Why Does My Elbow Hurt When I Grip the Bar?

Deadlifts, pull-ups, farmer's carries, anything where you're gripping hard, and there's a nagging pain on the outside of your elbow. If that's you, this is almost certainly tennis elbow, and despite the name, it has nothing to do with whether you've ever picked up a racquet.

What's actually going on

Tennis elbow, or lateral epicondylalgia, affects the tendons on the outside of your elbow where your forearm muscles attach, specifically the ones responsible for extending your wrist and stabilising your grip. Despite the name, gripping load, not tennis, is the far more common cause we see, particularly in people who've recently increased deadlift, pull-up, or carry volume.

It's a tendon issue rather than the joint or a muscle tear, driven by the tendon being asked to handle more repetitive load than it's currently able to tolerate, which is why it tends to build gradually rather than appear from one single lift.

Why gripping specifically triggers it

Every time you grip hard, your wrist extensor tendons, the ones on the outside of your elbow, are working to stabilise your wrist against the pulling force. Heavy grip work repeatedly loads exactly the tendon that's irritated, which is why deadlifts and pull-ups tend to flare it more noticeably than most other movements.

How long will this take

This is one of the more genuinely frustrating injuries because it doesn't resolve as fast as most people want. Mild cases caught early can improve within four to six weeks with the right load management. More established cases, especially ones that have been building for months, more typically take three to six months of consistent treatment to fully resolve.

The good news: it responds very well to the right approach, specifically progressive loading rather than just rest, but it does need patience rather than a quick fix.

Why just resting it often doesn't work

Complete rest can ease the pain temporarily, but tendons actually need progressive load to properly remodel and rebuild capacity. Rest alone, without a structured reloading plan, often means the pain returns almost immediately once you go back to gripping normally, because the underlying tendon capacity never actually improved.

How physio helps

Treatment centres on progressive tendon loading, starting light and building gradually, alongside hands-on treatment and dry needling for the surrounding forearm muscles where tension is contributing. Load management is a big part of this too: working out what you can keep training and what needs modifying in the short term, rather than stopping gym work altogether.

For gym-based patients specifically, we look at your actual grip and pulling technique to identify anything adding unnecessary load to the tendon, which is often a fixable technical detail rather than something you need to just push through.

Book an assessment

If elbow pain is limiting your grip work and it's been hanging around longer than you'd like, book an assessment online or call 0450 075 955. Read more about our approach to tennis elbow, sports and gym rehabilitation, and dry needling.

This article is general information, not a substitute for individual medical advice.