Ask Greg: Improving Elbow Stability & Eliminating Pain
Jarrod Asks: I am the head coach/programmer at a South Eastern suburb “box” and have a couple of athletes that need some help and they are looking to me for assistance and I’m not 100% I have the right answers! So I’m looking to you for help—no pressure.
Both of them have weak elbows. One’s struggles are due to fractures/dislocations of both elbows as a kid and one is due to chronic tendonitis from years of baseball. The end result is the same, both have trouble locking out snatches and jerks in an aggressive manner and maintaining the overhead position and when they fail it appears to a result of the elbow joint failing. Both are trying to work the root issue, but in the meantime they are looking for me to help them strengthen the elbow joint to hold the weight overhead. In essence the elbow(s) can’t keep up with the rest of the body’s ability.
I feel confident than I can program work that will strengthen the shoulder girdle, I can increase flexibility in the wrists, and I can increase squat numbers. However, finding a means to reinforce elbow stability seems to be eluding me. Any advice on programming or reference material would be a huge assistance in helping these athletes reach their goals.
Greg Says: Both are tough cases because you’re going to constantly trying to balance doing the necessary type and amount of work with that same work’s tendency to cause pain or inflammation. First and foremost, as in all cases, you need to ensure their overhead positions are as close to perfect as possible. The better their overhead structures, the less the elbow musculature will have to work and the less their issues will negatively influence their abilities to support weight overhead.
Primarily this means proper positioning of the barbell over the back of the neck and the shoulder blades locked forcefully into retraction and upward rotation—the simplest way to think of this is to squeeze the top inside edges of the shoulder blades together and to push the head through the arms so that the trunk is inclined forward very slightly, the bar is over the back of the neck, and the lifter is balanced over the foot. The stronger the base is, the more stable and strong the arms will be. If the shoulders are unstable, the elbows will have to do far more work to make up for that instability.
The next issue is ensuring that they’re receiving weights overhead in the snatch and jerk with this position established immediately. In other words, this position is locked in before the weight settles down onto the lifter rather than the lifter being slightly soft and then attempting to lock in the position as the weight begins to settle. It’s far easier to maintain this position than to establish it after the weight is being supported.
Then, of course, the elbows themselves do need to be addressed. For the lifter with tendonitis, that inflammation needs to be reduced as much as possible. This will likely require a reduction in training frequency (of overhead lifts), intensity and volume temporarily. Ice massage, hot/cold contrast and massage should all help. Extensive warm-ups for the elbows themselves are also important, and something I very rarely see done. Simple movements like elbow circles that include pronation/supination of the lower arm/hand are fine—this will get the joint warm and get some more synovial fluid pumping. I would also have him try some lightweight, high-rep work (20-25 reps) around the elbow to strengthen the tendons. Use simple exercises that don’t cause him any pain during or after—things like dumbbell presses or bench presses, supine dumbbell elbow extensions, and yes, even something silly like dumbbell kickbacks. I would also do some curls and rowing exercises for balance. He can also wear elbow sleeves in the gym to keep the joint even warmer, although if he ever wants to compete in weightlifting, he would not be allowed to wear them in a meet.
For the athlete with the fractures, the entire arm needs to be strengthened as much as possible. Use every pressing variation you can think of—press, snatch press, push press, snatch push press, incline bench press, bench press, more bodybuilding type exercises with dumbbells, etc. Also include bicep work with dumbbell curls, barbell rows, dumbbell rows and T-bar rows, and chin-ups. Work with 1-2 primary exercises for a few weeks at a time working on progressive strength, and then mix up the additional exercises week to week.
The other issue I’d be willing to bet is involved in both cases is fear of complete and forceful elbow extension, especially with heavier weights, which is to be expected. There’s no secret trick to get rid of this fear, but I would suggest exercises like jerk supports and jerk recoveries to both strengthen the position and build confidence with heavy weights overhead. Heavy overhead squats or snatch balances can also help for the snatch.
Finally, like with all athletes struggling with strong and stable overhead positions, I would have these lifters hold all snatches and jerks and related exercises overhead for 2-3 seconds. This is a very simple but effective way to both strengthen the position, but also improve their stability and build confidence through the sense of control.