/ NEW ARTICLE: VIDEO: How to Heal Elbow Tendonitis

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UKC Articles - on 04 Apr 2011
Training aid for Elbow Tendonitis, 2 kbIn this article experienced climber Bart van Deenen shares his personal experiences of beating elbow tendonitis and gives us an exercise routine that worked for him.

The instructions are clear and simple and include photos and a short video. We hope it works for you too.

Read more at http://www.ukclimbing.com/articles/page.php?id=3614

north country boy - on 04 Apr 2011
In reply to UKC Articles: Good article and some useful links. I can vouch for the effectiveness of the exercises described in the article having spent 6 months carrying out a similar daily routine.
Snoweider - on 04 Apr 2011
In reply to north country boy:
I hope this works as I'm fed up with low level tendonitits for 2 years now. :-(
PeterJuggler - on 04 Apr 2011
In reply to UKC Articles: How can I diagnose elbow pain as golfer's or tennis?
EBclimbing - on 04 Apr 2011
In reply to UKC Articles: Even better cos he sounds a bit like Arnie
Swig - on 04 Apr 2011
In reply to PeterJuggler:

It hurts in a different place. Althought when I had a bit of one (can't remember which) it took the physio a little bit of treatment (massage and ultrasound) to zero in one the exact location of the pain.
rallymania - on 04 Apr 2011
In reply to PeterJuggler:

(none medical answer ie i'm not 100% sure)

tenis is outside of the elbow and golf is the inside of the elbow (by inside i mean nearest your core)


gingerwolf - on 04 Apr 2011
In reply to UKC Articles: fantastic to see medical-releated useful information on UKC that has a basis in evidence-based research :)
Babika - on 04 Apr 2011
In reply to UKC Articles:
I'm really excited by this article! In January after physio, chiro, acupuncture and 2 x corticosteroid injections my GP told me I would never climb again due to 7 months of lateral (tennis) epicondylitis. I nearly passed out in the surgery....

My experience sounds just the same as Bart's, including the surgeon who said an op might not work and would only give me 80% or 90% usage.

I'm going to replicate this exercise RIGHT NOW :)

Thanks Bart
And UKC
Owain - on 04 Apr 2011
In reply to UKC Articles: I have been getting a numb pain on the inside of my elbow, the same area as the video directed but I wouldn't say I have been held back in any way by it. It came on after a heavy session at the indoor wall a couple of weeks ago and I had to apply deep heat to calm the pain down. These days the pain comes and goes so would you say I have a minor degree of golfers elbow or maybe a slightly strained tendon?
catt on 04 Apr 2011
In reply to UKC Articles:

Seems like a good time to repost this (originally pointed out by Simon Lee, with thanks...).

http://www.athlon.com.au/articles/r&i_dodgyelbow.pdf

The eccentric wrist curls sorted my elbow out, while I found the rotation type exercise didn't help much in my case, so worth incorporating both for rehab.

Dave M also wrote some interesting stuff on the subject

http://onlineclimbingcoach.blogspot.com/2011/02/golferstennis-elbow-etc-what-eccentrics.html
biscuit - on 04 Apr 2011
In reply to UKC Articles:

Some other variants - quite handy pieces of kit, easier to take around with you than weights.

http://blog.thera-bandacademy.com/2009/09/29/reverse-tyler-twist-with-the-thera-band-flexbar-for-gol...

'Cando' do a cheaper version of the flexbar.
Jonathan T - on 04 Apr 2011
In reply to UKC Articles: Interestingly there's no mention of osteopathy. I had golfers and tennis elbow in both elbows and a visit to an osteopath, who also happens to be a climber, fixed it after a course of treatment. No surgery, no injections. I regularly stretch now, including my chest which was a key thing for my problem.
Jody - on 04 Apr 2011
In reply to UKC Articles:

I can support Bart van Deenen's views with my own experiences.

A few years ago I developed bicep tendinosis and after trying various treatments it was the eccentric exercises (i.e. lowering the weight rather than lifting it) that worked the best by far.

Jody - on 04 Apr 2011
In reply to Jody:

I should add that 'program' I follow does include bicep stretches before, during, and after the exercise.
tradattack on 04 Apr 2011 - 77-76-77-166.static.unassigned.as8607.net
In reply to UKC Articles: that dude has the best accent!
rogpeppe - on 04 Apr 2011
i wish i'd known about this 10 years ago!
GazzerM49 - on 04 Apr 2011
In reply to UKC Articles: Thanks Bart, another "thumbs up" for eccentric work.
After 18 months of failing to shake off elbow tendonitus - through the recommended methods advised physiotherapists, a chiropractor, an osteopath, various masseurs and a sports doctor(resting, stretching, massage, ice, antagonistic work, creams, ibrubrofen, acupuncture (western and eastern approaches), myofascial release and eventual cortisone injections I eventually succumbed and had a tendon release operation (left lateral epicondial).
The decision was not taken lightly but was made possible by the misery of having a low grade pain pretty much all the time. If it had stopped or given me any hope of a change during the treatments above I would have continued with any of them. I won't ever know if I should have just continued for a little longer(excluding cortisone)in a subtly different way that I could have avoided the surgery.
I am now 4 weeks into a 6 week rest / gentle mobilisation process followed by light strengthening exercises. Obviously too soon to say how successful it will be in the long term but I will keep fellow sufferers informed.
The sticking point for me was conflicting advice on exercising through pain. I tried some eccentric work and easy pressups but it always hurt after so I packed it in - perhaps a mistake?
Perhaps the way forward for my more mildly affected "right" elbow is the gentlest of progressions through stretching / mobilisations whilst in mild pain through to the eccentric exercises that Bart and others describe. It seems counter-intuitive but some are claiming great results by working through this level of pain. I cannot climb / mountain bike at the moment anyway so its a good time to try.
CurlyStevo - on 04 Apr 2011
In reply to UKC Articles:
I am recovering from my second round of this with about 3 years of no problem.

I did a load of exercises that didn't help much TBH.

What did seem to help was going winter climbing with a compression bandage on (including a self gripping extra bandage around the tendon like the expensive specialist bandages you can buy). 2 days on the ben followed by a gorms day and a massive improvement. Since then been climbing with the bandage on. Yet more improvement.

I think cardio exercise helps too as it improves the blood flow.
gache - on 04 Apr 2011
In reply to Jody:

Was this tenodesis in the long head of your bicep?

I've been through 2 years of failing to find a cure for my bicep/shoulder issues so interested to hear exactly what you did, or whether anyone else has successfully used eccentric training on biceps/shoulders...
ads.ukclimbing.com
Toby S - on 04 Apr 2011
In reply to UKC Articles:

Excellent article, I've been having this very problem for the past month or so and was beginning to get a bit frustrated. I'll have to give that a bash.
mike lawrence? - on 05 Apr 2011
In reply to UKC Articles: Assuming the pain is quite mild can one continue to climb and do these exercises or should one abandon climbing until the pain goes entirely?

thanks

mike
maxsmith - on 05 Apr 2011
In reply to UKC Articles: bart, does this exercise only work for golfer's elbow? or also tennis elbow? i have suffered tennis in both elbows for the last 6 months, physio, ice, nsaid, exercises, nothing has yet helped
aostaman - on 05 Apr 2011
In reply to Toby S: I am sure that you used the term 'bash' prosaically, but either this video solution or the "Athlon' version (which are the same proposal in a slightly different form) need you to do this stuff gently and slowly over a long 'ish' period. After a lot of pain and worry I used 'Athlon' and did it religiously and worked it up gently over three months, climbed occasionally and it was successful.

The quick and easy 'fixes' generally don't, or they mask the problem. They include ibuprofen, all forms of 'cuffing' and support.

To be tedious I would also recommend reading the Athlon article a number of times. IMHO you need to understand the difference between tendonosis and tendonitis and the relationship between bone, tendon and muscle, and the more you understand, the more sense the long term solution feels and thus you can feel committed to it.

Good luck
CurlyStevo - on 05 Apr 2011
In reply to aostaman:

"The quick and easy 'fixes' generally don't, or they mask the problem. They include ibuprofen, all forms of 'cuffing' and support."

So you say but quite a lot of the new advice I've read is to the contrary. Compression isn't really about support it's about compressing out the excess fluids and not allowing them to reform during exercise. Also the support bands help take some of the strain off the tendon, which is usefull as it allows continueing of exercise. As long as your not causing net injury with tendonosis exercise of any form seems to help to me.


Jody - on 05 Apr 2011
In reply to gache:

The pain I had was in the upper bicep area, i.e. between the bicep and shoulder. When climbing steep routes/boulders the intense dull pain came on almost immediately, otherwise it usually came on after climbing.

Over about a year I tried various stretches and postural exercises with limited success.

After determining that I had Bicep Tedinosis and after searching the Internet I came across an article on a program eccentric exercises for Biceps. Unfortunately, I cannot seem to find this article again, therefore the following routine is based on memory/experience and as such should be treated with caution.

Originally I took three weeks out from climbing and approximately followed this routine:

1st week, 3 sessions spread over 7 days:

1st session:

Warm up + 3 sets of controlled 20 second bicep stretches.
2kg dumbbell weight.
3 sets of 10 repetition bicep eccentric curls for each arm.
Do the exercise standing. With each rep. start with the weight high, next to shoulder, and arm bent (i.e. the top position of a normal bicep curl). Take 3 seconds (approx. 3 slow breaths) to lower the dumbbell until arm is at full extension (i.e. hanging by your side). Use the other hand to help lift working into the start position for the next rep (i.e. avoid doing a normal bicep curl).
Repeat, swapping arms until 3 sets of 10 reps. has been completed for each arm.
Finnish with 3 sets of controlled 20 second bicep stretches.

2nd session:

Warm up + 3 sets of controlled 20 second bicep stretches.
2kg dumbbell weight.
3 sets of 10 repetition bicep eccentric curls for each arm.
2 seconds to lower weight
3 sets of controlled 20 second bicep stretches.

3rd session:

Warm up + 3 sets of controlled 20 second bicep stretches.
2kg dumbbell weight.
3 sets of 10 repetition bicep eccentric curls for each arm.
1 seconds to lower weight
3 sets of controlled 20 second bicep stretches.

2nd week, I repeated the process with 3kg. Reducing the time it took to lower the weight each session.

3rd week, I repeated the process with 4kg. Reducing the time it took to lower the weight each session.

When I went back to climbing I have found the bicep pain has hardly ever reoccurred, and when it has (usually after an intense period of climbing) it is at a very reduced level.

Unlike the ukc article I have continued to do on average one session of bicep eccentric exercises per week.

Most likely the program above is not as effective as it could be, or that the relationship between eccentric exercises and reduced upper-bicep pain, probably from tendinosis, is not as direct as suggested. However, the program did work for me.
Toby Dunn - on 05 Apr 2011
A good article, and it seems to be an effective treatment from quite a few subjective accounts. Eccentric wrist curls have been used as a treatment for tennis elbow by physios for some years.

Paul Evans - on 06 Apr 2011
In reply to UKC Articles:
Been struggling with left elbow tendinosis over many years, some times it goes away, some times (like for the past few months) it comes back. I've tried the athlon (R&I) eccentrics exercises which stress the FCU and they don't seem to hurt (or help) but from an initial try, the eccentrics which stress the pronator teres (as in the UKC article) do seem to both hurt and then help. However, in 2000 I had carpal tunnel decompression on my left wrist (nothing to do with the elbow pain!). So - long shot I know, but worth asking - do any medical types know - does Carpal Tunnel decompression affect the functioning of the pronator teres, and if so how? In a good or a bad way from the viewpoint of medial elbow teninosis?
Cheers
Paul
aostaman - on 06 Apr 2011
In reply to CurlyStevo: I would accept all of that, maybe I should have stuck to the 'core' of my post which should have been, 'it's a long-ish' haul, and there are no quick fixes although some of the points you make may help.
alimckay on 06 Apr 2011
In reply to Paul Evans: Quite often medial elbow pain (and lateral) is misdiagnosed as medial epicodylitis, when in fact there is more often that not a neural tension problem (where the nerve crosses the elbow is very close to the common flexor tendon origin).

This neural problem can be caused, by the typical climbers posture (hunched back), by pronator tunnel syndrome (maybe in your case) and climbing style. The nerve passes through the pronator teres muscle, so a contraction of that muscle can compress the nerve and cause pain (this may be what you're experiencing).

The nerve passes through a few obstacles including the carpal tunnel and the pronator tunnel, so releasing one may cause the problem to move up the arm to the elbow. The elbow is where the nerve bend round a corner and this can cause it to stretch (nerves don't like stretch) if the obstacles reduce movement.

So quite often neural "stretches" and changes in posture can actually help medial epicondylitis, it is quite hard to get your head around the fact that changing the posture of the back can help your elbow, but it works.

It's just another way to look at it, as strengthening the muscles doesn't always work. Of course it can be a mixture of the two separate problems.

Sorry for the long post, but hopefully it'll help some of you.

Alasdair
bvdeenen on 08 Apr 2011
Hi

I am the Bart that has made the original article at sites.google.com/site/healgolferselbow/

My wife had a tenniselbow (from bolting holds onto the gym wall), and she did the same exercise in reverse (lowering the weight to the inside). She had very similar results using the same rules of thumb.
maxsmith - on 08 Apr 2011
In reply to UKC Articles: thanks bart, do you suggest any stretching, icing or eccentric wrist curls alongside your exercises?
bvdeenen on 12 Apr 2011
In reply to louiesmith:

Hi.

I didn't do any stretching or icing during the exercises.
ASharpe - on 06 Jun 2011
In reply to alimckay: Do you have any links to info about this? I remember in Jerry Moffatt's book he mentions having an elbow operated on for nerve problems by some guy in Germany which I think took a long time to be diagnosed. Can't remember if it was medial elbow pain right enough.
I see a clinical review in the BMJ of tennis elbow has a summary point that "cortisone injections are harmful in the longer term and are no longer recommended in most cases."


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