Elbow & Forearm Injuries

The elbow is one of the most commonly injured areas in calisthenics. From the repetitive gripping of pull-up bars to the extension demands of dips and push-ups, the elbow complex is under constant stress. Understanding these injuries and how to prevent them can save you months of frustrating setbacks.

Red Flag Warning: Seek immediate medical attention for: obvious deformity, complete inability to bend or straighten the elbow, severe swelling developing rapidly, numbness in the hand, or injury following significant trauma.

Elbow Anatomy Overview

The Elbow Joint Complex

The elbow actually consists of three joints working together:

Humeroulnar joint:

• Hinge joint between upper arm (humerus) and forearm (ulna)
• Allows flexion and extension
• Primary stability joint

Humeroradial joint:

• Between humerus and radius
• Allows flexion, extension, and rotation

Proximal radioulnar joint:

• Between radius and ulna
• Allows forearm rotation (pronation/supination)

Key Structures

Medial epicondyle:

• Bony prominence on the inner elbow
• Attachment point for wrist flexors and forearm pronators
• Site of "golfer's elbow"

Lateral epicondyle:

• Bony prominence on the outer elbow
• Attachment point for wrist extensors and supinators
• Site of "tennis elbow"

Triceps tendon:

• Attaches at the olecranon (point of elbow)
• Straightens the arm
• Heavily stressed in pushing movements

Biceps tendon:

• Attaches to the radius
• Flexes elbow and supinates forearm
• Stressed in pulling and supinated grip work

Common Elbow Injuries in Calisthenics

Lateral Epicondylitis (Tennis Elbow)

What it is: Tendinopathy affecting the common extensor tendon on the outside of the elbow, particularly the extensor carpi radialis brevis.

How it happens in calisthenics:

• High-volume pulling (the wrist extensors stabilize grip during pull-ups)
• Grip-intensive work (muscle-ups, dead hangs, front lever)
• Sudden increases in pulling volume
• Working with straight bars when angles would be kinder

Symptoms:

• Pain on the outside of the elbow
• Pain gripping objects or shaking hands
• Weakness in grip strength
• Pain that may radiate down the forearm
• Tenderness directly over the lateral epicondyle

Risk factors:

• Rapid volume increases in pulling work
• Inadequate grip conditioning
• Training through early warning signs
• Age (more common over 30)

Medial Epicondylitis (Golfer's Elbow)

What it is: Tendinopathy affecting the common flexor tendon on the inside of the elbow.

How it happens in calisthenics:

• Heavy pulling with supinated grip (chin-ups)
• High-volume dips
• Front lever and planche training
• Muscle-up transitions
• False grip training for rings

Symptoms:

• Pain on the inside of the elbow
• Pain with gripping, especially with wrist flexion
• Weakness in grip
• Pain may radiate down the inner forearm
• Tenderness over the medial epicondyle

Why it's common in calisthenics: Golfer's elbow is more common in calisthenics than in many sports because of:

• The gripping demands of bodyweight training
• False grip positioning
• The pulling and transition movements unique to the discipline

Triceps Tendinopathy

What it is: Irritation or degeneration of the triceps tendon where it attaches to the olecranon.

How it happens in calisthenics:

• High-volume pushing (dips, push-ups, handstand push-ups)
• Locking out forcefully at end range
• Elbow hyperextension in support holds
• Planche training with locked elbows

Symptoms:

• Pain at the back of the elbow, especially the "point"
• Pain with pushing movements and elbow extension
• Pain locking out the arm
• May feel worse after rest (morning stiffness)
• Tenderness over the triceps insertion

Elbow Hyperextension Injuries

What it is: Acute or repetitive strain from the elbow going past its normal straightened position.

How it happens in calisthenics:

• Support holds on rings or parallettes
• Straight arm skills (planche, back lever, front lever)
• Locking out aggressively in dips or push-ups
• Falling and catching yourself with straight arms
• Some individuals have naturally hyperextensible elbows

Symptoms:

• Pain at full elbow extension
• Feeling of instability
• Pain in the front of the elbow (anterior capsule strain)
• Swelling after training
• Clicking or catching sensations

Biceps Tendinopathy

What it is: Irritation of the distal biceps tendon near its insertion on the radius.

How it happens in calisthenics:

• Heavy supinated pulling (chin-ups)
• Explosive pulling movements (muscle-ups, kipping)
• Front lever training
• Sudden eccentric loads on the biceps

Symptoms:

• Pain in the front of the elbow, slightly toward the outer side
• Pain with resisted supination or flexion
• Weakness in pulling or supinating
• Pain carrying heavy objects with arm bent

Grip-Related Issues

What they include: Various conditions affecting the forearm and grip strength:

• Forearm muscle strains
• Compartment syndrome (rare, serious)
• Nerve entrapments
• Grip fatigue

How they happen:

• Excessive hanging and gripping work
• Insufficient recovery between grip-intensive sessions
• Rapid progression in grip-demanding skills
• Training with swollen or fatigued forearms

Symptoms vary but may include:

• Forearm pump and pain during training
• Grip giving out unexpectedly
• Numbness or tingling in fingers
• Weakness that doesn't recover with rest

Prevention Protocols

Tendon Conditioning

Principles of tendon training:

• Tendons respond to load, but more slowly than muscles
• Heavy, slow resistance training promotes tendon adaptation
• Consistent, progressive loading over months
• Don't increase grip-demanding work too quickly

Eccentric exercises for tennis elbow:

• Tyler Twist with FlexBar (or DIY alternative)
• Wrist extension eccentrics with dumbbell
• 3 sets of 15 reps, daily or twice daily
• Expect 6-12 weeks for significant improvement

Eccentric exercises for golfer's elbow:

• Reverse Tyler Twist
• Wrist flexion eccentrics with dumbbell
• Same protocol as tennis elbow

Forearm and Grip Training

Balanced grip development:

• Train grip extensors, not just flexors
• Include wrist curls in both directions
• Rubber band extensions for finger extensors
• Rice bucket exercises for comprehensive forearm work

Progressive grip exposure:

• Gradually increase hanging time
• Progress to one-arm work slowly
• Build up to false grip over weeks, not days
• Include active rest periods between grip-intensive sets

Grip variations:

• Rotate between overhand, underhand, and neutral grips
• Use different bar thicknesses when possible
• Don't always train with the same grip width

Movement Modifications

For pushing movements:

• Don't lock out aggressively—maintain slight muscle tension at the top
• Control descent rather than dropping
• Use parallettes or neutral grip to reduce elbow strain
• Progress dip depth gradually

For pulling movements:

• Warm up the elbows specifically before pulling
• Vary grip positions throughout training
• Don't kip when elbows are cold or fatigued
• Build chin-up volume gradually if doing heavy supinated work

For straight arm skills:

• Build bent arm strength first
• Progress to straight arm positions gradually
• Don't force hyperextension—maintain slight bend if needed
• Balance pushing and pulling straight arm work

Warm-Up for Elbow Health

Elbow-specific warm-up sequence:

1. Arm circles: 10-15 each direction
2. Wrist circles: 10-15 each direction
3. Forearm pronation/supination: 15-20 reps
4. Band wrist flexion/extension: 15-20 reps each
5. Light grip work: Easy squeezes, finger extensions
6. Progressive pulling: Start with easy pulling before heavy sets

Time required: 3-5 minutes before upper body training

Treatment Approaches

For Tendinopathies

Phase 1: Load management (weeks 1-2)

• Reduce but don't completely eliminate loading
• Identify and modify provocative movements
• Isometric exercises at low to moderate intensity
• Example: Wrist extension hold against wall, 30-45 seconds

Phase 2: Progressive loading (weeks 2-8)

• Begin eccentric exercises
• Gradually increase load
• Monitor symptoms (mild discomfort during exercise is acceptable)
• Continue modified training

Phase 3: Return to training (weeks 6-12+)

• Reintroduce sport-specific movements
• Continue eccentric/strengthening program as maintenance
• Progress volume before intensity
• Address contributing factors

Important principles:

• Complete rest often makes tendinopathy worse long-term
• Controlled loading promotes tendon remodeling
• Expect improvement over weeks to months, not days
• Some discomfort during rehabilitation exercises is normal

For Hyperextension Issues

Acute management:

• Rest from provocative positions
• Ice for pain and swelling
• Consider compression
• Gentle range of motion within comfort

Rehabilitation:

• Strengthen biceps and brachialis
• Train elbow flexors to control extension
• Avoid end-range extension under load
• Consider taping or bracing for support during return

Training modifications:

• Maintain slight bend in support holds
• Use bent arm variations initially
• Progress to straight arm work gradually
• May need to permanently avoid full lockout under load

Return-to-Training Guidelines

After Tennis or Golfer's Elbow

Criteria for progressing:

• Able to grip without pain in daily activities
• Completed 4-6 weeks of eccentric protocol
• Pain during training ≤3/10 and doesn't worsen after
• No increase in morning stiffness

Return protocol:

• Start with 50% of previous pulling/gripping volume
• Increase by 10-15% per week if symptoms allow
• Continue eccentric exercises as maintenance
• Monitor for 24-48 hours after each session

After Triceps Tendinopathy

Criteria for progressing:

• Pain-free in daily activities
• Able to do pain-free bodyweight push-ups
• Pushing strength rebuilding

Return protocol:

• Start with push-up variations on incline
• Progress to flat push-ups, then dips
• Rebuild volume before adding intensity
• Avoid aggressive lockout initially

After Hyperextension Injury

Criteria for progressing:

• Full pain-free range of motion
• No instability symptoms
• Adequate strength in flexors

Return protocol:

• Begin with bent arm work only
• Gradually reduce the bend over weeks
• May benefit from elbow sleeve for support
• Consider permanent modification if symptoms recur

When to Seek Professional Help

See a healthcare provider if:

• Pain persists beyond 3-4 weeks despite modification
• There's significant weakness that isn't improving
• Symptoms are worsening despite treatment
• You experience numbness, tingling, or color changes
• There was a pop or snap during an acute event
• You can't fully straighten or bend the elbow

Professional treatment options:

• Accurate diagnosis (may need imaging)
• Physical therapy for targeted rehabilitation
• Shockwave therapy for chronic tendinopathy
• Injections (used selectively)
• Surgery (rare, for failed conservative treatment)

Key Takeaways

1. Elbow issues are often grip issues—condition the entire forearm
2. Tendons need time—expect weeks to months for tendinopathy improvement
3. Eccentrics work—Tyler Twist and similar exercises are evidence-based
4. Don't ignore early warnings—mild elbow pain can become chronic if untrained through
5. Vary your grips—same grip, same bar, same movement = accumulated strain
6. Warm up your elbows—they need specific preparation before pulling and pushing
7. Respect hyperextension—not everyone needs (or can safely achieve) locked-out straight arms
8. Balance your training—push, pull, grip flexors, grip extensors all need attention