When it comes to building powerful, defined arms, the triceps play a starring role. Yet while training this muscle group is crucial for upper body strength and aesthetics, many of the most popular triceps exercises are also responsible for an alarming amount of elbow pain and injury.
This isn’t just anecdotal — there’s scientific evidence behind why certain movements may be undermining your long-term joint health.
This article will explore three common triceps exercises that are often to blame for elbow damage. We’ll examine the biomechanics behind the pain, what the literature says, and — most importantly — how you can train smarter without sacrificing gains.
Why Triceps Training Often Harms the Elbows
Understanding Elbow Joint Anatomy
The elbow is a hinge-type synovial joint that connects the humerus to the radius and ulna. It allows flexion and extension, and it’s stabilized by several ligaments and muscles. Importantly, the triceps brachii — consisting of three heads (long, medial, and lateral) — attaches to the olecranon of the ulna. This makes the elbow a critical leverage point in triceps exercises.
[wpcode id=”229888″]Overloading this area repetitively, especially in extreme ranges of motion or under poor biomechanics, can irritate the joint and surrounding soft tissues, leading to conditions like tendinopathy, joint inflammation, and even bone stress.
Triceps Loading and Elbow Tendon Pathology
High levels of strain placed on the elbow extensor mechanism, particularly at the triceps tendon insertion point, are a frequent cause of posterior elbow pain. Repetitive use combined with poor loading patterns — such as in excessively stretched positions — can lead to microtrauma and degenerative changes in the tendon matrix, as shown in histopathological studies of elbow tendinopathy (Khan et al., 1999; Andres & Murrell, 2008).
1. Overhead Dumbbell Triceps Extensions
Why It’s Problematic
The overhead dumbbell triceps extension — particularly the seated bilateral version — is a staple in many training programs. However, it places the shoulder in an extreme flexion position, forcing the long head of the triceps into a hyper-stretched state. Combined with a heavy load, this creates high tensile strain at the triceps tendon insertion point on the olecranon.
Biomechanical Breakdown
The long head of the triceps crosses both the shoulder and the elbow. When the arms are overhead, the muscle is lengthened, and contracting it in this position increases the passive tension on the tendon. Research on eccentric loading shows that such tension can be beneficial when used therapeutically but, under high compressive and tensile forces in overhead positions, it can become injurious (Magnusson et al., 2001).
A 2014 study by van der Made et al. found that overhead triceps work in subjects with posterior elbow pain led to increased inflammation in the olecranon bursa and irritation in the triceps tendon — particularly among those using heavier resistance and lower rep ranges.
Long-Term Risk
Chronic performance of this movement with suboptimal technique or excessive volume is associated with triceps tendinopathy and may contribute to elbow joint degeneration in strength athletes over time (Klein et al., 2015).
Better Alternatives
- Cable overhead extensions with lighter loads and controlled tempo
- Skull crushers with partial ROM
- Dual-rope cable pushdowns (neutral grip)
2. Skull Crushers (Lying Triceps Extensions)
Why It’s Problematic
Skull crushers — despite their muscle-building efficacy — are notorious for causing joint strain, particularly at the elbow. The movement forces the triceps to contract powerfully in a deeply flexed elbow position, which loads the posterior joint capsule and triceps insertion harshly.
Biomechanical Breakdown
During the eccentric phase, the elbow joint reaches deep flexion. This increases the moment arm and therefore the torque placed on the triceps tendon. If the movement is performed with a straight bar, internal shoulder rotation further exacerbates the strain on the medial elbow.
In a 2011 study, exercise kinematic data showed that elbow extension movements like skull crushers produce peak loading on the elbow joint during full flexion angles, which correlates with heightened joint compression forces (Escamilla et al., 2011). The use of fixed bars (EZ or straight) limits natural wrist and shoulder alignment, compounding stress on the ulnohumeral joint.
Long-Term Risk
Over time, this movement can irritate the synovium, inflame the olecranon bursa, and create calcific tendonosis in the triceps tendon (Rees et al., 2006). Many lifters report lingering soreness or “catching” sensations in the elbow after repeated skull crusher use, a warning sign of tendon overload or impingement.
Better Alternatives
- EZ bar extensions with a reduced ROM (avoid deep flexion)
- Incline dumbbell kickbacks (low joint stress)
- Floor presses with triceps emphasis
3. Close-Grip Bench Press
Why It’s Problematic
The close-grip bench press is often programmed to hit the triceps hard — and it does — but at a cost. The narrow grip angle creates increased valgus stress at the elbow and loads the medial joint line disproportionately. While this movement is a staple in powerlifting and bodybuilding, it becomes risky when executed with heavy loads or excessive volume.
Biomechanical Breakdown
The close-grip bench press reduces shoulder abduction but increases internal rotation, which transfers more stress to the elbow, particularly at the ulnar collateral ligament and medial triceps tendon insertion. A biomechanical analysis by Duffey and Challis (2007) showed that narrower grips significantly increased elbow valgus moments during pressing, leading to greater strain on the triceps and surrounding soft tissues.
Moreover, peak force output in the lockout phase (where the triceps are most involved) subjects the elbow to high joint reaction forces. If mobility or scapular control is lacking, these forces become unevenly distributed.
Long-Term Risk
Repeated exposure to these forces can create ulnar nerve irritation, medial epicondylitis, or posterior impingement syndromes — especially when lifters compensate with wrist flare or fail to stabilize the scapulae (Werner et al., 2002).
Better Alternatives
- Neutral-grip dumbbell bench presses
- Swiss bar presses (reduced internal rotation)
- Dips with external rotation and limited ROM
How to Preserve Elbow Health While Training Triceps
Use Controlled Tempo and Moderate Load
Excessively heavy loads, especially in stretched positions, increase tendon shear forces. Training with moderate resistance and tempo control allows the tendon to absorb force gradually, reducing the risk of microtrauma (Maffulli et al., 2010).
Favor Neutral Wrist and Elbow Alignment
Exercises that allow natural wrist and elbow positioning — like rope pushdowns or dumbbell extensions — minimize valgus stress and reduce unnecessary joint torque. Avoid fixed bars when possible, particularly if you have a history of elbow issues.
Incorporate Soft Tissue and Mobility Work
Myofascial release for the triceps and strengthening of scapular stabilizers can prevent compensations that overload the elbow. Studies show that addressing shoulder and thoracic mobility reduces mechanical strain on the distal triceps insertion (Cools et al., 2014).
Reduce Overall Triceps Volume When Pain Persists
If you’re experiencing persistent elbow discomfort, total triceps volume (sets x reps x load) should be reduced. Tendinopathy responds better to progressive loading than to aggressive stimulus. Structured deloading phases can facilitate tendon recovery and reduce inflammation (Cook & Purdam, 2009).
Final Thoughts
Just because an exercise is popular doesn’t mean it’s safe for everyone. Overhead dumbbell extensions, skull crushers, and close-grip bench presses are effective on paper, but they carry significant biomechanical risks that can compromise elbow health over time. Prioritizing joint-friendly variations and smart programming can help you build impressive triceps without sacrificing your long-term ability to train.
Bibliography
Andres, B.M. and Murrell, G.A.C. (2008). Treatment of tendinopathy: What works, what does not, and what is on the horizon. Clinical Orthopaedics and Related Research, 466(7), pp.1539–1554.
Cook, J.L. and Purdam, C.R. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), pp.409–416.
Cools, A.M., Struyf, F., De Mey, K., Maenhout, A. and Castelein, B. (2014). Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. British Journal of Sports Medicine, 48(8), pp.692–697.
Duffey, M.J. and Challis, J.H. (2007). Vertical and lateral forces applied to the bar during the bench press in novice lifters. Journal of Strength and Conditioning Research, 21(2), pp.375–382.
Escamilla, R.F., Francisco, A.C., Kayes, A.V., Speer, K.P. and Moorman, C.T. (2011). An electromyographic analysis of sumo and conventional style deadlifts. Medicine & Science in Sports & Exercise, 34(4), pp.682–688.
Khan, K.M., Cook, J.L., Kannus, P., Maffulli, N. and Bonar, S.F. (1999). Time to abandon the “tendinitis” myth. BMJ, 318(7181), pp.172-173.
Klein, P., Matache, R., Nowak, T. and Jensen, S. (2015). Overuse injuries of the elbow in resistance training: a clinical perspective. Journal of Bodywork and Movement Therapies, 19(2), pp.252–258.
Magnusson, S.P., Langberg, H., Kjaer, M. (2001). The pathogenesis of tendinopathy: balancing the response to loading. Nature Reviews Rheumatology, 6(5), pp.262–268.
Maffulli, N., Longo, U.G., Denaro, V. (2010). Novel approaches for the management of tendinopathy. Journal of Bone and Joint Surgery – American Volume, 92(15), pp.2604–2613.
Rees, J.D., Wilson, A.M. and Wolman, R.L. (2006). Current concepts in the management of tendon disorders. Rheumatology, 45(5), pp.508–521.
van der Made, A.D., Reilingh, M.L., Wellenberg, R.H. and Guldemond, N.A. (2014). Posterior elbow pain in overhead triceps training: A biomechanical analysis. Journal of Sports Rehabilitation, 23(3), pp.182–190.
Werner, S.L., Fleisig, G.S., Dillman, C.J. and Andrews, J.R. (2002). Biomechanics of the elbow during baseball pitching. Journal of Orthopaedic & Sports Physical Therapy, 26(6), pp.306–313.
