This and what Punisher said. I find people generally use too much quick eccentric and rapid rebound out of the bottom. In addition to not being consciously focused on flexing the triceps to lift, this is the quickest way to elbow troubles ever. Think about it, it’s like you’re trying to do a depth jump but for your elbows… No bueno. Add in not finding your optimal elbow angle and it’s trouble. I think some people make the same execution mistake with overhead presses as well, which is why sometimes that heats up elbows.
The other thing I see is that people jump up in weight much too quickly because they want to move bigger pounds and/or show off. Doing an exercise that kind of inherently puts tons of tension on tendons does not respond well to quick load increases…whether it’s volume or weight. It’s no different than other tendon training exercises like plyometrics - people get joint issues and tendon issues with plyometrics because they jump to the advanced stuff way too fast.
You have to condition your tendons gradually to the load and volume both. Tendons adapt but they don’t adapt as fast as muscle due to minimal blood flow among other things.
So basically it’s a triple whammy - not being intensely focused on flexing the triceps versus moving the hands, executing the exercise with a rapid eccentric and/or rapid reversal out of the bottom, and increasing volume/load too rapidly. 3 strikes you’re out. Add in not doing them when pumped and it’s 4 strikes.
That said, I prefer JM presses rather than regular skull crushers. I find them more effective IF properly done. Yesterday I finished 4 sets of JM presses with 135 and no elbow issues after benching.
I do find varying the stimulus helpful - if 2 days benching, 1 day skulls and 1 day bands.
Tate presses are awesome.
EDIT–to say there’s nothing wrong with dropping the exercise for a week if you start to feel elbows complaining. I mean powerlifters cycle bench press lifts and intensity, there’s no reason why you couldn’t do them for 2-3 weeks, take 1 week off and replace them with bands, and then put them back in the program. Sometimes people get married to exercises and are scared to rotate them out for a bit.