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Anyone got any good rehab advice for elbow tendonitis?

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 andybenham 04 Oct 2005
Got myself a good dose of what appears to generally be known as Golfers elbow (tenderness at the nobbly bit on the inside of the elbow).

I've been off climbing for 2 months.

Didn't do much for the first month - I wasn't in a position to climb anyway as just had number 2 kiddy (a girl, as it happens, named Jenna) and simply expected it would improve by the time I was able to get out again. For the last few weeks I have been using ibuprofen, glucosamine/condroitin tablets, wearing a tuby grip and (occasionally) icing.

Slight improvement followed but not signifigant and now seems to actually be getting worse.

There is a 3 month waiting list for physio or £25 to see the local sports injury guru...who will probably tell me to keep resting till it stops hurting.

Anyone had/have this problem and know of any good treatments and rehab exercises to get me back in the picture?

(obviously it follows that I will not be holding anyone responsible for possible side (or lack of) effects of advice given).
 Chris Craggs Global Crag Moderator 04 Oct 2005
In reply to andybenham:

Had the same problem when I was doing a lot of pull-ups. Found a tubigrip rolled up tight - right across the end of the tendon - just whilst climbing - was a great help.
Probably not medically very sound but worked for me, I think it cuts down the leverage. Seen people using zinc oxide tape for the same thing, but you can take the tubigrips off between routes/pitches.

Good luck

Chris
 Chris the Tall 04 Oct 2005
In reply to andybenham:
Had this a couple of times and in my experience, rest is not answer.

Best solution for me was gentle climbing whilst wearing a support - velco strap about 2 inches wide - just below the elbow. Then put an ice pack on it immediately after exercise. I think you need to stimulate the blood flow in order to heal it.

The first time it flared up was just before I badly sprained my ankle. 5 weeks of enforced rest didn't cure it, but my first 3 or 4 climbing sessions afterwards did
 Skyfall 04 Oct 2005
In reply to Chris Craggs:

Yes, I use tape to do the same thing. It works to an extent.

As you say, I suspect I got it because I was doing too many pull ups/lat pull downs etc. Suddenly came on without much warning, a few months back and can't shake it off.

Seeing physio for other injuries who says that it's not just tendonitis that causes golfers elbow, it's usually connected with nerve problems radiating from upper back and you need to sort the two out together. Sounds like normal physio gobbledegook to me but who knows.

There's a lot said about it being one of these things that sorts itself out eventually - even if you carry on exercising. Anyone have experience of this?
 Skyfall 04 Oct 2005
In reply to Chris the Tall:

> The first time it flared up was just before I badly sprained my ankle. 5 weeks of enforced rest didn't cure it

I've had months of enforced rest (from other injuries) and mine is still there. Your comments make me hope that when other injuries are sufficiently OK to allow me back into climbing that it might go away... Too much to hope probably!

 Max factor 04 Oct 2005
In reply to Chris the Tall:

It's a b**ger to cure alright. I've just had 2 months off climbing indoors and bouldering/ sport climbing. It has not got any better, despite seeing a physio and doing the exercises (admittedly not that regularly- though they did seem to aggravate it). If anything it is worse than it has ever been.
Taping / ice / massage is the way forward if it is in the advanced or recurring phase, but if it is the first time you've ever experienced it I would just stop climbing and hope it gets better.
 SFM 04 Oct 2005
In reply to Chris the Tall:

I agree. I had ultrasound, pills the lot. Eventually found a specialist and he basically said just keep climbing but lower the intensity for a while. I found that stretching my forearms a lot and press ups helped speed things along. I think the mechanics are either scar tissue rubbing or the tendon flattening and dragging as the muscle flexes.
 mike123 04 Oct 2005
In reply to andybenham:
i ve got a fancy support that i got from my psio (about £20), its called an epi sport and is for golfers and tennis players. i think its much better than a velcro strap. it comes with some grusome diagrams expaining how it works. i think that the basic idea is to keep the tendons in line. both my elbows were in a right state, i had loads of psio on them (friction and ultra sound)and i m sure it helped. if your psio says just rest then try a different psio. mines a tri athlete and knows that if she says just rest that i wont.
i tried tape but got really sore skin from using it.
just googled epi sport and this is it:
http://www.docortho.com/Orthopedic_Supports/Product/Tennis_Elbow_Forearm_Cl...
mike
 John Alcock 04 Oct 2005
In reply to SFM:
My regime:
Tape forearms with velcro bands (20 pounds each).
Ice three times a day including just after climbing.
Place forearm on table and massage top surface ruthlessly with opposite elbow. Massage point of elbow gently.

I stuck to routes and avoided hard lock-offs and too many first joint moves for a while, until my elbows stopped feeling hot after climbing.

If the problem doesn't go away, a cortiszone injection is very effective in SOME cases.
 Skyfall 04 Oct 2005
In reply to mike123:

where can you get that one from in the UK? I have one of the wider ones but normally use tape as a narrower support seems to work best.
 Skyfall 04 Oct 2005
In reply to John Alcock:

>> Place forearm on table and massage top surface ruthlessly with opposite elbow. Massage point of elbow gently.

Do you mean that you massage the inner side of your forearm?
Kate Farley 04 Oct 2005
In reply to andybenham: Hi, Just hyjacking on a similar topic...
(excuse typos but it takes ages to type with one hand.)
i'm having similar problems but is both elbow and wirst tendons in right arm. I have history of tenosynovitis in R wrist but have had no problems since i started climbng 3 three yeasr ago. so i put the remission down to new strength from climbing.
the recent bout of both elbow and wrist doesn't seem really to do with climbing as it doesnt hurt when I'm on a route and is worse at work (desk job).
I've alway treated my wrist with ibuprofen (gel or pills), rest and ice packs. all of which have worked (slowly) in the past alongside physio of various types. I'm seeing Occ Health (eventually) in the hope that they will be able to help Ipermanently working at home ? ). but what I'm finding as bad at the moment is the shooting pains up my R arm to the shoulder.
I assume these are related to the tendon problems..(?) and can/should they be treated in the same way does anybody know?

And, if I have no pain when climbing, does that mean that I am doing myself no harm by doing so?

not sure what I contributed much to that, sorry.
K
 Fidget 04 Oct 2005
In reply to andybenham:

Definately see a physio! Put your name on the waiting list, and have one sports injury appointment while you're waiting.

I got golfer's elbow last August, didn't get it seen to until December, and it too until July this year to get (nearly completely) better. I had a month off climbing and saw a physio until the pain started to improve (as well as a steroid injection from the doctor and icing it every evening and doing stretches several times a day), started climbing again for 20 mins a week, built it up by 10 mins a week until I was back up to 3-4 full sessions.

Then at the end of July it flared up again worse than before, this times it's more concentrated and in a slightly different place ot before. This time I haven't stopped climbing, as low intensity climbing over the weekend makes it several times better (although a strenuous wall session makes it worse). If I feel it starting to hurt I'll stop. I also wear an arm clasp which absorbs some of the tension from the wrist flexor muscle so it's not all transferred to the attachment point of the tendon.

When you first get tendonitis you just get a swelling of the tendon. This can be fixed with ice and anti-inflammatories. If you carry on training, it becomes tendonisis which is where you get tears in the tendon fibres and you get scar tissue. The only was you can fix this, is by getting blood to the area, which is by ultrasound/laser from the physio, stretching, and massage. It helps to keep it moving - get some poi, or a powerball, or go swimming (although this makes mine worse), or light weights (but only if it doesn't make it hurt). You should still ice is (and maybe take anti-inflammatories like ibuprofen or voltarol) after exercising it, like somebody else has said to reduce any fresh inflammation.

Hope that helps.

 Fidget 04 Oct 2005
In reply to andybenham:

p.s. Forgot to say (and not sure if anyone else has)... a lot of the time, elbow tendon injuries in climbers are due to muscle imbalance. Make sure you train your triceps (dips, press-ups, etc), and also do some shoulder exercises (check out the shoulder health article).
Anonymous 04 Oct 2005
In reply to andybenham:

Do any of you people suffering with bad elbows live up in the North East...??
Kate Farley 04 Oct 2005
In reply to Anonymous: I do hope you're not soliciting...?
K
 Alan Stark 04 Oct 2005
In reply to andybenham:

It's a waste of time telling climbers they should rest this typr of injusry when all they want to do is climb, but I know from painful experience that keeping climbing even after physio and wearing a support only delays the healing process. My physio even included a course of electric impulse stimulation, and magnetic therapy as well as massage and anti inflammatories.

My injury was possibly a little unusual in that it was not just the elbow, but the main tendon attachment point in the biceps muscle where the most damage had occured. (A combination of climbing and repeated use a scaffold spanner on rusty fittings, but not at the same time)

I'm now climbing happily without wearing an elbow brace, but it took around 3 years to clear up completely, and for me to build up strength again. (Age probably does not help, as muscle tone is hard to regain in late 50's).

Good luck to anyone suffering a similar injury -- you have my sympathy. -- but be patient.
Anonymous 04 Oct 2005
In reply to Kate Farley:

soliciting what...?
Anonymous 04 Oct 2005
In reply to andybenham:
when i had tenis elbow i rested for 3.5 months. when it finally diappeared it seemed to do so quite suddenly.

i did some rehab exercises but only if they didn't agitate my elbow at all.
 SARS 04 Oct 2005
In reply to cider nut:

Muscle imbalance, lack of stretching, training when tired etc. All bad things which can cause injury.

I try to do complementary exercises to climbing each week (theraband, appropriate weight sessions during the year etc) as well as avoiding overtraining, eating well and getting enough sleep.

Seems to work. The last time I had a tendon injury, about four months ago (rotator cuff from over exertion) I recovered pretty quickly (4 weeks). Did this by regular physio, staying away from climbing but continued exercise.
 Martin W 04 Oct 2005
In reply to andybenham: I've been struggling with tennis elbow for over a year now (same basic thing as golfer's elbow but on the other side of the joint). A week or two's course of ibuprofen gives temporary relief but the discomfort comes back as soon as I stop the drugs. Rest, ice, massage & ultrasound don't make it go away either. Glucosamine & chondroitin do nothing (I've tried taking then for my knees before as well and got no benefit whatsoever.)

I do find that the velcro strap around the upper forearm helps to protect the injury, but it doesn't make it go away. I'm very wary about exerting the joint too much while it is painful for fear of making the injury worse.

The only thing that has really worked so far is the steroid jab. It took two to make it go away the first time, but I set it off again a couple of months later. Some more intense physio helped a bit, but in the end I opted to see an orthopaedic consultant. He gave me a third jab, which seems to have done the trick for now, but if it comes back again soon then then he wants to operate. Gulp.

Both the physio and the consultant have said that tennis elbow is unpredictable: in some people it just go away with time, some people respond to different treatments, other people can't seem to shake it off whatever they do. I hope you have an easier time of it than I have.
 John Alcock 04 Oct 2005
In reply to JonC:
> (In reply to John Alcock)
>
> >> Place forearm on table and massage top surface ruthlessly with opposite elbow. Massage point of elbow gently.
>
> Do you mean that you massage the inner side of your forearm?

The main massage which an osteopath showed me is along the top of the forearm with the palm of the hand facing the table. You'll usually find that tendonitis in the elbow makes the muscle which runs along the top tight and full of knots. It's good to massage the underside too, but less important for this injury.
Andy.Went 04 Oct 2005
In reply to andybenham:
I've had golfers once in left elbow three times in right, over a ten year period, always comes on when I'm training and reaching alltime strength high.........I've done loads of reading, tried all kinds of treatment bar cortisone, I would thoroughly reccomend the advice given by Eric. J. Horst in 'Training for climbing". Reading it will draw together and make sense of all the advice you have been given....some of the advice on here is real! bad!
 Fidget 04 Oct 2005
In reply to John Alcock:

That sound like the wrist extensor. The tendon that's attached to this is the one where you get tennis elbow. It's the wrist flexor (on the bottom of your forearm when your palm is facing down) that's connected to the tendon involved with golfer's elbow.
Hugeos 04 Oct 2005
1) buy a gyroscope, and use it. http://www.powerballs.com/ or snow and rock sell them

2) Stretch out everyday, using the exercises found on http://www.trainingforclimbing.com/ and in the book by Eric Horst

3) when you do return to climbing, don't jump straight back onto the overhangs! I did the following, slowly building up the grades:

- 1 month straight or slab, indoor 4c max
- 1 month straight or slab, indoor 5a/5b max
- then introduce slight overhangs for short routes etc, but do it all gradually

4) buy a support for the elbow. Any decent sports shop should sell a support for around £10-£15

5) If if even starts to vaguely hurt at any point in rehab period, stop your session immediately, stretch out and leave it for a few days

It took a while for me to get over my tendonitis, but it is worth taking the time to sort properly, otherwise the problem reccurs. I still wear the support sometimes, a year down the line.

Good luck mate.
Hugeos 04 Oct 2005
also, while I remember:

try an osteopath as an alternative to physio - they were great on my elbow problems.
OP andybenham 04 Oct 2005
In reply to Hugeos: cheers dude. One thing I had been looking for was some actual exercises to do.
OP andybenham 04 Oct 2005
In reply to andybenham: On a general note, cheers to all who took time to get back to me...there's a lot to think about here.

Initially I liked the idea that carrying on climbing could be a possibility though, knowing how useless I am at taking it easy, I think its probably best I continue to rest it, though I think I might try some easy slab routes outdoors I don't think I'm ready for the wall yet.

I reckon, given how long everyone says it takes to heal that maybe I will get on that waiting list...after all what is there to lose...
 Skyfall 04 Oct 2005
In reply to Hugeos:

I one of those gyrociser things but it doesn't really have much in the way of instructions. Other than simply holding it whilst you get it going faster and faster, what on earth do you do with it? Or is that it?
 mike123 04 Oct 2005
In reply to JonC:
you can get them off the web in the uk, will get jack to logon and tell you where he got his. i put mine on as soon as they start to tweak. seems to work. well worth a try.
mike
Hannah m 04 Oct 2005
In reply to andybenham:
Check that it IS the tendon.
I have had a problem with my left elbow since January.I thought it was golfer's elbow at first. I have rested it for weeks/months and it makes no diference to it- I have tried ice, ibuprofen, ultrasound, massage and physiotherapy with a very good sports physio - my GP said there was nothing wrong with it for months when I said I thought it was a nerve problem (affects gripping power in certain directions)- the physio wrote him a letter - I have just recently (September)visited a consultant who says it is the ulnar nerve pinging out of its groove (you can see it move across the medial epicondyl, inside the elbow as arm flexes). Not really very painful but sore and 'loose' - having more tests soon.Climbing, lifting 'not recommended'. Can climb very lightly but fed up of not being able to push things at all...am doing light weights with arm to prevent total atrophy! Possible minor operation might cure this.
Just have it checked and have it properly diagnosed.
H
Tim Lowe 04 Oct 2005
In reply to andybenham:

Had 4 lots of cortisone. Did bugger all good. Stretching and press-ups whilst carrying on climbing at a lower level till it got better.

Avoid campus boards and pull ups!!!

I'm now injury free

Tim
Hugeos 05 Oct 2005
The basic principle is that you hold it while it goes faster and faster, yes. You can reverse the direction of your wrist movement without a break in the gyro rotation (cos its a gyroscope, innit).

Then you can hold the gyro in different positions - with straight arm to the side, doing an arm curl, behind your back - while still revolving the Gyro as fast as you can.

You'll then quite quickly feel it working your forearm tendons and muscles, upper arm and shoulder.
 neilh 05 Oct 2005
In reply to andybenham:

I have had this sort of thing in various degrees of pain for 10/15 years now.No warming up .Cold climbing walls were the original cause.

Rest and stretching are the best bet.
dana 12 Oct 2005
I just got tendinitis in my elbows three and a half weeks ago climbing at rifle. I got it because i had not climbed for 8 months because of another injury. i have gotten acupuncture four times and it seems to help a little bit. a physical therapist told me that it will take four to six weeks to heal and then i can start climbing again. but hearing all this talk really depresses me. will it really take up to a year or more to heal??????? I don't know if i can go that long and not climb....since i haven't been climbing really for the past year it is driving me crazy!!!!
some_fulla_ant 12 Oct 2005
In reply to andybenham: I've had Golfer's Elbow on and off over the years. Here's what worked for me:

A bit of physio, rest, stretching, and ice massage initially until it's mostly pain free when you massage. At the same time, get into some muscle balacing exercises such as reverse wrist curls. People above have already mentioned the Eric Horst book, check it out. I started climbing again (indoors) after a few weeks, but avoided crimps like the plague as this is the hold type that caused problems for me. I was able to climb overhanging routes on big holds without pain, may be different for you. Heaps of stretching as well, especially the top of the forearm. I like the sound of a previous suggestion of massaging the top of the forearm with the point of one's elbow.

Once it's all good you can keep on top of things with reverse wrist curls every so often, and press-ups after each climbing session. I'm hardly a press-ups master so don't think you need to be cranking heaps of them for it to be worthwhile.
mike swann 12 Oct 2005
In reply to andybenham:
Good Ole Wal-Mart

One day, in line at the company cafeteria, Joe says to Mike behind him,
"My elbow hurts like hell. I guess I better see a doctor."
"Listen, you don't have to spend that kind of money," Mike replies.
"There's a diagnostic computer down at Wal-Mart. Just give it a
urine sample and the computer will tell you what's wrong and what to do
about it. It takes ten seconds and costs ten dollars..a lot cheaper than a doctor."

So Joe deposits a urine sample in a small jar and takes it to
Wal-Mart. He deposits ten dollars, and the computer lights up and asks for
the urine sample. He pours the sample into the slot and waits. Ten seconds
later, the computer ejects a printout:

"You have tennis elbow. Soak your arm in warm water and avoid
heavy activity. It will improve in two weeks. Thank you for shopping @ Wal-Mart"

That evening while thinking how amazing this new technology was,
Joe began wondering if the computer could be fooled. So he mixed some tap
water, a stool sample from his dog, urine samples from his wife and
daughter, and a sperm sample for good measure.

Joe hurried back to Wal-Mart, eager to check the results. He deposits
ten dollars, pours in his concoction, and awaits the results. The computer prints the following:

1. Your tap water is too hard. Get a water softener. (Aisle 9)
2. Your dog has ringworm. Bathe him with anti-fungal shampoo. (Aisle7)
3. Your daughter has a cocaine habit. Get her into rehab.
4. Your wife is pregnant. Twins They aren't yours. Get a lawyer.
5. If you don't stop playing with yourself, your elbow will never get better.
 Jonathan T 12 Oct 2005
In reply to andybenham: I've got golfers and tennis elbow in both elbows and I think it was originally brought on by excessive bouldering at an indoor wall, stopping weight training (muscle imbalance) and less stretching. My girlfriend is an oesteopath and climber and a friend of hers is also an osteopath and climber who's had tennis elbow. My experience of being treated by an osteopath is that most of my upper body muscles are too tight, especially my forearms and shoulders / chest. I found that a period of easier climbing, stretching, theraband work for the flexors and extensors of the wrist and the shoulder, and oesteopath treatment has started to have a positve effect.
Talking to my girlfriend and her mate reveals horror stories of people who ignored it for too long, had to resort to cortizone injections and then surgery with poor results.

As far as I'm aware, straps for the elbow don't fix the problem, they just change the insertion point of the tendon and therefore give some temporary relief from the problem. The original cause will still be there though. Similalry with pain relief tablets / gels, they do reduce some inflamation but also mask the pain which makes you think it's fixed.

If I was you, I would stump up the cash to see an osteopath or physio who has experience of climbing injuries, find out what is causing your particular problem and if you can't afford continuing consultations, self treat following the osteopaths / physios advice. You really need to find out what is causing your problem, rather than hoping someone's experience on here is the same as yours.

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