My elbows hurt like #%$@! when I do skullcrushers, but it's the only thing that makes my triceps grow. I gobble a handful of Advils to dull the pain when I train arms, but after reading about Tom Prince's brush with death [Flex Magazine, Jan 2004] I'm hesitant to keep taking ever-increasing doses of painkillers. What should I do?
If I was to make a bold guess, you're one of the more dedicated guys who can count your missed workouts for the past two years on one hand. The pain you're feeling is your body telling you it's time for a break, and I think it's time for you to listen. I'm hesitant about taking pain-killers even for short-term use, since it disables the body's warning system if you're about to get yourself really injured, and routinely taking them to just to cope falls in that iffy gray area between being "dedicated" and "stupid".
Nailing down the exact cause of the pain is something you should ask your doctor about. It could be microscopic tears that will heal by themselves, it could be damage to the cartilage, growth of bone spurs, or even problems with the bursa, the fluid-filled "cushions" that keeps bones from rubbing against each other. All things considered, odds are good you'll be OK once you get some rest. So what to do once the doc has ruled out the serious stuff?
I doubt you're knocking on death's door, but I'd recommend taking a week or two entirely off. You know, kick back and relax, get plenty of sleep and eat lots of protein-rich, healthy food to give your body a chance to recover. You may also want to try glucosamine to speed up the healing process. I had problems with bad knees and an old torn shoulder that went almost completely away after starting a daily 1,500 mg supplementation regime.
When you get back into the gym, you'll have to cut back on the weights you're used to for both triceps and chest training that involves pressing movements (since they activate triceps). You may have to settle for 50% of your normal weights for the first month, and then go up 10% per month (month 2 = 60%, month 3 = 70% etc). It sucks, but deal with it or say hello to your old friend elbow pain. Go for the pump and shorten your rest between sets to keep intensity up. As for exercises, it seems the extreme stretch you get from skull-crushers put extra stress on your elbows. Perhaps you can do partial reps where you stop 2-3 inches above your forehead instead? It may also be a good time to explore optional exercises, such as dips (assisted, until your elbows heal up), one-arm push-downs, kick-backs or any of the fancy tricep-machines that have sprung up over the past decade?