I often have patients ask me how many bicep curls they should be doing to help strengthen their arms, as a sports physician. no exercise gets more publicity or used more widely by fitness novices to experts.

However, if you do too many curls or do them incorrectly, you may experience elbow pain.

We'll go over why you might experience elbow pain while performing bicep curls, as well as how to fix the issue so you can keep working out those arms.

The 4 reasons you get elbow pain are:

• Using a weight that’s too heavy

• Not using varying forms of bicep curls

• Gripping onto the bar too hard

• weights can cause wrist pain. If you don't keep your wrists in a neutral position while curling weights, you can cause wrist pain.

Before we investigate the reasons behind elbow pain during bicep curls, let’s take a look at the basic anatomy of the elbow and how it relates to the bicep curl.

Basic Elbow Anatomy & How It Functions During Bicep Curls

The end of the arm bone is enlarged to form a rounded knob (capitulum) that articulates with a depression (fossa) on the outer end of the radius. The elbow joint is formed by the humerus articulating with the radius and ulna. The end of the humerus is enlarged to form a capitulum, which articulates with the radius.

There are four primary movements of the elbow, which are flexion, extension, supination, and pronation. However, for the purposes of the bicep curl, we will only be focusing on flexion and extension.

• Flexion (bending the hand towards the shoulder).

• Extension (straightening out the arm).

From here, the elbow remains in the same position as the forearm flexes and the weight is brought up to your shoulder. The bicep curl is usually started with the elbow in a fully extended position while standing and holding the weight in your hand. The palm of your hand should be facing forward and your wrist in a neutral position (not bent forward or backward). From this position, the elbow remains in the same position as the forearm flexes and the weight is brought up to your shoulder.

The elbow is bent with the weight in hand until it reaches the front of the shoulder, then lowered back down into the starting position.

Reasons You Get Elbow Pain During Bicep Curls

1. You aren't using the proper grip. 2. You're curling too much weight. 3. You aren't keeping your elbow locked in place. 4. You aren't keeping your wrist straight. There are four main reasons for elbow pain when doing bicep curls: improper grip, curling too much weight, not keeping the elbow locked, and not keeping the wrist straight.

1. USING TOO MUCH WEIGHT

If your hand and forearm aren't strong enough, it could affect your wrist position when you're trying to grip something heavy.

If your wrist is not in a neutral position, the force from the curl is displaced into your forearm, which puts extra pressure on the elbow and can cause pain.

2. NOT USING VARYING FORMS OF THE BICEP CURL

If you keep doing the same type of bicep curl, you may get an overuse injury. This is because the structures in your arm and elbow go through the same forces over and over again.

You can reduce your chances of an overuse injury by varying your technique for exercises like concentration curls or preacher curls. This changes the force exerted on your arm and elbow.

3. GRIPPING ONTO THE BARBELL TOO HARD

If you hold the barbell too tightly, the flexor tendons in your wrist will bend your wrist forward, which can cause elbow pain during bicep curls. This is because the tendons attach to the inner part of the elbow.

4. NOT KEEPING YOUR WRIST IN A NEUTRAL POSITION WHEN CURLING

If you bend your wrists too far forward, it can tighten the tendons that attach to the inner part of the elbow, causing pain.

If you bend your wrist backwards, it can activate the extension tendons in the wrist, which attach to the outer elbow. This can then lead to outer elbow pain.

Elbow Pain Diagnosis

Now that we’ve discussed the reasons you get elbow pain during bicep curls, let’s discuss the different elbow diagnoses that could be causing your issues.

You should always get a diagnosis from a medical professional instead of trying to diagnosing yourself based on something you read online.

Here are the most common diagnoses for elbow pain when related to bicep curls:

1. GENERALIZED ELBOW PAIN

If someone asks you where your elbow hurts and you can't point to one specific spot on the inside or outside, this is called elbow tenderness.

This can be linked to:

• A distal bicep tendon rupture is when the tendon that connects the bicep muscle to the elbow joint tears away from the bone. This is a rare injury, but has been seen in people who do a lot of bicep curls. There are special physical exams that doctors can do to diagnose this injury.

• If you experience elbow pain while doing bicep curls, it may be due to triceps tendinopathy. This condition is caused by repetitively straightening the elbow with a weight in hand. Patients typically have pain when they touch the back of their elbow.

• Osteoarthritis, which is also known as general “arthritis,” is rare in the elbow since the elbow is not generally subject to the same repetitive weight bearing that the knee joint is. However, it can happen if you repeatedly engage in activities such as bicep curls. Sometimes this can be a sign of another type of arthritis that requires a referral to a Rheumatologist.

2. INNER ELBOW PAIN

If someone were to ask you where your elbow hurts and you pointed to the inside of the elbow closest to the rest of your body, this would be considered a proximal joint.

This can be linked to:

• . Medial epicondylitis is caused by repetitive use of the muscles that help bend your wrist forward. This can occur if you are not using a neutral position while doing bicep curls.

• Sometimes pain felt in the inner elbow is actually caused by problems in the neck or shoulder. This can happen because there are areas where different nerves overlap, so they can send signals from more than one part of the body.

3. OUTER ELBOW PAIN

This is where the point is located. The point someone is referring to is located on the outside of the elbow, away from the rest of the body.

This can be linked to:

• This medical condition is commonly referred to as “golfer's elbow.” It is caused by repetitive use of the muscles that extend the wrist backwards. This often occurs when the wrist is not in a neutral position, such as when doing bicep curls.

• This is due to the way that the nerves are interconnected. Sometimes pain in the outer elbow can be caused by issues in the neck or shoulder. This is because the nerves are interconnected.

• If you do bicep curls with incorrect form, you can irritate the ulnar nerve, which can cause numbness, tingling, or burning on the outer part of your elbow.

What Should You Do When Your Elbow Hurts When Bicep Curling?

There are many ways to treat elbow pain when you are doing bicep curls. If the pain is recent ( within the last 4 weeks) and not caused by an injury, the following methods may help.

DID YOU LOSE ANY SENSATION?

Before we go into treatment options for your elbow pain, be sure you can still feel sensation in your forearm, elbow, wrist, hand, or fingers.

If you experience any new weakness in your arm, especially grip strength, you should see a medical provider immediately as it can be a sign of a more serious injury.

USE THE RULE OF TWOS

I love using the rule of twos when treating patients.

You should rate your pain on a scale from zero to ten before you start doing bicep curls. Keep track of the pain level in your elbow while you're doing the curls.

If your elbow pain, for example, increases by two levels (on a scale from one to ten on the pain scale), you need to either back down or be evaluated by a medical professional in person.

USE “RICE”, USE “PRICE” INSTEAD

Many are familiar with RICE, which stands for rest, ice, compress, and elevate. Fewer know about PRICE – protection added to the acronym.

This is called RICE therapy: Sometimes you'll use protection before being evaluated by a medical professional to prevent the elbow from further injury. This protection can involve a compression wrap or brace to control swelling and add support. This is called RICE therapy:

DECREASE INFLAMMATION

You can get ice for cheap (usually free), and it is one of the oldest anti-inflammatories that doesn't require a prescription.

I usually tell patients to put ice on their elbow for five minutes, then take it off for ten minutes to prevent skin damage.

If topical ice treatment isn't effective, you can try orally-administered medication or a topical anti-inflammatory from a medical professional.

Before beginning any exercises or rehabilitation, it is important to control the inflammation to avoid further irritating a painful elbow. More inflammation will only cause more pain.

USE TRAINING MODIFICATIONS

If bicep curls or any other activities cause you elbow pain, you should stop doing those activities to allow yourself time to heal.

If you are experiencing pain during bicep curls that persists even after resting, you may want to consider using lighter weights and higher repetitions. This is especially true if you have not been diagnosed with any other condition by a medical provider.

Frequently Asked Questions

What are some frequently asked questions that you get from patients?

SHOULD I USE A RESISTANCE BAND OR A CABLE MACHINE?

The advantage of a band is that the resistance is not only active during the curl but also when you are releasing the curl (straightening your elbow). The advantage of free weights over resistance bands or a cable machine is that the resistance is active during the bicep curl as you bring the weight up towards the shoulder. On the way back down (straightening your elbow) the bicep is under tension to release the curl. The advantage of a band is that the resistance is not only active during the curl but also when you are releasing the curl (straightening your elbow).

Placing resistance bands or a cable machine around your biceps during a curl exercise is important because it keeps the resistance constant, preventing injury to the tissue.

In addition to providing resistance, bands and cable machines also offer a greater range of motion, providing a better workout for the muscles and structures surrounding the elbow.

SHOULD I USE A WRIST IMMOBILIZATION BRACE?

A wrist immobilization brace can help you maintain a neutral wrist position during a bicep curl, which can reduce the risk of improper form and injuries.

Final Thoughts

If you follow the small adjustments suggested and include the appropriate treatments, you will be able to do bicep curls without any elbow pain. Good luck getting back into the gym.