How to Treat Kettlebell Lifter’s Elbow

In all my years as a practicing osteopath and a competitor, this is the most common injury I’ve seen.

As a competitor I have been watching the growth of kettlebell sport in the UK since 2011, and as an osteopath I have watched the injuries of the lifters involved develop and change radically. Complaints in the beginning were mostly about fatigue and torn hands, reflecting the underdeveloped techniques used in the sport back then. But kettlebell sport has gone from a strength discipline to a highly technical endurance one, and many of the injuries I see now are from overuse.

In kettlebell lifter’s elbow, the initial lift from the floor may feel fine, but pain is felt in the catch.

Kettlebell sport involves high repetition sets of repeated pronation and supination that place powerful loads onto the forearm tendons. With careful and progressive development in a kettlebell lifter’s training, this repeated pronation and supination isn’t a problem. But too frequent contact between bones and tendons can even eventually irritate and inflame the contact points.

In this series of articles, we’re going to look at the common kettlebell injuries this inflammation causes and their methods of treatment. We’ll start today with focusing on the elbow.

What Is Kettlebell Lifter’s Elbow?

Inflammation in the bone and tendons in the elbow area is commonly known as tennis or golfer’s elbow. Tennis elbow is felt as pain on the outer side of the elbow, over the lateral epicondyle bone. Golfer’s elbow is felt on the medial epicondyle bone on the inner side of the elbow. Both are a form of tendinitis and can take up to six weeks to develop and heal. If untreated, tendinosis can develop, which can last up to six months.

Both are a frequent affliction I see in kettlebell lifters, so for the purposes of this article let’s call it kettlebell lifter’s elbow.

Kettlebell lifter’s elbow feels sore, hot, and sensitive. A sharp tap over the lateral or medial epicondyle will elicit a sharp, ringing pain and you’ll likely hop about clutching your arm. Oddly, you might be able to pick up something like a kettlebell, but if you go to do up a button or pick up a mug you’ll feel like dropping it. Equally, taking a wider grip when picking up something like a brick can be agonising. For kettlebell sport athletes, the initial lift from the floor may feel fine, but the twist of the elbow in the catch is a real issue.

How to Treat Kettlebell Lifter’s Elbow

The best prescription for kettlebell lifter’s elbow is rest, but when I suggest that to an athlete I’m usually met with withering looks and comments on my sanity. The good news is we can also reduce the use of the elbow and manage the symptoms with some solid treatment techniques.

I’ve outlined the best of these treatment techniques below.

1. Wear a Brace

Braces are a cheat of sorts, as rest should be the primary method of management. They rely partly on reducing the ‘pull’ at the tendon to bone attachment and partly by moving the point of pressure down the forearm. Many people wear a brace the wrong way round, so make sure you get the correct size brace and wear it correctly.

I’ve shown the correct way below, with the larger bulge on the outer side of the arm.

How the brace should be applied.

  • Put the brace in place and then rest your arm on your thigh to steady the band.
  • Apply a comfortable stretch to attach the Velcro.
  • Work on the principle that if it falls off, it’s too loose, and if your hand goes blue, it’s too tight.

Wear the brace for about three to four hours at a time as a maximum. Use them while driving and doing desk work, but mainly when you are lifting. Don’t wear them at night, and if your elbow issue isn’t resolved after two weeks, seek appropriate advice from a qualified health professional.

2. Apply Localised Icing

Localised icing can be very effective in the first few days of kettlebell lifter’s elbow coming on. Apply the ice for a maximum of five minutes and follow up by massaging your arm from your elbow to your wrist. The direction of the massage may seem strange, particularly for me as we’re always told to move fluid towards the heart. However, there is evidence that massage with the direction of venous drainage is very remedial. It certainly is in my experience.

3. Perform Simple Mobility Stretches

Icing is best followed by wrist and forearm stretches like those I’ve given below. These are mobility drills that work the wrist extensors to alleviate the pain of kettlebell lifter’s elbow.

Elbow Mobility Stretch #1:

Mobility Drill 1

  • Bend the elbow.
  • Bend the wrist, using the other hand.

Elbow Mobility Stretch #2:

Mobility Drill 2

  • Once you reach a point of strong pull, but not pain, hold for twenty seconds.
  • Release and repeat five times.

To refine the movement, try twisting the wrist in various directions. You will find a sweet spot that is most effective for you. Remember every case is different, even between your left and right side.

Elbow Mobility Stretch #3:

Mobility Drill 3

  • Bend the elbow fully.
  • Using the other hand held across the palm, bend the fingers and wrist back as far as is comfortable.
  • Make sure you start with the little finger fully extended.

Elbow Mobility Stretch #4:

Mobility Drill 4

  • Keeping fingers and wrist extended, extend the elbow until the arm is straight or until it is too uncomfortable.
  • Hold for twenty seconds.
  • Release and repeat five times.

All of these stretches should be held for at least ten seconds, but not much longer than thirty seconds. I don’t fuss with the idea of a perfect time for holding these stretches. If you feel a longer hold is better for you, go for it.

Keep the Rest of Your Body Healthy

Specific mobility and recovery drills sometimes miss the wider issues of overall function in the body, so don’t get too hung up on mobilising the afflicted area. Look to increase your overall mobility to prevent further injury. Indian clubs, meels, yoga, and tai chi drills are excellent for this.

Later in this series, we will look at the common thoracic spine, thumb grip, lower back, and shoulder injuries I see in kettlebell lifters. Hopefully, once we have looked at the components, we can then pull it all together into a comprehensive approach that will help you lift without injury.

 The best prevention for injury? Perfecting your technique:

How to Master the Kettlebell Jerk

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