The medial head of the tricep is best targeted with reverse-grip (underhand) pushdowns, close-grip pressing, and any extension exercise performed with lighter loads through a full range of motion to complete lockout. The medial head is the primary mover during lighter efforts and the final degrees of elbow extension.
Medial Head Anatomy
The medial head is the smallest and deepest of the three tricep heads. It originates from the posterior surface of the humerus, below the radial groove. Like the lateral head, it does not cross the shoulder joint. EMG studies show it is active during all elbow extension movements regardless of load, serving as the "workhorse" head. The lateral and long heads are increasingly recruited as load increases.
Best Medial Head Exercises
Reverse-Grip (Underhand) Pushdowns
The gold standard for medial head emphasis. Using a supinated (underhand) grip on a straight bar or single handle shifts activation toward the medial head. Keep elbows tight to the body, extend to full lockout, and squeeze for a one-count at the bottom.
Programming: 3 sets of 15 to 20 reps. Keep the weight moderate — this is a precision exercise.
Close-Grip Bench Press
The medial head contributes significantly to the final push to full extension during close-grip bench. Pair this with reverse pushdowns for a compound-plus-isolation approach.
Diamond Push-Ups (Full Lockout Focus)
Performing diamond push-ups with a deliberate pause at full arm extension emphasizes the medial head. Slow tempo (3 seconds down, 1 second pause at top) maximizes time under tension in its strongest range.
Light Dumbbell Extensions (High Reps)
Any tricep extension variation performed with light weight and high reps (15 to 25) preferentially recruits the medial head. This makes high-rep extension work excellent for medial head development and joint health.
Resistance Band Pushdowns
Band pushdowns naturally load the lockout hardest (where band tension is highest), aligning perfectly with the medial head's strength curve.
Programming for the Medial Head
Include 1 to 2 exercises per week that feature reverse-grip or underhand positioning. Program at least some tricep work in the 15 to 20 rep range. Ensure full lockout on every rep. Use stretching to maintain full range of motion at the elbow.
Balance medial head work with lateral head exercises and overhead movements for the long head. Our best tricep exercises guide ranks the top movements across all heads.
Medial Head and Elbow Health
Keeping the medial head strong is one of the best ways to prevent elbow pain from training. High-rep, controlled extension work strengthens the tendon and surrounding tissue. If you experience posterior elbow discomfort, adding light medial head isolation work can actually help — provided there is no underlying tendonitis or strain.
