What causes sharp pain in the elbow while bending?

Question

Hello doctor,

I have had elbow pain for around six months. When I bend my arm at 90 degrees or more, I get a sharp pain. This is typically during skullcrushers, the top half of a tricep pulldown, some variations of pullups, and even some variations of pushups. I visited a physio who told me I have tendinosis, which means due to the intense friction in the area during these movements, my tight tricep tendon is pulling on my elbow tendon, and that is why I feel sharp pain at these angles. The solutions he has given me are not helping, and in fact, it is getting worse.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Thanks for explaining your situation so clearly. Chronic elbow pain like this, especially when it is worsening, is deeply frustrating. Given that it has been ongoing for six months and your current treatment is not only ineffective but possibly aggravating the issue, it is important to take a more strategic and perhaps multidisciplinary approach. Based on your description, a few things stand out:

Pain during elbow flexion of more than 90 degrees, especially under load.
Involvement in skullcrushers, tricep pulldowns (top half), pullups, pushups, all involving the triceps, and likely elbow extension or flexion under tension.

Diagnosis: Triceps tendonosis leading to traction on the elbow.

Immediate recommendations:

1. Stop aggravating movements- Strict deload.

You are likely stuck in a cycle of microtrauma without time for recovery. For now:

Stop all loaded triceps extension movements (skullcrushers, pushdowns, dips, overhead triceps, etc.)
Pause all pullups and pushups, especially those that stress elbow flexion angles more than 90 degrees.
Substitute with isometric exercises and unloaded mobility work.

Distal triceps tendinosis (your current diagnosis)-

Common in lifters.
Pain is usually at the back of the elbow near the olecranon.
Worse with triceps-heavy movements, especially when the elbow is flexed more than 90 degrees under load.

What you can start doing-

Isometric triceps holds:

Research shows that isometrics can relieve tendon pain and improve tendon loading capacity without causing overload.
Isometric triceps pushdown (pain-free range only).
Elbow at 45 degrees or less.
Three to five holds of 30 to 45 seconds, one to two times daily.

Eccentric triceps loading (only if pain allows)-

If the isometrics start to help, gradually reintroduce them.
Eccentric-only triceps extensions (lower the weight slowly, use both arms to reset).
Three times, 10 repetitions, light weight, three to four times per week.

Soft tissue work and stretching-

Gentle foam rolling or a lacrosse ball on triceps and surrounding fascia.
Triceps and lat stretches, not to pain, just to a mild stretch.
Consider dry needling or IASTM (instrument-assisted soft tissue mobilization) if available.

Check shoulder and scapular mechanics:

Poor shoulder mobility or stability can transfer stress to the elbow.
Work on scapular control, especially serratus anterior and lower traps.
Incorporate mobility for the thoracic spine and lats.

If you need further treatment recommendations and a prescription, do book a video call or audio call consultation with me as early as possible.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.