​By Tim Paynter, @paynterperiodization

​Do you suffer from bicep pain in the elbow during the bench press? If you’ve been powerlifting for long enough, chances are you’ve experienced this before. At times, the pain can be so bad it’s almost debilitating. What is this pain, what causes it, and how can you fix it? 

Biceps pain in the elbow is typically called distal biceps tendonitis which is caused by inflammation around the distal biceps tendon on the radial tuberosity (where the biceps tendon attaches to the forearm bone). However, for most of us who have been powerlifting for a long period of time, the pain may actually be associated with true inflammatory tissue changes (deterioration) in that tendon which is actually called tendinosis, not tendinitis. This commonly causes pain during flexion of the elbow, which for powerlifters occurs towards the bottom of the bench press. 

The onset of this pain is often associated with a strain from sudden increases in the amount of activity (increases in volume or frequency) or from overuse (accumulated damage over and extended period of time). However, sometimes this pain can also be associated with flaws in technique and form during the bench press. 

To “fix” this issue, you need to first take a step back and look at your current and previous training history. Have you recently had a rapid increase in volume, intensity, or loading in the bench press? If so, this may be a sign that you need to dial those back a bit. Reducing the total amount of sets, reps, and loads you’re using in training may very likely be necessary. If all of those parameters have been accounted for and you’re still experiencing biceps tendon pain, then there may be some corrections that are necessary in your form. 

One of the most common form issues I see during the bench that can cause this is improper stabilization of the bar. Start by making sure your shoulders are depressed with your shoulder blades pinched together to create a stable foundation. Once you’re confident in your shoulder stabilization, next you should check your grip width. A grip that is too wide often places excess stress on the shoulder, while a grip that is too narrow (which may be the cause here) places excessive stress on the elbows. I suggest a proper grip width that allows your forearms to be at or very close to perpendicular with the floor at the bottom of the bench press. Next, consider how you are applying force into the bar. One overlooked cause of elbow pain is when we are using our biceps and pecs to help stabilize and control the bar during the press by internally rotating our shoulders and elbows during the press, this puts constant pressure on the biceps during the bench press. Instead, stabilize the bar by externally rotating the shoulders and therefore the elbows during the bench press. Imagine you are trying to bend the bar towards you and pull it apart instead of trying to bend it away from you and push it together. This uses your triceps and back for stabilization instead of your biceps and front delts. This sounds a little complicated so if you’re unsure about it use a long piece of 1 inch PVC pipe to help practice. Make sure the pipe bends with the ends towards the ground, raising the center of the pipe bending it away from you. If the ends are bending towards the ceiling and center is bending in towards you, you’re doing it wrong. 

If your programming and form have been addressed and you’re still experiencing this pain it may be a good idea to take a short break from bench pressing or looking at other lifts such as the squat, deadlift, or any assistance exercise where you may also be placing excessive strain on the biceps’ tendon. Correcting your grip/grip width during the squat may also be necessary, as well as, ensuring your arms are not bent at all during any portion of the deadlift. You may also try avoiding assistance exercises that are putting excessive strain on the biceps’ tendon like curls, pulldowns, etc.

While some aches and pains are common to powerlifters, they don’t all have to be accepted as part of the game. Look for ways to correct underlying issues and address these aches and pains before they become worse or cause irreparable tissue damage. I hope these tips help, if they do, please let me know which ones. If you know any other fixes, feel free to let me know as well. As always this is NOT medical advice and you should certainly consult medical attention for any injuries sustained while powerlifting. Thanks for reading. 

​Recovering from Minor Injuries
By Tim Paynter, @paynterperiodization

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​Hey, powerlifters! We need to stop being afraid to take time off when we’re injured. 

I see it time and time again. A lifter gets injured but continues trying to train, despite the injury. We’ll often say things like, “I can just train around it” or “I can push through it”. While we can all admire that dedication and drive to succeed, it is rarely effective and often causes minor injuries to turn into something much worse. So, what should we do when we find ourselves suffering from a minor injury? Take time off? No way, right?! Actually, yes way… I say this from experience. In my time under the bar, I’ve been lucky enough to never have any sort of catastrophic injury. However, I have dealt with numerous muscle strains, partial muscle and tendon tears, SI dysfunction, low back pain, rib subluxation, tendinitis, etc. So how have I overcome them? Rest. 

Sometimes not going into the gym and training is harder for us, mentally, than training hard. To many of us, training is as much about sport as it is about therapy. We want to push ourselves hard because during that training session, even if only for a moment we can forget about everything else that is going on outside of the gym. It is a release of the stress and struggles of day-to-day life. But when we are injured, we must understand the difference between therapy and sport. If we want to be competitive then we must understand that we are not going to be able to compete to the best of our abilities if we’re injured. 

Aside from the typical ice therapy, heat therapy, and other immediate responses, I’ve found that most minor injuries like muscle strains, tendinitis, and others are often completely healed the most efficiently by simply staying out of the gym for a short period of time, typically less than 4 weeks but occasionally up to 6 weeks. We need to let our bodies rest and use all of its resources towards healing the injury. When we continue training through or around the injury many of our body’s recourses are taken away from healing that injury and put towards muscle recovery from the continued training. This, in turn, prolongs our recovery time. 

So, what should we do during that time off from the gym? We can and should do things that increase blood flow such as some form of cardio, stretching, mobility work, etc. that does not involve using the injured area.  I would suggest staying away from anything that stretches the injured area, especially if it is an injured muscle. We should also spend this time evaluating what may have caused the injury in the first place and attempting to correct faulty movement patterns, poor exercise selections, etc.

Once we’ve taken a sufficient amount of time off, which is going to differ based on the injury type and extent of that injury, we can ease back into training. That is often going to involve very light training for anything that involves the injured area to access tolerance. We should not try to jump right back in where we left off. Chances are we’re going to have lost minimal strength and fitness over such a short break, especially if we keep our nutrition in check during this break. But we should still start off light to be cautious and build back slowly. In terms of longevity, we’re better off safe than sorry. Take one to two training blocks to slowly work back up to where we were before the injury and to correct the issues causing the injury. In the grand scheme of things, a few weeks off and a couple of lighter training blocks isn’t going to affect the end goal of being as strong as possible for as long as possible much at all. However, jumping right back in and going balls to the wall without addressing underlying issues just to reinjure the affected area will certainly cause a much longer set back.

I know this isn’t necessarily what we want to hear, but it is often what must be done. Sure, we can spin our wheels for a bit and possibly end up in the clear later on but it’s most likely not the most efficient way to recover. This is simply my experience and what I suggest for my athletes, it is certainly not medical advice and I have no credentials, aside from personal experience. However, I’ve seen it work many times over for myself and others willing to try it.