Preventing Elbow Pain in the Squat

by Nick Delgadillo, SSC | June 22, 2017

We’ve been very successful in convincing a large number of people that The Squat works better than any other version of squatting for producing a strength adaptation. Enough people have had contact with a Starting Strength Coach, have read our books, or have watched our videos that you’re likely to see at least one other guy at the local 24/7 Fitness Club Spa squatting with his thumbs over the bar and eyes on the floor, going below parallel, and writing in a log between sets on any given Monday or Wednesday evening.

Along with this proliferation of our methods, some of the errors that were common 5 or 6 years ago aren’t so common anymore – so uncommon that people show up at seminars and for coaching sessions already over-correcting the things that we spent years yelling at everyone about. Until relatively recently, I never had to tell anyone to not shove their knees out or to not overextend their low back. These things are fairly individual issues, though, meaning that the individual lifter is able to overdo the back extension, so they do it because they haven’t been told not to.

A more universal misinterpretation of our instruction method involves the grip in the squat. A lot of you are experiencing quite a bit of pain right now that is the result of too wide a grip. Having your hands too wide necessitates overextension of the shoulder (elbows way up) and excessive forward pressure by the hands into the bar to hold the bar in place, because the wide grip artificially shortens the forearm and reduces support from the elbow up to the bar. The shoulder overextension causes you to round your upper back as you approach the bottom of the squat, requiring you to flex your wrists at the bottom and on the way up so that the bar feels secure on your back. The stress at the elbow caused by the excessive loading of the externally rotated upper arm, the flexed wrist and loaded wrist flexor muscles, or the internally rotated forearm results in lateral or medial epicondylitis – tennis or golfers elbow – a nasty, painful condition.

A grip that’s too wide. The upper back is loose and the bar will be secured through shoulder overextension and wrist flexion.

Notice the angle of the arms relative to the torso and the upper back position.

The correct squat grip will be as narrow as possible without having to bend the wrists to hold the bar. This is actually narrower than you think it should be, but here’s the key: as you narrow the grip, the upper back needs to tighten to hold the bar. The hands and arms are there to wedge the bar into place, not to push into the bar for a more secure grip. The tightness of the bar placement is a result of upper back tightness and extension of the upper back by lifting the chest, not shoulder extension and hand pressure. The elbows will be low and the forearms will be almost parallel with the torso.

Even with a bad shoulder, sufficient tightness can be achieved with a narrower grip.

Cueing elbows down and chest up secures the bar without the need to crank the elbows up.

Next time you get under the bar, use the following procedure:

Secure your hands on the bar. Put the bar way down into your palm. Don’t slide the bar down onto your wrist. With your hands locked in place, squeeze your traps hard and pull your shoulder blades together. Get under the bar, continuing to tighten your traps and shoulder blades. As your back comes in contact with the bar, take the pressure completely off your arms, hands and elbows. Stand up and take the bar out of the rack using your upper back to hold the bar in place. Keep your elbows down, chest up, and think about squeezing into the bar with your back and holding it with your traps. Remember that your arms are there to wedge the bar in place and not to apply forward pressure into the bar, and remember that “chest up” does not mean a vertical back angle when you squat. If you don’t feel the tightness in your upper back or you need to push into the bar with your hands, come back out from under the bar and narrow the grip another finger width. Once you’re back under the bar, take a second and make sure you can distinguish the feeling of pushing with your arms and squeezing with your back to secure the bar. Keep the upper back tight and elbows down as you squat. After each rep, do a quick check to make sure you haven’t started pushing with your hands again.

A sufficiently narrow grip with elbows too high.

The shoulder overextension is corrected by cueing the lifter to pull the elbows down.

This correct grip may be more uncomfortable at first if you’ve been using a wider grip. People with legitimate shoulder problems will need to modify the grip as necessary, but that’s not you. Discomfort is fine. Pain is not. If you’re in the middle of dealing with a horribly inflamed elbow, you’ll need to stop aggravating it immediately by following the above procedure deliberately before each set. If you’re squatting with a round upper back or with elbows up high and wrists and upper back in flexion, fix your grip and squeeze your upper back. Your squat will benefit immediately from the more efficient transfer of force through your back into the bar.