The medial head is one of 3 heads of the triceps. The other 2 heads consist of the lateral & long heads. Targeted concentration on the medial head specifically can be a challenge because it is heavily involved in all triceps exercises, especially those that emphasize elbow extension. However, some exercises and variations can emphasize it more due to biomechanics and muscle activation patterns.

What are the top exercises for concentrating on medial head activation?

Reverse Grip (Supinated) Triceps Pushdowns

• Why? Studies suggest a reverse grip increases medial head activation because of the wrist and forearm position, which slightly de-emphasizes the lateral head.
• Where’s the Evidence? According to Saeterbakken et al. (2017), indicated increased medial head activation with a supinated grip compared to neutral or pronated grips. https://pubmed.ncbi.nlm.nih.gov/28658015/
• A peer-reviewed study by Villalba et al. (2024) investigated how forearm position affects triceps brachii activation during the triceps push-down exercise. The researchers found that using a supinated grip (palms facing up) significantly increased electromyographic (EMG) activity in the long head of the triceps brachii compared to a pronated grip (palms facing down). https://journal.iusca.org/index.php/Journal/article/view/250

Close-Grip Bench Press

• Why? The close grip shifts more load onto the triceps than the chest, and during full extension, the medial head is particularly emphasized during engagement.
• Where’s the evidence? A 2020 study in the Journal of Strength and Conditioning Research showed that narrow grip variations increased overall triceps recruitment, with consistent medial head involvement.
• More supporting info: The Close-Grip Bench Press https://journals.lww.com/nsca-scj/Fulltext/2017/08000/The_Close_Grip_Bench_Press.5.aspx?utm_
• Comparison of Muscle Activity between the Horizontal Bench Press and the Seated Chest Press Exercises Using Several Grips https://pmc.ncbi.nlm.nih.gov/articles/PMC10203828/?utm_

Cable Pushdowns with V-Bar or Rope

• Why? Rope and V-bar allow better end-range contraction and slightly better medial and lateral head recruitment than a straight bar.
• Where’s the evidence? EMG studies (e.g., Signorile et al., 2002) show that while all triceps heads are active, the medial head plays a larger stabilizing role, especially when multiple grip positions are allowed.
• They found that changes in exercise intensity and speed affected the rate of fatigue in all three heads, including the medial head, suggesting that the medial head is actively engaged during triceps push-downs. https://pmc.ncbi.nlm.nih.gov/articles/PMC7047337/
• Another study by Kholinne et al. (2018) examined the role of each head of the triceps brachii in elbow extension at different shoulder elevations. They reported that at shoulder elevations of 90°, 135°, and 180°, the medial head generated significantly higher muscle force than the long and lateral heads, indicating its increased involvement in elbow extension at these angles. https://pubmed.ncbi.nlm.nih.gov/29503079/

Keep this in mind: 

The medial head is always active during elbow extension and is more active in exercises requiring strict form and stabilization. It is less affected by shoulder position than the long head, meaning grip and elbow position matter more for activation.