Tip: Elbows Inflamed? Build Biceps Anyway

Got elbow pain? Stop making it worse with your arm training. Try this instead.


There's nothing worse for a lifter than dealing with joint inflammation like elbow tendonitis. When the orthopedist tells you the only way to remedy that pain when flexing or extending your arm is rest and recovery, it conjures up images of church lady arms that swing to and fro during heavy clapping.

It can take six months or more for tendonitis to go away. Are you really going to stop training your arms for that long? Probably not. The good news is that you don't have to. You have one more card to play before downsizing your T-shirts to fit your shrinking arms. That card is blood flow restriction (BFR).

Brad Schoenfeld covered blood flow restriction (BFR) here and its benefits have been well documented in the research community. Just recently, a meta-analysis was published (Lixandro, 2018) pitting traditional heavy-load training against low-load BFR training to see which was more efficient at growing muscle and strength.

Using almost 50 studies, it was determined that low-load BFR was just as effective in terms of hypertrophy as traditional heavy strength training. Sure, strength suffers a great deal in the absence of lifting heavy shit, but at least the sleeves will still hug the arms nice and tight.

Place the restriction (wraps or cuffs) directly between the medial deltoid and bicep. Wrap your arms with a perceived tightness of 7/10. This will provide enough pressure to occlude the cephalic vein, but ensure you're still allowing arterial flow.

Check for a distal radial pulse (at the wrist) after you're wrapped to make sure it's not too tight. Don't do the exercise if you can't find your pulse.

BFR mimics the intensity of lifting heavy without actually lifting anything heavy. The light loads (20-30% of 1 RM) used for standard BFR training will typically allow a lifter to get away with doing movements they otherwise couldn't do with an inflamed elbow.

Additionally, the pooling of blood during a series of BFR curls or extensions creates a cushion of sorts for the elbow that minimizes pain even further.

Use BFR up to 2-3 times per week for best results. Try it wherever arm work is programmed in your current protocol and see if you can do it without pain. You probably can.

The most heavily researched set/rep scheme is 30-15-15-15. It's considered the gold standard by practitioners. It looks like this:

  • Set 1: 30 reps
  • Set 2: 15 reps
  • Set 3: 15 reps
  • Set 4: 15 reps

Take only 30 seconds rest between each set. Unwrap after set 4. Breathe.

  1. Lixandrão, Manoel E., et al. "Magnitude of Muscle Strength and Mass Adaptations Between High-Load Resistance Training Versus Low-Load Resistance Training Associated with Blood-Flow Restriction: A Systematic Review and Meta-Analysis." Sports Medicine, vol. 48, no. 2, 2017, pp. 361–378., doi:10.1007/s40279-017-0795-y.
Tim Hendren, CSCS, has been training clients for 13 years in Baltimore, MD. Tim is a body composition and strength specialist. He also has extensive experience working with patients in cardiac rehab. Follow Tim Hendren on Twitter