I'm fine with the ones on the elbow.
It's the ones on the hands that get me.
I just never ask for modifications, at least for the flys and stuff above the head with the bar, because I am not in real pain in my neck/shoulder area. I am just weak. It doesn't bother me except during very specific stuff; I deal with it by keeping either my weights or reps lower than I do for other stuff. I also modify stuff on my own, given the background I have in fitness, in a former life. I'm not a real pro, but I know enough, to keep myself from getting hurt. The person who teaches my class is a PT, so there's no issues with her doing contraindicated stuff. In fact, I switched one of my days, so I wouldn't have the one who just pushes everyone to the point of craziness, with no regard for individual issues.
I guess I could ask her for some strengthening stuff for the neck and shoulders, but I am having enough trouble doing the up dogs that keep my back in shape at home.