How to train biceps while minimizing the stress on the lateral epicondyle of the humerus? (proper moves, use of rubber tubing, elbow support brace, etc.)

  • 1
    Your best course of action is to pose this question to a physical therapist. Beyond that, I would avoid any movement that would force you to rotate your forearm. For example, performing seated biceps curls with your palms facing forward without forearm rotation should be doable.
    – rrirower
    Apr 25, 2015 at 15:25

2 Answers 2


Issues with the lateral epicondyle (the bony bump on the outside of the elbow) are a result of a few problems:

  • Tennis Elbow (Lateral Epicondylitis)
  • Fracture
  • Cubitus Valgus

"Minimizing stress on the lateral epicondyle" is too broad. It leaves Why unanswered.
Not knowing why or in what stage of rehabilitation (e.g. onset - surgical recovery) makes it difficult to recommend anything.

The big question being should you avoid putting stress on certain muscles or should you be exercising these muscles.

When it comes to exercise the most important is to do stretch exercises and, very important, warm up before working out. Rehabilitative exercise requires working with light loads with a minimum of two days between workout days.

Minimizing stress on the lateral epicondyle while exercising the biceps should not be too much of an issue. I would think the concern would be more about triceps (extensors) and biceps (flexors). These, being an antagonistic pair, the two need to be trained together or an imbalance could lead to injury.

There are three muscles directly related to the lateral epicondyle:

  • extensor carpi radialis brevis
  • Anconeus
  • Supinator

As shown in the first two images, the biceps are not in proximity to the lateral epicondyle or the medial epicondyle. Also notice the close proximity of the Triceps and Anconeus. In the case of tennis elbow the injury is a result of the extensor carpi radialis brevis muscle (top left center) which is associated with wrist extension and abduction actions.

Anconeus assists in elbow flexation of the forearm and stabilizes the elbow when rotating the forearm. It is associated its prime mover the triceps stabilizing the elbow during flexation. Elbow extensions are ultimately achieved through the synergistic relationship between the triceps brachii and the small anconeus muscle.

Forearm Extensors

Medial Epicondyle

There are many muscles in the forearm and the extensors are prone to repetitive stress syndromes (e.g. carpal tunnel). Other lateral epicondyle related muscles are buried deep.

forearm cross section

By dissecting the extensor muscles the Supinator muscle is revealed.

Supinator always acts together with biceps, except when the elbow joint is extended. The supinator is less involved with rotation under heavy load. Under heavy load, the biceps take over.

The supinator is to the biceps as the Anconeus is to the triceps. triceps brachii, which is responsible for extension of the elbow joint.

Both supinator and Anconeus stablize the elbow by way of the lateral epicondyle and are responsible for rotation of the forearm.

The abductor pollicis longus lies immediately below the supinator and is sometimes united with it.

Supinator lateral epicondyle

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Rotation of the Forearm is Key

To minimize stress on the lateral epicondyle you must minimize rotation. To minimize rotation you must choose a biceps exercise that does not work a muscle associated with rotation.

Lateral Epicondyle

The bicep Brachii is responsible for two motions in the elbow: flexion and supination (rotation).

Many biceps exercises also work the brachioradialis which is related to rotation (supination) of the forearm.

The biceps brachii muscle alone does not directly affect the epicondyle. To minimize stress on the lateral epicondyle care must be taken not to rotate the forearm when doing biceps exercises. There are some biceps exercises to avoid as well such as the reverse curl and reverse pushdowns. You may want to avoid the reverse wrist curl as well.

When the elbow joint flexes, a synergistic contraction of the brachialis and the biceps brachii is required.

Other muscles with tendons that attach near the lateral epicondyle.

  • extensor digitorum
  • extensor carpi ulnaris
  • extensor digiti
  • pronator teres
  • pronator quadratus

Many biceps exercises also work the brachioradialis which is related to rotation of the forearm. The brachioradialis is worked in arm and back exercises. The arm exercises include:

  • Dumbbell Curls
  • Hammer Curls
  • Preacher Curls
  • Reverse Curls

The Back Exercises:

  • Reverse Chin Up
  • Lat Pulldown
  • Seated Rows
  • Dumbbell Rows
  • T-Bar Rows

EZ-Bar and Cubitus Valgus

Cubitus Valgus is due to a lateral epicondyle fracture or a common anatomical variation, where the elbow joint is twisted outward from the center of the body (cubitus valgus). This is where the forearm angles (carry angle) away from the body when the arm is fully extended downward with the palms facing forward. This will cause barbell curls to be painful because the elbow joint angle causes the wrists to have to break excessively. The solution is to use an EZ-Bar rather than a straight bar. A seated curl machine would offer greatest stability.

Braces and Other Exercises

I am not qualified to give advice for rehabilitation.

check out these guys: Tennis Elbow Treatment

Select an Exercise that works only the brachialis and the biceps brachii and NOT brachioradialis.

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For most of the Upper Body workouts and few of the Lower Body workouts we do require arm movement. So, you are working your arms as well admist other things each time you work on some region of your body. But if you "really" need to work on your biceps you need to twist your elbow. There's no other way around it. The heavier you go. The bigger the biceps. I suggest that you go light in the beginning with an elbow strap. Which could ease the elbow a little bit. But as you go heavy. Let some one help you out in giving you that extra push. Unless it doesn't hurt you. Also if you're injured try consulting a physician before proceeding.

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