Looking for opinions on Triceps Work Variety

[ChimarraoMate]

I have a question and a theory, but honestly, I am just not sure. Seems like the consensus is, if it hurts do not do it. Then you have the guys who got hurt and will not do certain moves because they think those moves are at fault. I am trying to make an honest attempt at reasoning what I have been doing wrong, and if variety will prevent it in the future.

Details:
When I started lifting 4 years ago, I found that I loved doing Dips. I became really strong at them, and used them for most of my compound triceps work. Then about a year in, I started doing other lifts: Many types of extensions, close grip presses, etc. but I still kept dips in my routine as a staple. Form was good and I always go full ROM for max stretch (ie forearms and biceps touch. Shortly after adding extensions I started to feel pain in my elbow. Funny thing is, I did not feel the pain when doing dips, but it was very painful in extensions. I then had X-rays and learned I had a bone spur on the tip of my olecranon process.

After 9 months of conservative treatment, I opted for surgery. That was about 18 months ago. Well, the pain diminished, but never went away. I have taken a much slower approach to recovery, and even had taken a few months off because of shoulder surgery in the same arm. Shoulder surgery was not related to the dips, but to repair a separated shoulder from an accident.

So, it really has been a 18 months of stale mate for me. But now that I am back up to lifting the weights I was when I had the surgery the pain is back. Now it hurts with dips, extensions, pretty much all triceps work. Dumbbell presses do not hurt.

Here are pictures of my elbows. Note the bad elbow has a scar going vertical from the surgery, but the horizontal line, which is more visible, is a dimple caused by the newly forming bone spur. The bump is hard bone, and there is no fluid swelling.

Good Elbow:


Bad Elbow:



The Questions:

From the shape of the spur, it looks kind of like it formed from doing repetitive work, causing the triceps to always pull on the elbow with force in the same direction... i.e. Dips. Do you think the pain is higher on close grip work and extensions because they are working focusing more on different triceps heads that causes the tendon to pull slightly across the spur at a different angle? Or do you just think extensions and close grip bench are less elbow friendly than dips? I am asking because, I have a feeling I am going to need to do surgery again, and do not want to come back through this again. Am I better to keep a lot more variety in my lifting with different extensions and exercises for triceps? One of the reasons I have stuck with dips is because I never stopped progressing on them when I lift. I have however changed up my routine every 6 weeks and will change my rep range, weighted, and volume with dips.

Last question, which compound movements will work the triceps focusing more on different heads and angles? Any recommendations for keeping balance?
Thanks, I know it is long.

Edit: I do work a big variety of grips and angles on presses using a barbell and dumbbells for my chest work, which I know hits my triceps too.

[IronCharles]

I'm not qualified to offer any any medical suggestions regarding your condition, but I will say that dips are a great mass builder, and my primary tricep exercise. I never feel any sort of elbow pain with them, but I do get minor pain with pressdowns or extensions.

[ChimarraoMate]

I'm not qualified to offer any any medical suggestions regarding your condition, but I will say that dips are a great mass builder, and my primary tricep exercise. I never feel any sort of elbow pain with them, but I do get minor pain with pressdowns or extensions.

Interesting... I hear that a lot from veteran lifters. What about my theory on the cause? Do you think after years of taking a preference in certain lifts we have a propensity to create grooves in our elbow (i.e. bone spurs) because we are favoring certain moves too much? Mine really seems to follow the tendon in the direction of the pull. I assume this is why certain lifts hurt right were the spur point is and others do not.

I do not see raw tention across the elbow being the cause of pain, because the compounds that do not hurt as much are surely putting a lot more tention on the triceps than the isolations are with much less weight applied.

[pastorgbc]

Interesting... I hear that a lot from veteran lifters. What about my theory on the cause? Do you think after years of taking a preference in certain lifts we have a propensity to create grooves in our elbow (i.e. bone spurs) because we are favoring certain moves too much? Mine really seems to follow the tendon in the direction of the pull. I assume this is why certain lifts hurt right were the spur point is and others do not.

I do not see raw tention across the elbow being the cause of pain, because the compounds that do not hurt as much are surely putting a lot more tention on the triceps than the isolations are with much less weight applied.

I do not get any pain with dips and close grip benches. I can also do overhead extensions without chronic pain, although I did tear my triceps about three years ago doing overhead extensions and now steer clear.

Lying triceps extensions are a different story. I love the movement, but I will get elbow pain from them. A big problem with the movement occurs when the elbows flare out while doing them. This can happen in people with large pecs. It can also happen when you use heavier weight. My experience is the movement must be done strictly, with the elbows stationery, or I have problems. Since this is difficult for me, I don't do them.

Ray

[ChimarraoMate]

I just returned from the doctors office. We have scheduled another surgery on my elbow. The bump you see in the picture is from calcium deposits in the tendon. He showed me how the bone spur was removed in surgery 18 months ago, and it did not grow back, but calcium deposits grew in the tendon itself above where the spur was removed. He said this sometimes happens as the result of swelling in the tendon, which likely began to occurred after my last surgery, and additional swelling from sports use caused it to continue to grow. Having a high concentration of calcium to D3 can also contribute to calcium to grow durring healing where it should not because it creates a hormonal imbalance. So, I guess I will go back under the knife next week and he will remove all the calcium from the tendon. Then he said he will put me on a long term anti-inflammatory durring recovery to keep it from reoccurring while I heal. I guess this happens in about 10% of the cases from first time surgery.

[jcpeyton]

sucks about the surgery again, good luck healing this time. just wanted to add my two cents as I'm also a 40yr old. I've been working out for over 20yrs and one thing that I can guarantee is there are all sorts of sometimes unexplainable pains associated with lifting. when you have something that seems to be prominent when doing a certain movement, the best course of action is to move away from that exercise for several weeks and do something different. Come back to it later and see how it feels. i've been doing that for years. i've had pain just about everywhere and bursitis in my shoulder so trust me, it's a good plan to adopt. but of course in your case right now, when you are injured, you're injured. got to take care of that first. good luck.