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I took a break from barbell squats. Got diagnosed with tennis elbow, received a cortisone injection, got a medical elbow strap and haven't been doing any heavy back squats in the 3-6 rep range for almost three weeks now. I also ceased to do intense rows and curls as well, just to be on the safe side.

I hate front squats with a passion and really would like to get back into good old back squats, but I'm afraid the tennis elbow will come back.

The tricky part with this condition is that I don't notice the pain right away, but it sets on with a significant delay - took me a while to figure out it's not the bench pressing that causes the pain. Hence it's extremely difficult to gauge what exactly is causing tennis elbow when squatting.

My question: What are causes for this condition when back squatting and how can I adjust my form to prevent relapse (e.g. high bar vs. low bar, wide grip vs. narrow grip, elbows pointing behind vs. elbows pointing to the floor...)

  • Tennis and Golfer elbows take forever to heal if you don't have the time and/or money to get them treated like the pros do. What sort of rehab are you doing? Most things are gonna hurt for a while, the real question is: how much do they hurt you and do they make it worse? You should see a medical professional over this, I'm serious, this can take years to get better if you don't address it accordingly. If you need people to correct your technique, you have to post videos. Since so many movements can cause this, perhaps get a personal trainer? – Raditz_35 Apr 24 at 10:14
  • @Raditz_35 Really? Mine just took a commitment to rest plus a few exercises. In the end the expensive treatments didn't do anything more than address the acute inflammation. – Dave Liepmann Apr 24 at 10:56
  • @DaveLiepmann this can vary a lot. Tennis elbow can be nasty and long, but as with everything, this depends. We shouldn't give definite medical advice though, I'm not qualified either. But I'd recommend taking it seriously enough to not fully trust advice from people that don't have any insight on what caused this in the first place and what needs to be corrected. – Raditz_35 Apr 25 at 0:32
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I used to get elbow problems from back squatting, and what helped was

  1. increasing range of motion in my shoulders
  2. a two-phase approach to the elbow: first rest until the acute problem was over, then strengthen it over time with lots of controlled pull-ups, starting with low volume performed slowly.

Shoulder ROM helps because getting your hands on the bar, especially in a low-bar squat, requires scapular retraction and external rotation of the shoulder. I improved those through a daily morning practice of arm circles and shoulder warm-up, by being conscious of my posture, improving ergonomics of my work desk, and doing more pulling than pushing exercises in my workout programming. I also got benefit from doing basic physio exercises, especially the wrist/elbow stretches and the towel twist.

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  • Thanks for your answer! Point 2 is self-explanatory. Could you clarify 1., i.e. in which degree of freedom would an increased ROM in the shoulder be beneficial? What excercises did help you with achieving that? – UnbescholtenerBuerger Apr 23 at 13:34
  • @UnbescholtenerBuerger I edited to clarify :) – Dave Liepmann Apr 23 at 14:44
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    thanks a lot again! This seemed to help a lot! – UnbescholtenerBuerger May 17 at 16:02
  • @UnbescholtenerBuerger I'm so glad to hear that. Viel Erfolg beim training! – Dave Liepmann May 17 at 19:32
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Mark Rippetoe has addressed this very well in numerous videos and on his podcast. This condition almost always comes about because your wrists aren’t straight. Many people compromise this because of crappy shoulder mobility.

See the following article from Nick Delgadillo on the reasons why your squat form is probably causing this.

Elbow pain in the Squat

Then read this article by Dr. Jordan Feigenbaum and pay particularly close attention to the “Pin Firing” section in which they use chin-ups to fix it. I can say firsthand that this fixed my tennis elbow despite it being a somewhat painful process.

Elbow Tendinitis and What to do About It

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