Biceps Pain in the Bench Press

​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.