How To Fix an Elbow Flare

Written by: Lindsay McGuire, MS, CSCS, PT, DPT

Many powerlifters and athletes, in general, have one side or limb that is stronger and more stable than the other. In powerlifting, many of us have this blatantly pointed out during the bench press. One common biomechanical error that occurs during the bench press is when the elbow flares out laterally. This is shown below with the first photo demonstrating a normal bench press and the second photo showing his right arm flared out laterally. This article will discuss some of the possible reasons for this and a few suggestions on how to correct this issue.

Normal

Right Elbow Flared Laterally

When the elbow flares out laterally, your shoulder moves into internal rotation (shown below)1 and which puts the shoulder at a biomechanical disadvantage and also puts the shoulder at higher risk for injury.  This also subsequently is coupled with slight shoulder elevation and abduction putting the athlete at further risk for injuries including developing shoulder impingement which I have discussed previously in past articles regarding this topic.

 

With this being said, one way to counter this movement is to strengthen your external rotators of the shoulder to decrease the internal rotation that occurs.  Three external rotators of the shoulder are infraspinatus, teres minor and of course the rear deltoid. These are shown below

Now how do we successfully target these muscles? The following are a couple very effective exercises to strengthen these are the following:

 

1.) Sidelying External Rotation

Lay on your side with your hips perpendicular to the surface you are lying on. Put a towel beneath your elbow. Keep your elbow at 90 degrees with your wrist held neutral throughout the whole movement. Make sure your hips and trunk do not rotate. Slowly rotate your shoulder throughout full range of motion as shown. This can be progressed using light dumbbells, bands and performing the movement throughout different ranges of motion. For example, performing this by something I call “quarters”. This means you complete 25% of the motion then come back to starting position. Then perform 50% of the movement and come back to starting position. Then 75 % of the movement and come back to starting position then complete 100%. That is considered 1 repetition. Then repeat.

2.) Wall walks (up and down/lateral)

  

This is a very effective way to strengthen your external rotators in a more functional way as this incorporates scapular and humeral movement while you stabilize your shoulders in a neutral position and simultaneously activating your external rotators as you would do during a bench press thus translating very nicely over to your bench.

My next stability statement may seem obvious, but many training programs tend to lack on this aspect… single extremity movements. If every movement you perform is performed with a barbell/ground/platform connecting your hands, you will always have one extremity taking more of the force than the other. Even with dumbbell work, if this is performed symmetrically and simultaneously, there will still be an individual stabilization aspect lacking. Performing single arm activities requires you to stabilize completely with that extremity and forcing the rest of your body to adjust based on the unilateral single load. I require my athletes to perform single arm dumbbell press, overhead press, flys etc. in order to counter this.

Now that we address the strength aspect, its time to address the mobility and flexibility aspect. No matter how strong your external rotators are, if there are other muscles lacking flexibility, you will still encounter issues. One stretch I normally prescribe with this biomechanical issue is a levator scapulae stretch. The levator scapulae run from your cervical spine (C1-C4) to the superior/medial aspect of your scapula. Its job is to elevate and downwardly rotate your scapula. In normal shoulder elevation, your shoulder blade will upwardly rotate to clear the head of your humerus. See below. If your levator scapulae is tight and remains in a shortened position, you will have a harder time upwardly rotating your scapula to clear your humerus during the concentric portion of the bench press. A common substitution is for the shoulder to internally rotate and elevate. Shown below.

This demonstrates the 2:1 movement that occurs called scapulohumoral rhythm. The first 30 degrees of humoral elevation, there is no scapular movement, after this, for every 2 inches the humerus elevates, the scapula upwardly rotates. If this rhythm is off you will end up with compensations from other aspects of your shoulder girdle, which will again lead to future injuries.

Here is a simple stretch to increase the flexibility of the levator scap:

Rotate your head and look down towards your opposite armpit, bring the ipsilateral arm up and apply some overpressure to increase the stretch. Additionally, put your contralateral arm behind your back as shown. Perform 1-2 times per day for 30-60 seconds.

The second muscle group that is a major contributing factor is pectoralis major. Pec major is responsible for a multitude of movements including humeral internal rotation. The pec major runs from clavicle/sternum to the lateral aspect of the humerus. (see below)4. When this is tight, it decreases the ability for your shoulder to move into external rotation due to its pull into internal rotation.

Here is a simple stretch  to increase the flexibility of the pectoralis major:

While laying on a foam roller, keep your knees bent and head supported on the foam roller. Bring both your arms out to the side. Hold for 60 seconds. The angle in which your arms are can be varied. Do not continue stretch if your hands start to feel numb or cold or start to tingle.

Perform the exercises 3 x a week for 6-8 weeks with 15-25 repetitions and the stretches 1-2 x a day for 6-8 weeks to help decrease your elbow flare on bench press.

If you have pain in your upper extremities you may consider seeing your primary care physician or local physical therapist to further address these concerns. If any of these exercises cause pain do not continue to perform, as these may not be appropriate for you.

References:

  1. HEP2go. HEP2GO. 2018; https://hep2go.com/.
  2. Riches R. Shoulder Exercises & Workouts 2015; http://www.robrichesfitness.com/training/shoulder-exercises-workouts/.
  3. Applied Anatomy: Shoulder & Scapula – Part 2 – Scapulohumeral Rhythm. 2018; https://triagemethod.com/index.php/category/training/.
  4. http://teachmeanatomy.info/upper-limb/muscles/pectoral-region/.

 


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