In the quest for mass, many people have used skullcrushers as a tricep exercise, only to end up with aching and tender elbows. If you google "skullcrusher pain" you get an idea of just how prevalent it is. After reading numerous posts on a variety of fitness forums, I think it's safe to say that the number of pain sufferers far exceeds the painfree.
It seems like it affects almost everyone who does this exercise. Surprisingly however, I couldn't find a single article on the biomechanics that cause it, so I had to dig a little deeper and do my own write-up.
I posted it in my training journal but since a few folks thought it would be a helpful post for others, I'm putting it here as well.
Skullcrushers and Elbow Pain
In this write-up, I will address the following topics:
Why It Hurts
What To Do About It
The Anatomy of the Elbow
The elbow is made up of three bones, connected by muscles, ligaments and tendons. The humerus is the large upper arm bone. The ulna and radius are the two bones in the forearm.
The elbow joint is actually three separate joints; the ulnohumeral joint, the radiohumeral joint and the superior radioulnar joint. This allows the forearm to move up & down, side-to-side and rotationally.
The elbow also has four main ligaments. On the medial aspect of the elbow is the ulnar collateral ligament that connects the ulna to the humerus. On lateral aspect of the elbow is the radial collateral ligament that connects the radius to the humerus. The other two ligaments are the annular ligament and the quadrate ligament. They connect the radius to the ulna. There is articular cartilage anywhere that two bony surfaces come into contact with each other, allowing the elbow bones to move easily as the elbow bends.
The biceps, brachialis and brachioradialis muscles flex the elbow. The triceps muscle extends the elbow. Other muscles that move the hand at the wrist also originate at the elbow. These muscles attach via tendons to the medial and lateral epicondyles.
The bursa is a small fluid filled sac that decreases the friction between two tissues. Bursae also protect the bony protrusions on the elbow bones. There are three different bursae around the elbow the largest of which is the olecranon bursa in the back of the elbow.
The Biomechanics of Skullcrusher Pain
Looking at the anatomy of the elbow, it's easy to see that the human arm wasn't designed to hold a heavy weight in an inverted, suspended position. In part, this is why skullcrushers are so effective at isolating the triceps but it's also the reason why they end up hurting.
In addition to the stresses that are placed on the tricep muscle, it's a movement that compresses the outer elbow joint. This compression increases the amount of friction on the tricep tendon as it inserts into the olecranon at the tip of the elbow. This friction in turn irritates the olecranon bursa, which reacts by becoming inflamed. This is called Olecranon bursitis.
Why Does Olecranon Bursitis Hurt like Hell?
As anyone who's bumped their funnybone knows, there are a surprising number of nerve endings in the elbow joint. A swollen bursa is no different than a water balloon and any engineer can tell you that water cannot be compressed. So every time you bend your elbow, you're squeezing that water balloon and the pressure is being transferred directly to those nerve endings.
More bending = more pressure = more inflammation, which is why your elbows can hurt for days after doing skullcrushers. People who attempt to ignore the pain and not let the inflammation subside, tend to regret it:
So What's The Cure?
For starters, stop doing skullcrushers when your elbows begin to hurt and don't try to macho it out with that stupid "no pain, no gain" cliché.
Rest is the most effective treatment. Ice will reduce the inflammation. Cortisone injections will alleviate elbow pain and swelling but almost always deteriorate the ligaments after repetitive doses.
There are a variety of equally effective tricep exercises that will not place as much stress on the elbow joint. Dips and Close-grip Bench Press are the first two that come to mind.
The important thing is to not lock yourself into a paradigm of thinking that there is only one exercise that is going to get you larger triceps and then to ignore your body's warning signs. Rather than injure yourself and end up not growing at all, find an alternative path to your goal. You may get there slower, but it's better than not arriving at all.
I'll add the caveat that I'm neither a doctor nor a kinesiologist...this is simply what I've put together from my own research. Doubtless there are a whole lot of folks out there far more qualified than me to describe why skullcrushers hurt but until they step up and add their $0.02, this is the best conclusion I've got.
Thread: Skullcrusher Pain