Step 1: Identify the cause of pain

Lateral elbow pain is typically caused by inflammation of the forearm tendons which cross this point of the elbow and become damaged due to repetitive strain, this is known as tendonitis. If lateral elbow pain is generated from gripping or if when pressing on the lower lateral elbow this can be seen as confirmation of tendonitis. You may be wondering why gripping would generate pain on the elbow while it is the forearm flexors which perform the hand gripping action, while this is true the elbow extensors on the posterior side of the forearm are also substantially activated during this motion in order to prevent the wrist from flexing forward while performing the gripping action.

Conversely medial elbow pain in the medial front side of the elbow is often caused by tendonitis of the forearm flexors, confirmation for this is if pain is generated when performing a wrist curl or when stretching the wrist into extension.

Elbow pain that has a symptom of radiating numbness or a tingling sensation which runs down the forearm and possibly into the hand is a cause of a nerve issue. If this symptom is brought about by simple head movement then I would recommend seeking medical help. Compression of the ulnar nerve generates a sensation down the inside of the forearm and sometimes to the fourth and fifth fingers or even up into the biceps. Compression of the ulnar nerve can also decrease grip strength. To test for ulnar nerve compression perform an unloaded bicep curl on the tested arm, with the other hand push the tested arm even further into flexion, if this causes the symptoms of ulnar nerve compression this is likely the cause of elbow pain. Compression of the radial nerve generates a deep aching or burning sensation in the lateral elbow which can extend down into the hand. To test for radial nerve compression put the arm on the tested side down straight while standing, with the other hand push down on the shoulder on the tested side to stop it from shrugging upwards, next turn your hand on the tested side so that your palm is facing backwards and clench your fist over your thumb and flex your wrist, now lift the arm outwards as if performing a lateral raise, if this causes symptoms of radial nerve compression this is likely the cause of elbow pain.

Step 2: Testing for disruption in the kinetic chain

The joints of the body can be seen as a chain, as improper mechanics of one joint can often lead to the disruption of the joint above or below this, in the case of the elbow poor wrist or shoulder mobility often results in large amounts of force placed on the elbow while resistance training, thus causing injury. For this reason it is important to test wrist and shoulder mobility. 

To test for wrist mobility, place both palms of your hands together in front of you as if praying, your thumbs should be touching your chest. Keeping your hands in contact with your chest move them downwards, eventually the bottom part of the palms of your hand will drift apart, but as long as this point is after the forearm is aligned with your elbow you likely have sufficient wrist mobility.

Shoulder mobility must be tested for external and internal rotation

• Assess external rotation - sit cross legged with your back flat against a wall, hold a light pole like object (such as a broom) at just beyond shoulder width out in front of you with a pronated grip, keep your arms fully extended and raise your arms overhead, if you was unable to comfortably get your arms to touch the wall you likely have poor shoulder external rotation.
• Assess internal rotation - stand upright with your arms elevated in line with your shoulder, bend your elbows to 90 degrees with your palms facing outwards as if surrendering. Rotate your arm slowly downward till your palms face the ground, if you weren't able to achieve this comfortably you likely have poor shoulder internal rotation.

Any issues found in shoulder mobility should be addressed as their own issue rather than as part of a different problem.

It is also important to become more mindful of the position of your joints while resistance training, especially when fatigued. It is common in movements where the barbell is held in the hands above the wrist, such as squat or bench press, for the wrist to move into extension, this is usually done subconsciously to allow for the wrist to carry the barbell without any conscious movement in the wrist, however, this places large amount of stress on the forearm flexors often leading to medial elbow pain.

Step 3: Addressing the issue directly

Isometric holds targeting injured joints have been shown to significantly decrease pain. To target lateral elbow pain, associated with the forearm extensors, a great exercise involves holding a light dumbbell with a pronated grip, sit on the edge of a chair with your elbow resting on your knee and your wrist and elbow in line, keep your wrist in this alignment without dropping into flexion or moving into extension, hold this for about 40 seconds for 3 sets. To target medial elbow pain, you can simply hold a dumbbell or kettlebell down by your side, an added challenge will involve walking with this load, again do this for about 40 seconds for 3 sets.

Soft time mobilisation can help to increase the flexibility of the forearm muscles crossing the elbow joint and decrease pain, using a small hard ball, such as a pool ball, and rolling it over and around the anterior and posterior forearm musculature may be worth doing if you feel it is effective.

Nerve gliding or slider techniques, for those with nerve related elbow pain, is worth considering, although if this is ineffective you should stop. Gliding techniques stretch the nerve and can generate large amounts of pain in some people, on the other hand, slider techniques just aim to move the nerve without placing as much tension on it. The overall goal of these techniques is to improve blood flow to the area, thus decreasing inflammation in and around the nerve. For ulnar nerve compression a good exercise involves standing with your affected arm out to the side in line with your shoulder, you palm of your hand should be facing outwards and your humerus externally rotated so your fingers face the ground, now simultaneously bring your arm in front of your body, as you curl your arm, while maintaining your wrist in the same position so that your palm now faces the ceiling. For radial nerve compression a good exercise involves standing with your non affected arm press down on the shoulder of the affected arm, the affected arms hand should be rotated so it is facing behind you, grasp your fingers around your thumb and maximally curl your wrist, than bring your arm outwards as if performing a lateral raise, although do not expect your arm to reach as high. If these exercises have been effective for you, you can perform about 4 reps of them every few hours throughout the day.