority of cases where an exerciser will feel discomfort or strain along the outer part of their elbow are simply due to incorrect execution of the aforementioned movement.

Fortunately, correcting these issues is often quite simple, and will require only careful attention and practice in order to instill within the exerciser’s muscle memory.

1. Shoulders Rolling Forward

Encountered second most frequently to elbow flaring, a forward-movement of the shoulders as the exercise is performed can lead to excessive pressure being placed on the joint of the elbow, resulting in pain and a generally unstable push-up.

push up shoulders rolling forward

From an external point of view, this can appear as if the exerciser is extending their head and neck forward as they lower themselves to the ground, or that their hands are simply too low along the torso, causing the elbows to shift as the exercise is performed.

While there are multiple causes of the shoulders rolling forward during a push-up, remedying it is simply a matter of ensuring that the hands are placed horizontally parallel with the shoulders, and that the torso does not shift forward as the movement is performed.

2. Excessive Downward Momentum/Sudden Halting

“Dropping” the torso at the start of each push-up repetition can cause significant shear force to be placed on the elbow joint, leading to pain and generally poor results as the muscles are worked to a lesser degree.

push up dropping

This is due to the need to abruptly halt the momentum at the bottom of the repetition, of which will cause the elbow to absorb the entirety of the exerciser’s own body mass alongside the force produced by the drop.

Performing the push-up in a slow and controlled manner - especially during the descending phase - will not only keep the elbows in healthy shape, but also maximize the benefits you may accrue from regular push-up performance.

3. External Elbow Flaring

The most frequently seen (and main) cause of elbow pain during the push-up is excessive elbow flaring. 

Just like in many other exercises, allowing the elbows to translate force while in a disadvantageous position where they are far from the sides of the torso can easily lead to a host of different issues, with pain and shoulder dislocations being the most common.

While this can occur for a variety of reasons, it is most likely due to the exerciser performing the push-up with an incorrect stance, or otherwise with poor wrist mobility - both of which are easily correctable prior to even starting the exercise.

To alleviate flaring of the elbows, the exerciser should strive to keep the elbows vertically in-line with the wrists, and to keep the hands spaced just the right distance apart so as to avoid improper rotation of the shoulders and elbows simultaneously.

For individuals having trouble preventing their elbows from flaring, placing the hands somewhat closer together (just shy of shoulder width apart) and tucking the elbows against the sides is one way of doing so.

4. Shoulders Rotating Internally

Internal shoulder rotation is just as much an issue in exercise performance as it is in maintaining proper posture, as one or both of the shoulders rotating towards the midline of the body can easily result in rotator cuff issues or pain along the elbow.

The latter symptom is caused by the elbow bending out of an advantageous position and otherwise flaring so as to allow the shoulder to maintain its internal rotation biomechanic, something that is best entirely prevented during the push-up.

In certain cases, internal rotation of the shoulder during movements like the push-up can also be caused by weak or inflexible upper back musculature, or otherwise poor push-up habits that have nothing to do with the shoulders themselves.

In order to correct this issue, the exerciser should first identify the cause behind their internal shoulder rotation. If poor or weak upper back muscles are to blame, including exercises like the inverted row or pull-up can help alleviate the issue and lead to better posture, both in and out of the gym.

Otherwise, if poor push-up form is the main cause, the exerciser should remedy their elbow flaring using the tips mentioned earlier in this article, as well as ensure that the elbows are vertically parallel to the wrists at the start of the exercise.

5. Hands Pointed Inwards

During the initial starting stance of the exercise, the hands should be pointed forwards or otherwise slightly outwards as is natural with the range of motion of the wrists.

push up hands pointed inwards

However, placing the hands with the fingers pointing inwards can cause the elbows to flare so as to compensate for the awkward forearm position - thereby leading to pain and a general failure to adhere to correct form.

Correcting this particular cause of elbow pain involves simply aligning the hand with the elbows, as well as performing wrist mobility exercises so as to maximize the effective range of motion of the hands.

Physiological Issues and Other Mistakes Unrelated to Push-Up Form

Unlike issues relating to the form of the push-up itself, there are certain problems relating to the exerciser’s physiology or their training methodology that can lead to elbow pain. 

These problems are often more difficult and time-consuming to correct than form issues, and will require several changes be made in the exerciser’s lifestyle or in other areas outside of their workouts.

1. Poor Elbow Mobility

Whether due to a history of injury, the effects of aging or simply a lack of mobility work - possessing poor elbow mobility can lead to a number of unpleasant symptoms during exercise, with pain being the chief complaint among them.

All exercisers should seek to perform dynamic mobility movements on a regular basis, especially prior to beginning a high-volume workout involving push-ups. 

To do so, including movements like the forearm flexor stretch, forearm radial deviation movement and the behind the neck elbow flexion stretch within your mobility drill should help alleviate the lack of elbow mobility present in your arms.

2. Excessive Volume and Overtraining

One cause for elbow pain that can affect exercisers of all training levels is that of overtraining; a term used to encompass all the physiological issues that can come from training too intensely at too often an interval.

This is further compounded by other bad habits relating to training methodology, such as insufficient nutritive intake, poor recovery work or other lifestyle factors that further affect the efficiency of the body’s recovery after a workout session.

The cause of overtraining is quite simple - training too often. To avoid this, it is generally advised that most exercisers take at least one day between training sessions that involve the same muscle groups and joints.

For the push-up, this equates to avoiding performing exercises that target the deltoids, triceps and pectoral muscles the following day - as well as limiting the amount of volume performed within a given training week.

If you have eliminated other possible causes of your elbow pain (such as form or mobility problems), then it is a good idea to investigate whether your push-up volume is in excess of what is needed to progress at your training level. 

3. Poor Recovery Methodology

As was touched upon earlier in this article, making mistakes or otherwise having poor methodologies in regards to recovery after training can easily lead to pain and cause greatly reduced results from said training.

Recovery methodology is arguably just as important as the training itself, and requires that the exerciser sleep for a sufficient length of time, take days off from training the same parts of the body consecutively, as well as consume enough macronutrients and calories to fuel this recovery.

While this may seem like a lot, it is actually something that many individuals are already doing - albeit at a suboptimal level. Small tweaks to your lifestyle are all that is needed to correct poor recovery methodology, such as choosing more protein-rich food and prioritizing sleep.

Unfortunately, poor recovery methodology is somewhat harder to identify than other issues that cause elbow pain from push-ups, and as such it is best to first eliminate other culprits listed in this article prior to investigating whether you are recovering properly.

When to See a Doctor for Elbow Pain

Though your elbow pain may be mild or you may feel as if it does not require medical attention, such a symptom can be indicative of a far more serious injury or physiological condition that cannot otherwise be corrected without intervention from a professional.

If your elbow pain is debilitating and sharp, or is otherwise accompanied by symptoms like numbness, tingling, a loss of range of motion within the afflicted elbow or otherwise any other symptoms that affect the actual function of the joint - then yes, it is indeed time to see a physician.

Even if none of the aforementioned symptoms are present, it may still be a good idea to seek out the advice of a medical professional, as they can help pinpoint the exact cause of your pain, thereby saving you time and energy investigating every aspect of your training.

Frequently Asked Questions (FAQ)

Can Push-Ups Damage Elbows?

Yes - despite the seemingly low impact of push-ups, performing them improperly or to excess can easily damage the soft tissues of the elbows. 

In particular, the extensor tendons that connect the forearm muscles to the elbow joint are the most susceptible to repetitive strain caused by improper push-up execution, and can even be permanently damaged if not allowed to recover properly.

Should I Do Push-Ups if My Elbow Hurts?

As much as possible, it is best to avoid any sort of strenuous exercise while experiencing symptoms of pain or other signs of injury.

While not all cases of elbow pain mean that you are injured, it is best to avoid the risk of incurring or otherwise worsening an injury, as doing so may put you out of the gym even longer than avoiding exercise will.

If you absolutely wish to continue training despite your elbow pain, ensure that the exercise is performed with perfect form, and that you immediately cease training if the pain worsens or other symptoms become present.

What is the Fastest Way to Heal Elbow Tendonitis?

Cases of elbow tendonitis will vary in severity, as well as the length of time in which it is needed to recover fully.

Depending on a host of characteristics such as age, gender, diet and medical adherence, individuals can recover from elbow tendonitis in as little as 6 months - at which point a full cessation of symptoms can be confirmed, allowing them to return to their original activities without worry.

More severe cases of elbow tendonitis may require surgical correction or the usage of specialized physical rehabilitation techniques, and as such it is best to consult with a physician prior to attempting any form of rehabilitation yourself.

Final Thoughts

Checked all the boxes but still feeling elbow pain? It might be time to switch out the push-up for an exercise that is more compatible.

As always, if you are unsure of how to go about correcting your elbow pain, it is best to speak to a professional that may aid in safely correcting whatever is causing such symptoms.

References

1. San Juan JG, Suprak DN, Roach SM, Lyda M. The effects of exercise type and elbow angle on vertical ground reaction force and muscle activity during a push-up plus exercise. BMC Musculoskelet Disord. 2015 Feb 10;16(1):23. doi: 10.1186/s12891-015-0486-5. PMID: 25881172; PMCID: PMC4327800.

2. Chou, Paul & Hsu, Hsiu-Hao & Chen, Shen-Kai & Yang, Su-Kuan & Kuo, Chia-Ming & Chou, You-Li. (2011). Effect of Push-up Speed on Elbow Joint Loading. Journal of Medical and Biological Engineering. 31. 161-168. 10.5405/jmbe.772.

3. Donkers MJ, An KN, Chao EY, Morrey BF. Hand position affects elbow joint load during push-up exercise. J Biomech. 1993 Jun;26(6):625-32. doi: 10.1016/0021-9290(93)90026-b. PMID: 8514808.

Debbie (Deb) started powerlifting and Olympic lifting in High School as part of her track team's programming; She continues to train in order to remain athletic. Inspire US allows Deb to share information related to training, lifting, biomechanics, and more.
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