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The Reason You Get Elbow Pain When Back Squatting

It may seem weird that your elbows would hurt during a lower body exercise. The barbell back squat may be an exercise that mainly works your legs, but it requires good positioning of the bar to perform it successfully. You will run into problems if you can’t get your arms behind you to get hold the bar.

​You may be getting pain on the inside of your elbow, this is the medial epicondyle of the elbow. The muscles along the front of the forearm that flex the wrist and hand share a common tendon and attach right here. When the tendon gets irritates it’s called medial epicondylalgia, or golfer’s elbow.


So how does this play into the back squat?

​To create good tension and prevent the bar from rolling off your back you need to get a solid grip on it and pull it down. The common cue is to “bend the bar” over you back. If the wrist is bent too far back, then the forearm muscles will be on stretch. Contracting these muscles while in this position will put a lot of stress on them. They are not meant to produce a large force in a stretched position. This is how the elbow pain comes on, but…

       Bad (Wrists Bent Too Much) 
             Good (Wrists More Neutral)


​​What’s the real cause of your elbow pain?

​It’s more complicated than just poor wrist positioning. It could be that you just need to think about it and just roll the wrists forward into a more neutral (hand stacked over wrist) position, but it’s more likely that you have a limitation in your shoulder mobility. In this position the shoulder needs to be extended (brought behind the body) and externally rotated (rotated away from the body). If these things are limited, then the elbow may roll forward and bend the wrist back. This would be the root cause of the forearm muscles being stretched and becoming irritated.

​How do we know if your shoulder mobility is limited?​
​For extension, with the arm hanging at your side bring it straight behind you. You should be able to get your arm back about 60 degrees. Watch for any compensations like rolling the shoulder forward or leaning forward at the low back or hips. This will give you a false idea of how much range of motion you truly have.

​For external rotation, sit on the floor with your back against the wall. Bring your arm up to 90 degrees wit the elbow bent. Rotate your shoulder and bring the back of your hand towards the wall. You should be able to get the back of the hand to the wall without arching your low back.

What do I do now?

​If either of these are limited, then this is most likely the cause of your elbow pain when squatting. This is a common issue that we see with elbow pain when squatting. We can work with you to get your shoulder more mobile and get you back to squatting pain free! If you don’t find a limitation in your range of motion, then it could be a few different things. We can go through a in depth evaluation to determine the cause and get you back in the gym. If you are interested in working with us, then fill out this form and we can give you a call to discuss what else it could be and how we can help you!


Dr. Brett Dick

PT, DPT, Owner of Limitless Performance Physical Therapy

We Help Active People ​Improve Pain And Performance ​In Their Favorite Sports And Activities.
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