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Elbow injury help

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 nickb 25 Jul 2019

Hi 

I have a tendon or ligament problem on the inside of my elbow, it was a dull ache yesterday and now after a boulder session has increased to being very uncomfortable so much that I dont want to use my arm much and is painful, especially when straightening my arm. 

Does anyone have any advice about what the cause may be or any useful exercises or stretches that might help? 

Currently using a tmsling to try and minimize any strain. 

Thanks in advance.

 plyometrics 25 Jul 2019
In reply to nickb:

In the short term you can’t go wrong with rest, ice and NSAIDS. 

Wouldn’t recommend you stretch anything for the time being. 

Fingers crossed it’s either a mild tweak or simple overuse, all of which are easily helped to heal using the above tips. 

2
 dominikk 25 Jul 2019
In reply to nickb:

Sounds like classic tendininosis or tendinitis.

Neither ice nor NSAIDS will do you any good. Ice is useless, NSAIDS will just mask the underlying issue. Rest, if it doesn't go away it's probably tendinosis which means eccentric exercises are the way to go. There's a lot of tips regarding this common climbers overuse condition. The only treatment that has any reasonable scientific background are exercises, combined with stretching and soft tissue massage.

To elaborate: tendinitis is an inflammation of the tendon which connects your forearm muscles to the elbow. It's often the start of tendininosis which is the actual damage to your tendon structure and not inflammatory. It can take quite a while to heal, the longer it is ignored the more severe it gets.

Disclaimer: I'm no physician or physiotherapist. My girlfriend suffered from this condition quite severely and as it took longer and longer to heal I researched as much scientific background as I could. Because I like her and because it gets in the way of our climbing holidays...

Post edited at 21:51
In reply to nickb:

Have a look at the Theraband website, they have advice on stretching and strengthening for inner and outer elbow problems and, of course, a product to sell (Therabar?) - you can replicate their exercises without buying their Therabar. Has helped me in the past.

 dominikk 26 Jul 2019
In reply to nickb:

To complete my post from last night here are two links. The first is an article originally published in rock&ice, the second one a later update. They are quite detailed in how to do the excersises, the guy has developed a specific program for these kind of issues.  I don't know if this specific approach is the only true possibility but it falls in line with the general research that tendons need to be strengthened in order to heal. If it's just an inflammation resting might be enough but damaged tendon tissue does not seem to recover properly unless it's challenged.

http://drjuliansaunders.com/dodgy-elbows/

http://drjuliansaunders.com/ask-dr-j-issue-223-dodgy-elbows-revisited/

 simonacarr 26 Jul 2019
In reply to nickb:

I have had 6 months of issues with ulnar nerve / tendonitis in my left arm. On the mend now. Here’s what i found helpful...

1. See a good physio. Ideally one who knows climbing. Dry needling seemed to make a difference. 

2. I found eccentric bicep curls and tricep extensions to have really helped. 

3. Stop leading and  traversing. Focus on climbing which is lower grades and isnt Crimpy. Downclimb as part of warm up and warm down. 

4. Stop crimping, open hand as much as possible. 

Hope that helps, hope its not as bad as mine was (if its ulnar nerve a much longer recovery). 

 Andy Reeve 26 Jul 2019
In reply to nickb:

Hi Nick,

As others have said, if it doesn't spontaneously get better soon I'd get it checked by a physio who is at least familiar with the physical demands of climbing.

However, it does sound like medial tenonosis (as dominikk has provided links about). Another useful source of information is from John Roberts: https://johnroberts.me/outdoors/2016/03/10-things-ive-learned-about-climber...

Finally, just a note of caution. If it is medial tendonosis I would go very steadily with it. I have had his on and off for the past decade. One of the reasons it is so insidious is because (in my experience at least) it often feels okay once I have warmed up, so I have fallen into the trap of warming up slowly => deciding it feels fine so I must be cured => in my excitement I have a massive session => once I've finished and start to cool down it hurts worse than it did at the beginning => rest a few days and repeat. Needless to say, this doesn't help; conversely however I have found complete rest to be pretty much just as bad!

Good luck with it.

 kaiser 26 Jul 2019
In reply to nickb:

Your age is in your favour but, as others have said, tendon injuries need respect and patience

 heleno 27 Jul 2019
In reply to nickb:

I suffered from elbow problems for several years at a time when guidance was much less well developed than it is nowadays.  My mistake was to stop climbing completely for weeks (and even months at one point) and then try to restart at close to my normal level.

Current advice is to rest for only a short period until any inflammation has subsided, and then to start gently climbing - but considerably below your usual grade.  This is the hard part as it's always so tempting to push yourself!!!  But if you stick to it, alongside stretching and eccentric strength building, you have the best chances of a decent recovery.

The turning point for me was when my partner broke his arm a month before a holiday booked in Spain.  We spent the first half of the trip climbing 4s, and built up from there.  That was 10 years ago, and I've had nothing but the occasional twinge since.

Removed User 27 Jul 2019
In reply to nickb:

Is the pain just below the joint? If so it's golfers elbow.

I'm afraid that rest is the main cure if that's what it is although ice packs, massage and stretching will help speed recovery.

1
 teapot 28 Jul 2019
In reply to dominikk:

These articles are really good and well worth reading very carefully.

I had golfers elbow for years and even gave up climbing for 9 months at one point. In the last 6 years I not had any issues.

A few tips 

1) Never climb while still taking ibuprofen. You are masking the injury and will aggravate it. 

2) That 2nd article covers extension exercises with elbow at different angles: when I added this to my extension exercises (after years of problems) I found it amazingly effective. I rarely see anyone who recommends this or who does it. I also tend to use only 1-2.5kg rather than the higher weights often recommended and they work really well.

3) I came across a supposed miracle stretch by some wad (maybe Varian) which recommended a lie-ing down stretch which I tried and totally buggered my elbows! Maybe I did it wrong, but if you come across it take care. 

4) Build an elbow stretch routine into your daily routine and a ALWAYS after a climb. 

 Neil Morrison 28 Jul 2019
In reply to Removed User:

Ice is a bit out of favour these days, check out the second Saunders article. I gave up on it years ago. Heat, on the other hand, is good.

 Iamgregp 29 Jul 2019
In reply to nickb:

If it’s golfers elbow (which it sounds like it might be to me) Tom Randall has a really novel stretch that he reckons cured him of it. 

I had just a mild bit of soreness on this region and did this for a couple of weeks and it really seem to have helped. https://www.google.co.uk/amp/s/tomrandallclimbing.wordpress.com/2012/11/23/...

 Powderpuff 30 Jul 2019
In reply to nickb:

I have suffered with bad elbows for a long long time but at the moment they feel great. The following I believe help enormously.

1.Eccentric wrist curls

2.Theraband 

3.Open hand more, crimp less

4.Tom Randall stretch

Best of luck with your recovery.

 simonacarr 05 Aug 2019
In reply to nickb:

New video from Dave Macleod on elbow tendonosis should also be useful. 

https://www.youtube.com/watch?v=_iMueqiCsVI&t=1572s

In reply to nickb:

I was just about to link to Dave's video but saw it posted above. It's made me feel more positive about my injury! 

Has anyone here fallen onto an outstretched arm/hyperextended their elbow in a twisting motion which causes pain at the medial epicondyle (or at least in this area?) I was bouldering last week and on an awkward press move my arm suddenly straightened and twisted outwards and I heard a crack. Physio says I've injured the common flexor origin which is similar to golfer's elbow, just acute and sudden onset. I feel pain at the base of the elbow too, though, so I'm wondering if it's a two-fold injury. Might get a scan next week.

Post edited at 14:40

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