In 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.
VIDEO: Eccentric Exercise for Golfer's Elbow
I'm a fairly accomplished rock climber that suffered three years (between 2005 and 2008) of golfers elbow (or medial epicondylitis). I went through all the usual therapies; ice, rest (months), corticosteroid injections, and none of them helped. At a certain point even simple things like washing my hair, or closing a car door hurt. I dreaded that I would have to give up my sport.
After having been told by an orthopaedic surgeon that even surgery would probably not really help (only 50% chance of success), I was quite desperate. One last bout of searching the internet found some promising links (below) on successful use of eccentric exercise with professional soccer players with Achilles and patella tendon injuries.
I managed to translate their work to an effective program for my elbow; the results were quite spectacular. I started in January 2008 and I was mostly healed in about 4 weeks (no more pain in daily life activities), and could sport (climb) again at my maximum level after some 4 months. The effect of the exercise is quick; after two weeks you'll start seeing results, after 4 weeks the pain has mostly gone. I kept doing the exercise until autumn 2008 to get rid of the final pain twinges that occurred at some angles of the elbow. I have been pain free since late 2008.
I've created this page for fellow sufferers, that have the discipline to exercise a few times a day for a few minutes to cure their epicondylitis; I hope it's as effective for you as it has been for me. I've done these exercises in the first half of 2008, and my elbow has been healthy since then. I'm climbing harder than ever.
Bart van Deenen
- a bit of broomstick.
- a 0.5kg, 1kg and 2kg weight. Sports store.
- 2 weight clamps. Sports store.
I've marked the stick with a cm. scale, starting at 9cm on the nearest clamp.
The intensity of the training is defined by the multiplication of the weight and the distance from your hand to the weight: in this example: 0.5kg * 22cm = 11. If you move your hand to 25cm on the scale, the exercise increases to (25*0.5) = 12.5, so that is already 14% more. Increase the centimetres slowly to increase the intensity of your training!
How to train
Start with a low weight and a short distance (for me it was 0.5kg and 15cm). The exercise must hurt, but not so much that your elbow hurts more after the exercise is over. Do 10 or 20 repetitions a few times a day. Increase the stick distance (and eventually the weight) as needed. Make sure that when you increase the weight, you decrease the distance, so that the intensity stays more or less the same.
I found that immediately after the exercise the elbow felt better, sort of warm and numb.
You can keep doing sports during the eccentric training period, just let the pain decide how much you can do.
After 2 weeks I started noticing real every day improvements, where pain for typical household chores would be gone.
I increased the intensity every day or so, and after 4 weeks most of the every day pains were gone.
Eventually I was working with 3kg at 25cm (intensity 75), to get rid of the last pains that I only experienced with overhanging climbing.
It took months for all the pain at every angle of the elbow to disappear. At the end I did the exercise with a really bent elbow (no longer resting the hand on the knee) because that was the only elbow angle where I still felt pain.
My wife had problems with a tennis elbow (lateral epicondylitis), and did the same exercise in reverse, i.e. lower the weight on the stick inwards instead of outwards. The same rules apply and it's just as effective.
These links set me on the trail of eccentric exercise.
- Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up
L Öhberg, R Lorentzon, H Alfredson
- Eccentric rehabilitation exercise increases peritendinous type I collagen synthesis in humans with Achilles tendinosis
H. Langberg, H. Ellingsgaard, T. adsen, J. Jansson, S. P. Magnusson, P. Aagaard, M. Kjær
general background on tendinosis (tendon degeneration). Unfortunately also lists all the ineffective "therapies".
This Dutch language site by Mattijs Abeelen has a section on 'training of tendons'. The comments section have my original comments while I was doing the exercises.
All this exercise took place in early 2008. I've been climbing hard since then, and I am currently climbing better than ever (7b redpoint). My elbow is still fine.
UPDATE: 24 March 2011: I have mails of 5 people that are doing the exercise. Of three of them, I know they have very positive results, one is euphoric having gone through pretty much the same non-working "treatments" that I did. I'll do some mail excerpts next time I'm online. Please DO mail me if you are doing the exercise and have results (positive or negative).