When your elbow has been sore for months, it can feel like it limits everything that involves gripping, pulling or pressing. You might have tried resting it, only for the pain to come straight back. Tendon-friendly strengthening and a closer eye on your weekly load can help you keep training on track.

Why long-term elbow pain can linger

Long-term elbow pain in active people usually involves the tendons that attach your forearm muscles to the elbow. Tendons get stronger when they are loaded gradually. When they are rested, they lose some of their ability to cope, so the pain returns as soon as you train again.

That is why the most helpful approach is usually to strengthen the tendon steadily, while keeping training at a level it can handle. The encouraging part is that most people with this kind of elbow pain find it improves over time, often within a year, and strength work can help it along.

Tendon-friendly strengthening

A good tendon programme builds from holds to slow movements to heavier work. Something to try three or four times a week:

• Holds. Rest your forearm on a table, palm down, with your hand over the edge. Lift your hand against a light weight and hold for 30 to 45 seconds. Repeat a few times.
• Slow lifts. In the same position, lift and lower the weight slowly, taking about three seconds each way.
• Towel twists. Hold a rolled towel in both hands and slowly twist it, as if wringing it out, in each direction.
• Grip squeezes. Squeeze a soft ball or rolled towel for a few seconds, then fully let go.

If the pain is on the inside of your elbow, you could do the same holds and lifts with your palm facing up.

Start with a weight that feels like effort but not strain. Build up gradually, adding a little weight or a few repetitions every week or two.

Managing your weekly load

How much your elbow does across the whole week matters more than any single session. Some ideas:

• Count your total pulling and gripping sets each week, and keep increases small.
• Spread pulling sessions across the week rather than doing them on back-to-back days.
• Mix heavier and lighter weeks, especially if you climb, row or lift often.
• Remember that work and home count too, like long days at a mouse or a weekend of DIY.

If your elbow flares after a particular week, look back at what changed. It is often one extra session or a jump in volume.

Adjusting grip and technique

Small changes can reduce the strain on your elbow while you build strength:

• Use a neutral grip, with palms facing each other, where you can.
• Use straps for heavier pulling, so your grip is not the limit.
• Try thicker grips or a towel around the bar to spread the pressure.
• Keep your wrist straight, rather than bent back, when pressing or carrying.

Reading how your elbow responds

A mild ache during strengthening that settles by the next day is usually fine. If your elbow is sorer the following morning, or everyday tasks feel harder, ease back to the previous level for a week before building again.

Flare-ups happen with long-term tendon pain, and they do not mean you are back to square one. Dropping back for a few days usually helps it settle.

Keeping the rest of your training going

Long-term elbow pain does not need to limit your legs, core or fitness. Squats, lunges, bridges and cardio can carry on as usual. If you would like to follow along, VIDA has short videos of sit to stands, lunges and bridges you can use at your own pace.

Keeping track

Progress with tendons tends to come from steady weeks rather than quick fixes. Your VIDA pain check-in is a good way to notice patterns, like whether your elbow flares after heavier weeks or particular exercises.

What to take away

• Strengthen your elbow three or four times a week, building from holds to slow lifts.
• Keep an eye on your total pulling and gripping sets across the week.
• Spread pulling sessions across the week.
• Use neutral grips, straps and thicker grips to ease the load.
• Drop back for a few days if your elbow flares, then build again.

‍