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Sports Medicine

Joint Custody

If you want to press heavy weight, you better take care of your triceps tendon.


Big arms are like fast cars: everyone wants to have them, but not many are willing to pay the cost to get them. If you’ve been in the iron game for a while, you probably understand that a large portion of the arm anatomy comes from the posterior aspect of the arm known collectively as the triceps. As the name implies, the triceps consist of three heads: the long head, medial head and lateral head. While the origins of the heads are all slightly different, they all insert into one common triceps tendon. A well-designed program has you performing exercises that hit all three heads. The problem is, all of those exercises utilize the same triceps tendon, which has a tendency to become inflamed from overuse.

The action of the triceps is to extend (straighten) the elbow. Compound movements such as bench presses (barbell or dumbbell), shoulder presses and dips all target the triceps. Isolation exercises such as rope or straight-bar pressdowns, triceps kickbacks and overhead triceps presses (with dumbbells/barbell/EZ-bar) also target the triceps. While isolation and compound exercises are fairly common knowledge among experienced lifters, it’s often forgotten that the triceps also statically contract in exercises such as pullovers, straight-arm lat pulldowns and bent-over lateral raises/reverse flyes. This can sometimes lead to trouble — you might think you’re giving the muscles a rest day after your triceps workout the day before, but if you’re incorporating pullovers or straight-arm lat pulldowns as part of your back workout, you’re not really resting the triceps at all. This could result in overtraining and injuries to the triceps and/or the triceps tendon.

Due to the different insertion points of the triceps, specific exercises target certain areas more effectively. For example, an overhead triceps exercise such as a skullcrusher will target the long head of the triceps more effectively because that head is put in a prestretch position due to its anatomical origin. These particular exercises, while providing fantastic results, must be integrated into your training program intelligently due to the amount of excess tension that the prestretch position places on the long head of the triceps as well as the triceps tendon.

Strain on the triceps tendon from repetitive pushing movements or from overloading it beyond what it can tolerate may cause triceps tendonitis, which is when damaged triceps tendon tissue experiences swelling and pain in the posterior aspect of the elbow or slightly above or below the posterior aspect of the elbow. In severe cases of triceps tendonitis, you may notice swelling in the back of the elbow or experience weakness when attempting to straighten the elbow against resistance. You may also feel pain and tightness when performing a stretch to the triceps or point tenderness when firm pressure is applied near the posterior aspect of the elbow. In less severe cases, you may only experience a minor ache or stiffness when performing activities requiring a forceful or repetitive contraction of the triceps.

Once you have developed triceps tendonitis, it’s essential to provide a period of rest for healing to take place and for the swelling to subside. (Even if you can’t see the swelling, the tissue may still be swollen internally.) Ice, flexibility exercises and, occasionally, nonsteroidal anti-inflammatory drugs are sometimes recommended by your health-care practitioner. A certified athletic trainer or physical therapist may also help in providing you with an appropriate rehabilitation plan that will get you back to your normal activities. See “7 Tips For Pain-Free Elbows” for some tried-and-true injury-prevention tips to help keep your elbows healthy.

7 Tips for Pain-Free Elbows

1. Perform a general cardiovascular warm-up for five to 10 minutes and a movement-specific warm-up for two to three sets before beginning your heavier work sets.

2. Don’t begin your triceps workout with an overhead movement, as this places excess stress on the triceps tendon. Instead, start with either compound triceps exercises such as dips, or isolation exercises such as rope triceps pressdowns.

3. Allow at least one day of rest between working the triceps. Remember that exercises such as shoulder presses, chest presses, pullovers, straight-arm pulldowns and reverse flyes also recruit your triceps. If you perform these exercises the day before or after triceps training, you’re not really providing adequate rest.

4. Perform no more than one to two overhead triceps exercises for a maximum of eight sets per workout so as not to provide excessive strain on the triceps tendon.

5. Check your ego at the gym door. Don’t lift more weight than you can safely handle, and don’t reach failure on every rep of every set of every exercise.

6. Stretch your triceps with static stretches upon completing any workout in which you utilized the triceps.

7. If you feel elbow tightness or discomfort, ice the elbow for 15 minutes as a preventative measure.