Most people chasing big arms obsess over the "horseshoe." They hammer the lateral head for that outer pop or the long head for sheer mass. But then there’s the medial head. It's the workhorse. This muscle sits deep, tucked away under the long head, and honestly, it’s the reason your elbows don’t hurt when you bench heavy. If you’ve ever felt like your triceps look "thin" from the front or lack that dense, 3D thickness, you’re likely neglecting tricep medial head exercises. It isn't just about aesthetics, though. This specific head of the triceps is active during almost every pushing movement, acting as a stabilizer for the elbow joint. Without a strong medial head, your lockout on the bench press will always feel a little shaky.
Think of the triceps as a team. The long head is the flashy star. The lateral head is the one everyone notices at the beach. The medial head? It’s the offensive lineman. You don't see it much, but nothing works without it.
Why the Medial Head is Tricky
Anatomy is weird. The medial head is actually active during almost all tricep work, but it really only takes the lead in specific ranges of motion. Specifically, it dominates during the final 20 to 30 degrees of elbow extension. If you're short-changing your reps and not locking out, you're basically leaving the medial head on the sidelines. It’s also unique because, unlike the long head, it doesn't cross the shoulder joint. This means you can't "stretch" it by moving your arm overhead. You have to beat it into submission with mechanical tension and specific hand placements.
Most lifters assume a standard pushdown covers it. Kinda, but not really. To truly prioritize the medial head, you need to look at grip and shoulder position. An underhand (supinated) grip is the classic "secret" here. When you flip your palms up, you change the line of pull. You'll feel a distinct "bite" near the inside of your elbow. That’s the medial head waking up.
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The Best Tricep Medial Head Exercises for Real Growth
1. Reverse Grip Cable Pushdowns
This is the gold standard. Most people hate these because they can’t move as much weight as they do with a standard overhand grip. Get over it. Use a straight bar or an EZ-bar attachment. Palms facing the ceiling. Keep your elbows glued to your ribs. As you push down, focus on the "squeeze" at the bottom.
The beauty of the reverse grip is that it naturally limits the involvement of the lateral head. It forces the medial head to do the heavy lifting. Don't go so heavy that your shoulders start rolling forward. That's a ego move. It ruins the tension. Instead, try higher reps—think 12 to 15—where you really hold that peak contraction for a full second. You’ll feel a burn that’s totally different from your usual tricep pump.
2. Close-Grip Bench Press (The Final Two Inches)
The close-grip bench is a mass builder, period. But to make it one of the better tricep medial head exercises, you have to change your intent. Don't just bounce the bar off your chest. Stop an inch above your torso, then drive upward, focusing exclusively on the lockout.
The medial head is most active at full extension. If you stop just short of lockout to "keep tension on the muscle," you're actually skipping the part of the rep where the medial head works hardest. Use a grip that's about shoulder-width apart. Going too narrow just hurts your wrists and doesn't actually help your triceps. It's a common mistake.
3. Tate Press
Named after powerlifting legend Dave Tate, this move is underrated. Lie on a bench with dumbbells. Point your elbows out to the sides. Bring the dumbbells down toward your chest so they form an "A" shape, then flare them back up.
It looks funky. It feels even funkier. But because your elbows are flared, you're putting the medial head in a position where it has to produce a massive amount of force to straighten the arm. It's an "elbow extension" exercise in its purest form. Be careful with the weight here; this can be taxing on the tendons if you're too aggressive.
4. JM Press
Imagine a skull crusher and a close-grip bench press had a baby. That’s the JM Press. It’s a staple at Westside Barbell for a reason. You lower the bar toward your neck or chin, tucking the elbows slightly, and then drive it back up.
The key difference here is the "roll." As you lower the bar, your forearms and biceps should almost touch. This creates a massive stretch on the medial and lateral heads. Because the bar path is so specific, it targets the lower portion of the tricep—the area right above the elbow. If you want that "thick" look around the joint, this is the one.
The Role of Grip and Mind-Muscle Connection
It sounds like "bro-science," but the mind-muscle connection is vital for the medial head. Because you can't see it in the mirror as easily as the lateral head, it's easy to let other muscles take over. When doing pushdowns, try using a "suicide grip" (thumb over the bar). This often helps align the force directly through the ulna, which can increase the activation of the medial fibers.
Another tip: focus on the "pinky side" of your hand. When you push, imagine you're driving the weight down primarily through the outer edge of your palm. It sounds small. It makes a huge difference.
Research and Reality
A study published in the Journal of Strength and Conditioning Research looked at EMG activity in the triceps during various exercises. While the long head showed massive activation during overhead movements, the medial head stayed consistent across almost all exercises but peaked during those involving a supinated grip or full lockout.
However, we have to be honest. You cannot completely isolate any head of the triceps. Your body doesn't work that way. It’s about shifting the percentage of work. You’re tilting the scales, not turning off the other muscles. If someone tells you an exercise "only" hits the medial head, they're lying. Or they don't know anatomy.
Common Mistakes to Avoid
- Flaring elbows on pushdowns: Unless you're doing a Tate Press, keep 'em tucked. Flaring shifts the load to the chest and shoulders.
- Half-reps: If you don't lock out, you aren't doing a medial head exercise. Period.
- Too much weight: The medial head isn't huge. If you use "ego weight," the larger long head and your lats will just take over the movement.
- Ignoring the eccentric: Don't let the weight snap back up. Control it. The medial head is working to decelerate that weight too.
Programming for the Medial Head
You don't need a "Medial Head Day." That’s overkill. Instead, sprinkle these movements into your existing push or arm days.
A smart way to do it is to start with a heavy compound like the Close-Grip Bench Press for 3 sets of 6-8 reps. Focus on that hard lockout. Follow that with Reverse Grip Cable Pushdowns for 3 sets of 12-15 reps to get the blood flowing and target the medial fibers specifically. Finish with something like the Tate Press for 2 sets of 20 to really flush the area.
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This approach hits the muscle with different intensities and rep ranges. It addresses the medial head from multiple angles—heavy mechanical tension and high metabolic stress.
The Elbow Health Benefit
Ask any veteran lifter about their elbows. They’ll probably moan. Chronic elbow pain (tendonitis) is the plague of the lifting world. Interestingly, strengthening the medial head is often part of the solution. Because the medial head is the primary stabilizer of the elbow joint, having a weak one can lead to instability. This instability forces the tendons to work harder than they should. By building a robust medial head, you're essentially building a "sleeve" of muscle around the joint that absorbs shock and provides a solid foundation for your heavier lifts.
Actionable Steps for Your Next Workout
To get the most out of your tricep medial head exercises, follow these specific steps during your next session:
- Prioritize the Lockout: On every tricep movement, hold the peak contraction for a count of "one-one-thousand." If you can't hold it, the weight is too heavy.
- Supinate Your Grip: Swap your standard rope or V-bar for a straight bar and use an underhand grip for at least one exercise.
- Adjust Your Volume: The medial head responds well to higher frequency and volume. Since it's a smaller muscle and doesn't cross the shoulder, it recovers relatively quickly. Try hitting it 2-3 times a week with moderate volume.
- Monitor Your Elbows: If you feel "bone on bone" clicking during these movements, adjust your hand width. Everyone's carrying angle is different. Find the width that allows for a smooth, pain-free lockout.
- Use Fat Grips: If you have access to them, using thicker handles on reverse grip pushdowns can sometimes help engage the forearm and medial tricep complex more effectively by forcing a tighter squeeze.
Consistent focus on these small tweaks will fill out the lower, inner portion of your arm that most people miss. It’s the difference between having arms that look good in a tank top and arms that look thick from every possible angle. Stop ignoring the medial head; it's the foundation of your pressing power.