/ Medial Epicondyle (Golfer's Elbow) - push pain

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Davib - on 21 Dec 2016
I've got medial epicondyle pain (a.k.a golfer's elbow) in my left arm. I 100% caused by over training lock-offs and accept I am a very foolish man for doing so.

I've had minor versions in the past so always include plenty of press-ups, dips and stretching in my pre & post climbing. As this is worse than previous occasions i'm taking a month's rest from any climbing as well.

The problem I have now is that the medial epicondyle is hurting when i extend my arm and flex my fingers. It used to be the case that pain would only come during a lock-off or other action with a bent elbow. Now things like a handstand or downward dog are making it hurt. These used to be my go-to's for countering golfer's elbow, now i'm worried they may make it worse.

Does anyone else have any experience of a similar problem or have any suggestions? Is it just really inflamed and needs lots of rest first.

P.S. Things i've already tried / trying include: Tom Randall's floor stretch, the 'weight-on-a-stick' eccentric exercise, PowerFingers bands, palm up & down wrist curls, increasing turmeric in my diet (natural anti-inflammatory).
La benya - on 21 Dec 2016
In reply to Davib:

you need to rest a little to allow as much swelling to go down as possible. once at your base level of pain, start eccentric loading exercises, they should hurt a little, but not lasting... ie, you're trying to stimulate blood-flow by activating the area, but not working it too hard to aggravate it.

i think the key for you as you know all the exercises (as it was for me, too), is too allow sufficient rest before attempting these exercises. i found 1 week would be ok for mild flare ups and a month for my worst one, before the exercises had the desired effect.

also, read up on radial nerve flossing, i found this to be a game changer.... and it feels great
JR - on 21 Dec 2016
L JolGunn - on 21 Dec 2016
In reply to Davib:

I would suggest to keep the place warm, maybe even put on ointment warming
Davib - on 21 Dec 2016
In reply to Davib:

Thanks everyone, some really useful stuff here, will add the radial nerve flossing exercises to my rehab routine and follow the 10 Things link. Can take advantage of the Christmas excess and replace climbing with eating!
zmv - on 21 Dec 2016
In reply to Davib:

Definitely have a look at this:

http://onlineclimbingcoach.blogspot.co.uk/2011/02/golferstennis-elbow-etc-what-eccentrics.html

If you really value your climbing health and for future injuries I recommend his injuries book.

In short what has so far worked for me was not getting minor tweaks turn into bigger ones and constantly be trying to vary the crags, climbing walls and partners I am training with.

In terms of eccentrics - if I get a flare up of golfer's elbow symptoms, I do a stint of 3 sets of 10-15 wrist curls, the ones in which the palm is facing upward with a weight which is not light (5 kg and more depending on strength levels). The idea is that these should provoke a mild pain (like 3 out of 10), do these religiously for 6 weeks and remove the cause for the elbow injury to begin with and I'd be surprised if your elbow was not significantly better.

Good luck!
Si dH - on 21 Dec 2016
In reply to Davib:

Rotational eccentrics worked best for me, what I think you call weight on a stick. It's important to get the elbow angle correct (whatever causes most discomfort.)
Gresham suggests use of Powerfingers bands to train your extensors is good for elbow issues too, by removing imbalances in the forearm. I've been doing these for about 8 months and haven't had any issues this year (but who knows if it's cause and effect.) It's certainly something worth trying, especially given how you describe your straight arm pain, as this suggests to me that it is a forearm issue. Stretching out your flexors carefully might also help.
geordiepie - on 21 Dec 2016
In reply to Davib:

Just to reiterate what's already been said eccentric exercises really are the only exercises you'll need if it is indeed golfers elbow. Different variations work for different people. For me wrist curls did nothing but weight on a stick with arm fully extended works a treat. Rest really doesn't seem to help and the exercises sometimes make it worse before it gets better.

Good luck
jsmcfarland - on 22 Dec 2016
In reply to Davib:

Worth pointing out with any rehab/physio you have to be consistent with it to see some results. Plenty of people (myself included) have had various elbow tendonopathies and started rehab programs and given up too soon before the body has time to respond. It took several months of eccentrics without much results before a sudden marked improvement when I was fixing my tennis elbow
mike123 - on 23 Dec 2016
In reply to Davib:
As above , weight on a stick works for me , Julian Saunders articles dodgy elbows and dodgy elbows revisited are must reads and also this video:
http://www.vimeo.com/110276040
Which , as mentioned above, shows how to get the angle correct .
Edit : just re read your post , have you tried playing with the angle of your arm as described in the video ? Made a big difference to mine and if I was sensible enough to just keep doing it they almost certainly wouldn't be sore this morning after last nights wall session
Post edited at 08:52
Davib - on 01 Jan 2017
In reply to Davib:

Thanks once again everyone, i'm seeing some improvement, I think the point about keeping a strict regime over a long period is really important. I'll come back to you with any miracle cures that I discover along the way.
Murderous_Crow - on 01 Jan 2017
In reply to Davib:

If you've not done so, it may be hugely helpful to get assessed by a good sports physio. Dry needling, massage and stretching may be of great benefit, helping to restore basic function and promote healing.

I'll explain. It's likely that you have areas of disrupted tendon architecture in muscles originating from the epicondyle where micro-tears are manifest in the tissue. This is accompanied by pathological changes in the surrounding fascia, which becomes 'sticky' and bound, for want of a better term. This compounds the syndrome by effectively starving the site of local blood flow. This degenerative process becomes a vicious circle, with lack of healing predisposing to increased risk of injury and so on. As such your history of gradual worsening is fairly typical.

People are correct in recommending eccentric exercise methodologies for rehab, however it's critical that basic function is restored before or (depending on severity and other factors) along with rehabilitative strengthening. As such, you are more likely to be able to reap the full benefit of such exercises once an assessment has been made and appropriate interventions applied. Don't misunderstand - effective rehab is largely down to you, and how much effort and patience you apply. But acute interventions such as myofascial release will likely greatly improve your chances of success.

Luke



teapot - on 02 Jan 2017
In reply to Davib:

I have have managed golfer's in my right elbow on for the last decade. Nothing particularly ground breaking to add, except that I tried everything like you for years.

Rest - only temporary fix- but I still don't abuse my elbows as much as I used to I.e I back off after 4 or 5 goes on a move which I know will aggravate it.

That Tom Randall stretch move caused me to make it alot worse- I.e. it overstretched it. Take care with that one.

In the last 2 years my elbows have improved massively - for me the secret seems to have been the extension exercises, but with 3 different angles. 90 degree elbow x10, full entended x10, and fully locked x10.

I have ignored the advice about having heavy weights. I use about 2kg - I add an extra 0.5 for the full locked.

I do it twice a day every day!
sebastian dangerfield on 02 Jan 2017
In reply to Davib:

I've found the 'power bar'quite good - it can be used for eccentiric wrist curles, but also just bending it (similar movement to turning a door nob).

Also, I've been doing bikram yoga (one of the hot ones) for a bit and it seems to have sorted my elbows and shoulders out. It includes Tom Randall's exercise (but more extreme). Another one that feels like it helps my elbow is called 'standing bow pulling pose'
Davib - on 09 Jan 2017
In reply to Murderous_Crow:

Thanks Luke, i've just moved to Cape Town for 5 months, so have more free time, will find a physio and get on with those eccentrics.
ads.ukclimbing.com
alx - on 09 Jan 2017
In reply to Davib:

The latest podcast on trainingbeta.com covers elbow tendonitis, useful information!

https://www.trainingbeta.com/media/esther-smith-elbows/

I would recommend checking out this book - it is a picture guide that takes you through how to stretch and unlock tight muscles of which would contribute to your problem, worth the money!

https://www.amazon.co.uk/Becoming-Supple-Leopard-Preventing-Performance/dp/1936608588



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