Chronic Elbow Injury: Alternative Exercises to Press and Bench Press?

Bigger Stronger Leaner Jim Wendler 5/3/1 Coaching
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Hello Everyone,

Its not a hard thing to figure out, but i have been thinking about the whole deal a lot and its really bugging me out, so some feedback or advise would really be appreciated.

I’m 34 now and i have been working out most of my life but got into more serious training a couple of years ago.
Seven years ago i had a mean elbow fracture and reconstruction using bone from my hip. Although my doctors told me not to lift more than 10lbs i was able to start lifting weights again four years ago. I guess you can appreciate that not lifting is hardly an option.
I’m doing 5/3/1 for six months now and its a very rewarding and motivating phylosophy.
Constantly buying more plates got my wifes attention so she made me see an elbow specialist, to check how my arm is keeping up. So far, everything feels and looks OK, but i was told that every rep on pushing exercises is wearing my elbow further down, so i have to expect getting full elbow replacement at least 10 years sooner than otherwise (lets say around the age of 60 instead of 70). Being able to train after 60 is important to me, so i’m thinking about changing things up a bit.
So now I am looking for exercises i could use in my programm instead of the Press and Benchpress. I would probably not get rid of them completely, but degrade them to accsessory lifts and reduce volume considerably or ditch them and concentrate on hyperthropy and isolation of the shoulder joint.

So far my thoughts on Options are:

  • Pullups
  • Rows

Problem with these exercises (as with most) is that breakdown in form allows for more and heavier reps so you really have to be disciplined not to lie to yourself about needing a reset. But discipline over motivation, right?

Do You guys have any other thoughts on upper body multi joint movements i could use in a programmable manner that wouldn’t be stupid?

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You didn’t listen to your doctor the first time, and now you want to listen to advice from unqualified internet strangers? Not a good plan.

You’re in between a rock and a hard place, I would go see another doc for a second opinion. Or a PT who works with athletes. I would not start working only pulls without balancing on press, much like I wouldn’t only press and not pull. Go see a medical professional.

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If you get the elbow replacement at 60 will it last you the rest of your life?

Like I’m thinking if it does than all g. Go lift

If not there’s a few ways to think about this. The things to think about is that like surgeries hit you pretty hard when you’re older and function tends to go downhill even if we do our best to exercise and stay active to slow down the process.

If you lift and stay active you’ll be relatively strong and mobile by the time the surgery rolls around at 60. You’ll come out of it better in every way than someone who’s sedentary. Being younger you’ll also recover better.

What happens after… if you are gonna get another surgery after 60/70 it’s gonna be an unpleasant experience. Life’s hard enough in your 80s and 90s without having a big surgery. The recovery process is going to be a slog as well.

If you’ve been inactive all the way through to 70 your level of functioning is probably going to have gone down by that point and the surgery is going to keep your elbow itself relatively functional and pain free but overall it’s going to set you back a bit without that baseof fitness built up beforehand.

Discuss these options and possibilities with a surgeon and make sure to emphasise what your current lifestyle and future goals are and how important this is for you. A physio or physical therapist may also be of assistance.

Think about your priorities and what you want for your life especially in old age and retirement. “Functional” is a pretty broad term but you can be that without touching a barbell. If you want to be active or push yourself there’s plenty of ways to do that without messing up your elbow. If you just wanna lift you gotta accept there’ll be negative effects to that.

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Thank you both for your time and opinion on that matter.
I guess i made a mistake and put too much emphasis on my situation and not my actual question.
My actual question still stands:
What are your thoughts on programmable upper body Lifts that don’t involve pushing.

But for further clarification:

I am not asking whether to train or not to train. I am seeing a specialist and getting all the scans done and compared to the old ones. I am confident that my doctor is giving me a balanced opinion.
That opinion is that it may feel ok to Press at the moment but that in all probability there will be long term consequences. I am well aware of that, so i want to adapt and change my routine.

You definitely have a point here. But i am not planning on ditching training the pushing muscles altogether. I just want to shift my focus away from pushing and implement the chest and delts in an assistance manner. So more isolation (flyes, raises) and pushing in low weight/high rep fashion and intensity techniques.
In my mind it should be able to balance heavy pulling work this way. Please share if anyone has a different opinion on that since i didn’t think this might be a big issue.

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I have a similar-ish situation (4 rotator cuff surgeries, told not to lift at all and find a new outlet) I am back to competing and have even set a couple of world records in my class. This was a long, careful 4 year road back, first surgery in '14, started back competing in May '18.
With the help of my PT who also lifts, I have restrictions to “help” prevent another tear. (and I am willing to accept them as they let me continue to train, something is always better than nothing) .

Basically back squat and bench press are out due to how they will impact my shoulder. I tried some other exercises because of the mentality you need a “laying press”. Dumbbell variations and Floor press ended up being out too, pissed off my shoulder, we ruled that the issue was the shoulder blades being pinned down. So all laying presses are out.

This is not a big deal because of strongman I always did front squat in training anyway. The issue was “program following OCD”, 531 has bench so I must bench. In order for my training longevity I had to accept that I would have to modify all 531 programs I do. I have been doing 531 since 2009/10? and it took a while to get used to having to modify bench day with no 531 laying press substitute.

There is a risk to what you are doing, as with myself. You have to decide if it is worth it. Then you have to decide if you are willing to accept you can’t train like the average person anymore.

You need to test and find exercises you can do (and can’t do so you know to avoid them). My testing led me to the only exercises for chest I could do without pissing off my shoulder was push-ups. I bought a weight vest for progression(not 531). My press exercise now, and probably always will be, is Press-ups 5 x 10, adding 5lb periodically. Sometimes even just doing bodyweight.

Because of the competitions I do now, I need OH press training as well as a jerk type. So my “bench day” is axle clean and jerk. OH day is still OH. Both days use 5x10 press-ups.
Pull was TRX rows, I have progressed on to dumbbell rows (barbell rows are still kinda dodgy)

Squat day is always Front squat.

Those were the changes I found to allow me to train at a high level while not injuring my shoulder. I no longer do strongman because stones are bad for it and also yoke has the same compression issue as back squat. I now compete in the USAWA all-round weightlifting events, since there are so many lifts, I can pretty much work around my limitation. Obviously I can’t do any laying pressing,back squatting or arm length hold events but luckily they haven’t been in any comps so far…

I hope you can find a way to work around it.

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Can you do arm work? Is that ok for your elbow? I’ve heard of some powerlifters do high rep band pushdowns for their elbow health. Combine that with high rep curls. Should be a fairly easy way to build some arm muscle without being too taxing on the joints.

I know Jim has said something like “athlete the lower, bodybuild the upper,” so, like you said, find movements like flyes and raises that don’t involve the elbow too much. Get a pump. Focus on upper body muscles, not movements. I find that usually pushups, like @John_Henry said, aren’t too bad on the joints. They’re not perfect, but often much friendlier than barbell/dumbbell work.

Batwing raises are a movement Dan John came up with. Helps keep your shoulders healthy and build up those smaller upper back muscles. You can do pull aparts and face pulls too. I’ve seen Paul Carter do some type of plate raise - basically a front delt raise, holding a 25lb plate, all the way to overhead. Joe DeFranco’s got a routine called the Shoulder Shocker. Don’t remember what’s in it, but I know some older guys have used it to build up their shoulders without pissing off their joints.

TRX rows, or ring rows, or just rowing up to a barbell set up in rack work, as do barbells and dumbbells.

Back squats probably won’t wear down the elbow, but may irritate the bicep if done improperly…so you should be good as long as there’s no severe tightness or anything.

You probably already know all this, but I’d say just keep doing what you can to keep your legs, hips, and back strong with heavier movements, and focus more on training your upper body like a bodybuilder - higher reps, muscle over movement, etc. There’s options!

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Awesome post, I have different shoulder issues but really needed to read this right now, thanks for taking the time on it.

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No problem, hope it helps and good luck! Shoulders suck lol

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Hi Guys, Thank you all for replying.
Had my final checks and MRI yesterday which confirmed, that everything is fine at the moment “It looks good for that what it is”. The muscle helps compensate a couple of missing parts and stabilizes the elbow.
Anyway there is not much cartilage in some parts left, so i’m definately gonna change things up and try to avoid classic pressing and go back to a bodybuilding approach for the upper body instead of a powerlifting one.

I wish you all many more years of pain free lifting!