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Elbow Pain During Squats: part 2 addressing the root cause

One of the biggest issues seen in those struggling with elbow pain during the squat is lack of shoulder mobility to get into a comfortable rack position without compensations elsewhere discussed in PART 1.

IF you just passively move the elbow through flexion and extension you will find very very few have a true elbow flexion or extension range of motion limitation. Also in many cases elbow flexion and extension will not elicit any symptoms, even at end ranges of flexion like as seen during a back squat rack position.

The elbow pain stems from having to really compensate at the elbow and forearm because of restrictions upchain in the thoracic spine, shoulders, and anterior chest. Often times you will find deep root soft tissue limitations in muscle groups that pull the shoulder into flexion, horizontal adduction, and internal rotation. Pec Major and Pec Minor, Teres Major, and the lattismus. Seeing a massage therapist is a viable option or receiving treatment from a physical therapist for soft tissue work is indicated however the problem lies in not using active movements to lock in those changes in tone and tension.

If you watch people squat they will spend ample time preparing their lower body to move but what they fail to address is breathing and bracing and shoulder mobility preparation drills. So that is exactly what this LEARN will detail in giving you some helpful and practical solutions to address the root cause.

Drills to address these key areas:

1) Rib Cage

2) Thoracic Spine

3) Pec Major, Pec Minor, Anterior Deltoid Extensibility

4) Shoulder Rotation

You will find if TEST and then RE-TEST you will have given yourself a buffer zone to move more freely and get into a better position without excessive strain on the elbow joint.

90/90 Breathing Drill

Breathing drills are important for everyone, but especially so for squatters. Breathing helps synchronize rib cage position, thoracic spine position, and chest muscles to work in a more optimal and coordinated fashion. During the exhale really focus on keeping the rib cage down, not flared up towards the ceiling.


The goal here to keep the legs bent up to keep yourself from extending in the lower back and flaring the ribs. You can have a small space between the wall and mid back but not enough to stick a full arm in that space. Just a hand. Try to keep the backside of the forearms and upper arm against the wall as you slide down and over the head. Focus on breathing, especially the exhale which will help pull the rib cage to a more neutral position.


Inhale through your nose initially and exhale through your mouth and rotate your knees to the right. Inhale again, exhale and let your knees rock further to the right. You should feel a stretch across the front of your left chest. Continue this breathing sequence until you have taken 4-5 breaths, in through your nose and out through your mouth.


With this we can pin the arm to the ground and rotate our trunk to get more of a chest opener. Often times we try to keep the rib cage, sternum, collarbone, and trunk static and move the arm we reach a sticking point or wall in which we compensate the stretch. This changes the kinematics of the movement to get more of a stretch on the pec muscle and anterior deltoid.


Avoid arching the lower back with this movement. The goal is to create a packed shoulder and use that tension to keep your shoulders and chest from rounding forward.


The band works as mobilization for the glenohumeral joint for a posterior glide. Palms down on the bar puts the shoulder into more external rotation which is needed for back squat shoulder mobility. The biggest key here is to keep your shoulders pinched in the back. Try not to let your upper trap take over this movement keep the shoulder blade down towards your back pocket.


These are practical solutions to improve your shoulder mobility as it relates to back squat limitations. All of these address some combination of ribcage position, breathing, soft tissue extensibility, shoulder retraction and depression, and the thoracic spine.

Next up in the series are isolated loading strategies for the elbow pain you are dealing with to recondition those painful tissues and get you out of pain sooner!


Dr. Bryan Keith

Myomuv PT

We help active adults and athletes return to the activities they love without pain, without taking time off, and feeling more confident and capable than ever before.