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Online Hallamshire Physio Clinic (Read 10265 times)

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#25 Re: Online Hallamshire Physio Clinic
November 02, 2016, 07:24:21 pm
I dislocated my elbow maybe 3 years ago, and at the time, I got a nerve impingement test (electrical current thing), which found some nerve impingement, but not enough to recommend any treatment. Recently, the outside of my hand on that side has become kind of numb all the time, sometimes painful, and also the skin on the little finger has gone really dry and sore, and I am unable to fully straighten it some of the time. I'm wondering whether this could be related to the elbow injury. It is kind of sore on the back on my elbow (I can't rest it on a desk etc) though the joint itself is fine for climbing etc. That elbow does look larger than the other one, suggesting to me that there has been some bone growth after the injury which could be meaning there is less space for the nerves to travel through the joint? I don't really know how to go about getting it checked out though. I have a GP, but they're not really any use for things that aren't really really simple or really really serious as they are massively oversubscribed. I can't imagine they could do anything about that either. Who would you approach for this kind of thing? Do you think that the problem is likely damage from the dislocation, and what (if anything) could be done about it? Thanks very much.

Thanks Evil  Interesting problem.  Yes, I would agree that the previous dislocation is probably contributing to your symptoms.  Trauma to the nerves around the elbow in not uncommon following a dislocation.  This could give you the pain and numbness.  You also get neurotrophic changes to the skin as as a result of nerve damage as regulation of tissue is via the nerve and this could account for the dry skin (and even nail bed changes).  Even if the original nerve conduction studies were fine, there must have been some level of damage and this is now symptomatic. The elbow might be producing additional bone around the various tunnels (osteophytes) and these could be encroaching on the nerve. Additionally if your neck is tight from sitting (or throwing yourself of boulders!) the combined neck and elbow trauma can cause something called a 'double crush phenomena'  i.e. the nerve that is damaged at more than one point along its course is more likely to be symptomatic. 

What to do?  I suspect you need to get the problem assessed by someone.  The first port of call is your GP but if that is not helping ask them to refer you to a physiotherapist or even Neurologist if the numbness is persistent. 
Thanks
Steve


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#26 Re: Online Hallamshire Physio Clinic
November 02, 2016, 09:17:24 pm
Hi
This is referred from your shoulder or neck.  I assume it is a shoulder control problem that is an issue with certain wide holds as it is fine normally.  A muscle injury would be more consistent.  If its was 'super painful' you might have had a neck/nerve irritation that slowly improved but only caused problems with certain positions.  Stretch you neck and strengthen your shoulder but continue climbing.  Strengthen the shoulder in positions that reproduce your symptoms i.e. wide moves above head hight but do both pulling and pushing type exercise. 

Thanks
Steve H

Thanks for this Steve. I've been stretching my neck quite a lot over the past few days and it's made a massive difference. It's not 100% sorted but it's a hell of a lot better.

There was one more thing I was wondering about injury wise. I had an a2 that hung around for a long time but it finally healed from what I can tell. A month or more later I injured something in my palm. It's not very painful but it gets worse when I climb on it.

It's either side of the a1 and causes swelling when I stress my hands through climbing.

Below is a picture of the areas that are swollen.


« Last Edit: November 02, 2016, 09:24:52 pm by mctrials23 »

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#27 Re: Online Hallamshire Physio Clinic
November 03, 2016, 03:00:54 pm
What to do?  I suspect you need to get the problem assessed by someone.  The first port of call is your GP but if that is not helping ask them to refer you to a physiotherapist or even Neurologist if the numbness is persistent. 
Thanks for the response. I just need to force myself towards the GP now...

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#28 Re: Online Hallamshire Physio Clinic
November 04, 2016, 10:41:05 am
OK, feeling a bit like I'm falling apart, lots of issues on my left arm and hand which I think may be related!

Both my shoulders are stiff and sore (have been for years!) but in my left arm I get a dull pain on the inside where the bicep joins the elbow. My left wrist has been sore for about a year and a half which at first I had put down to having a baby, saw a physio and had an ultrasound which showed nothing and the physio suggested I quit climbing, what did I expect at my age and didn't I have my hands full enough with a small child, I'd also talked to them about pain in my ring and middle finger but they totally ignored that. Taping when climbing helps, if I try to pull with just those two fingers it aggravates my wrist and hurts the fingers a bit but the wrist also hurts when I flex it back and it makes a lot of grinding noises.

Now I also seem to have buggered the index finger on the same hand and it's stopping me climbing. The middle joint is swollen, looks a bit bruised and very painful when fully stretched or clenched. It has improved with a week of rest (I couldn't switch a light on without yelping last week!) but I'm concerned about it stiffening or becoming a long term niggle if it's not sorted properly now. I did it on a side pull finger pocket moving up and around it, I did it probably 8 times and started to feel something a bit off so stopped that but carried on climbing with no worries, an hour after I finished climbing it was agony.

Sorry that there's lots there, I feel like I probably need to go and see someone but I'm not sure if it should be a physio (who has a bit more of an open mind!) my GP, minor injuries or a sports massage therapist! Any help you can provide would be appreciated.


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#29 Re: Online Hallamshire Physio Clinic
November 04, 2016, 11:14:00 am
Excellent, glad this thread is back.

I currently have a niggle which manifests mostly in my neck which feels tight and stiff, get a bit of discomfort in the back left when turning my head, can't turn it as far to the left as I can the right. Feel the discomfort turning it either way.
The discomfort manifests in trapezius, deltoid and inside of the elbow on the left too.
Symptoms feel better once warmed up and engaged in activity than when cold or inactive.
Feel a bit weaker than normal on my left-hand side, not just in climbing related activities, e.g. struggled to lift my bike over a stile with my left arm whereas it's straightforward with my right.
Hi Nai
This sounds like you are irritating a nerve on the left hand side of your neck.  The pain into your deltoid, traps etc are probably referred pain as is the problem with your elbow.  I assume you sit at work so correct your sitting position and stretch your thoracic spine (lost of upper back rotation). Stand regularly and reach up to the ceiling.  If this does not improve over the next few weeks you might need to see a physio.  If the weakness in your left arm deteriorated see your GP.
Steve

Thanks for the reply Steve. If anything things have been getting worse this week with other symptoms too, I've made an appointment for next week.

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#30 Re: Online Hallamshire Physio Clinic
November 08, 2016, 11:25:51 am
Hi,
You do sound like you have a lot going on!
I would tend to be focusing on the more proximal issues initially i.e. your shoulders. This could be the cause of all your secondary issues. Basically if you are not moving through the trunk and shoulders well along with possible muscular issues and control then you will be putting increased stresses and load at the elbow, wrist and fingers. Often with bilateral (both) shoulder stiffness and soreness I would be thinking that it is more related to your thoracic spine. If you are stiff in this area or lack sufficient rotation then your shoulder movement will be compromised. Can you lift your arms fully above your head lifting your chest and ribs and can you rotate left and right being able to look behind? If you have a sedentary job I.e. Computer/ desk based then every hour lift your arms above your head 5 times. Most people hardly ever get there arms above their heads during the day. You may be going from one extreme to the other?
Your finger problems sound like they could be related to a pulley strain, possibly A3 on your index finger. Start trying to stretch it into your palm and make sure it fully straightens.
Back off crimping and slowly start to climb easier grades and add in crimps as symptoms allow. Basically don't overload the tendons too soon, allow the tissues to adapt and strengthen again.
The first thing I would suggest is to research some local Physio practices and see or ask if any of them have experience with climbing injuries although the shoulder problem ( or thoracic spine!) should be easily sorted and addressed first. You do need to be seen in person as you have many issues that are probably all related and too many to discuss in detail.
Let me know how you get on and if you have any other details you've forgot to mention such as mechanisms of injury or aggravating factors then send them on.
Regards Matt
OK, feeling a bit like I'm falling apart, lots of issues on my left arm and hand which I think may be related!

Both my shoulders are stiff and sore (have been for years!) but in my left arm I get a dull pain on the inside where the bicep joins the elbow. My left wrist has been sore for about a year and a half which at first I had put down to having a baby, saw a physio and had an ultrasound which showed nothing and the physio suggested I quit climbing, what did I expect at my age and didn't I have my hands full enough with a small child, I'd also talked to them about pain in my ring and middle finger but they totally ignored that. Taping when climbing helps, if I try to pull with just those two fingers it aggravates my wrist and hurts the fingers a bit but the wrist also hurts when I flex it back and it makes a lot of grinding noises.

Now I also seem to have buggered the index finger on the same hand and it's stopping me climbing. The middle joint is swollen, looks a bit bruised and very painful when fully stretched or clenched. It has improved with a week of rest (I couldn't switch a light on without yelping last week!) but I'm concerned about it stiffening or becoming a long term niggle if it's not sorted properly now. I did it on a side pull finger pocket moving up and around it, I did it probably 8 times and started to feel something a bit off so stopped that but carried on climbing with no worries, an hour after I finished climbing it was agony.

Sorry that there's lots there, I feel like I probably need to go and see someone but I'm not sure if it should be a physio (who has a bit more of an open mind!) my GP, minor injuries or a sports massage therapist! Any help you can provide would be appreciated.

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#31 Re: Online Hallamshire Physio Clinic
November 08, 2016, 12:07:36 pm
If both arms are a problem I would suspect this is referred from your neck.  Don't ice/stretch your forearms bit concentrate on your upper back and neck.  If you sit at a desk for long periods this might be a contributory factor.
The nerve issue has been advised it will recover with rest. However the forearm ache is still present. You mentioned concentrating on upper back/neck. What exercises/stretches would you recommend doing for this?

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#32 Re: Online Hallamshire Physio Clinic
November 10, 2016, 02:31:40 pm
Hi Coops,
The nerve will recover and on restarting climbing remember to slowly load the arm again on easier grades and increase this as symptoms allow.
Regarding neck and upper back exercises; I would regularly reach your arms above your head making sure you lift your chest and upper back then lower and let upper back relax. In sitting you could cross your arms and rotate your trunk left and right. I would also rotate your neck to the opposite direction at the same time. Basically move and watch prolonged periods sitting in front of a computer. If this doesn't help it is probably worth visiting a local physio.
Regards Matt
If both arms are a problem I would suspect this is referred from your neck.  Don't ice/stretch your forearms bit concentrate on your upper back and neck.  If you sit at a desk for long periods this might be a contributory factor.
The nerve issue has been advised it will recover with rest. However the forearm ache is still present. You mentioned concentrating on upper back/neck. What exercises/stretches would you recommend doing for this?

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#33 Re: Online Hallamshire Physio Clinic
November 10, 2016, 02:41:58 pm
Hi,
It's an unusual place to get swelling as it is either side of your joints and tendons. I can only think that maybe your pulley injury has meant that you have or are putting extra loads and stress through the palm. Also with pulley type injuries although you have strained the ligaments at the finger you can still have issues further up the tendon and even into the muscle belly.Try comparing some finger and grip exercises to your other hand and see if it feels the same. It could be weaker or fatigues quicker. Also back off the grades for a few weeks and decrease the amount of crimping and see what happens.
Regards Matt
Hi
This is referred from your shoulder or neck.  I assume it is a shoulder control problem that is an issue with certain wide holds as it is fine normally.  A muscle injury would be more consistent.  If its was 'super painful' you might have had a neck/nerve irritation that slowly improved but only caused problems with certain positions.  Stretch you neck and strengthen your shoulder but continue climbing.  Strengthen the shoulder in positions that reproduce your symptoms i.e. wide moves above head hight but do both pulling and pushing type exercise. 

Thanks
Steve H

Thanks for this Steve. I've been stretching my neck quite a lot over the past few days and it's made a massive difference. It's not 100% sorted but it's a hell of a lot better.

There was one more thing I was wondering about injury wise. I had an a2 that hung around for a long time but it finally healed from what I can tell. A month or more later I injured something in my palm. It's not very painful but it gets worse when I climb on it.

It's either side of the a1 and causes swelling when I stress my hands through climbing.

Below is a picture of the areas that are swollen.



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#34 Re: Online Hallamshire Physio Clinic
November 10, 2016, 03:10:53 pm
Hi Coops,
The nerve will recover and on restarting climbing remember to slowly load the arm again on easier grades and increase this as symptoms allow.
Regarding neck and upper back exercises; I would regularly reach your arms above your head making sure you lift your chest and upper back then lower and let upper back relax. In sitting you could cross your arms and rotate your trunk left and right. I would also rotate your neck to the opposite direction at the same time. Basically move and watch prolonged periods sitting in front of a computer. If this doesn't help it is probably worth visiting a local physio.
Regards Matt
Hi Matt, thanks again for yours and your colleagues' help. I am off to Font next weekend and my GP said I should be ok for it but take it easy, which I'm not very good at doing...  ::) Nerve is beginning to feel better, will try and get down the wall next week to test it lightly though I think I have a busy week ahead. I'll try the neck and upper back exercises. Thanks!

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#35 Re: Online Hallamshire Physio Clinic
November 19, 2016, 11:55:07 pm
Hello HP chaps.

I have shoulder and elbow problems. First sign ofproblem was on a weeks holiday in Fontainebleau back in April this year. Three days on, with no real warning signs I got acute pain in my left elbow. It hurt like hell, I'm not one to complain usually but it was extremely uncomfortable. That was the last time I climbed this year.

Over the course of the year, things have worsened overall. Elbow pain had improved, but is still there. My shoulder has become very painful however. I do a manual job, very physical, as a tree surgeon. The pain is when my arm is extended out, usually above my head or with arm outstretched. Example being putting fresh bed sheets on, I reached out to tuck one corner in and lost my footing slightly and put weight down through my arms whilst they were both outstretched. The pain was intense!

I did have a session with an NHS physio who thought I had a shoulder impingement. I ended up going to see a private physio as the pain was unbearable and the waiting time was lengthy on NHS. I have been to the private physio a few times, by don't feel like I'm getting far in all honesty.

I miss climbing, and I worry I'm not going to be able to do it ever again! I'm stuck in a rut really, as I can't recover properly because of my job, but have to work as I'm self employed.

Any thoughts?


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#36 Re: Online Hallamshire Physio Clinic
November 20, 2016, 12:12:36 am
Oh yes, additional info I forgot.

Private physio man says I have extremely tight tendons (?) in dodgy left arm. He speculated I might had a small stress fracture whilst in Font, but as no X-ray was taken we'll never know. He has been using ultrasound and massage on elbow and shoulder.


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#37 Re: Online Hallamshire Physio Clinic
November 20, 2016, 08:31:34 pm
Thanks for the advice Steve, as always very appreciated.

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#38 Re: Online Hallamshire Physio Clinic
November 24, 2016, 09:03:21 pm
Hello HP chaps.

I have shoulder and elbow problems. First sign ofproblem was on a weeks holiday in Fontainebleau back in April this year. Three days on, with no real warning signs I got acute pain in my left elbow. It hurt like hell, I'm not one to complain usually but it was extremely uncomfortable. That was the last time I climbed this year.

Over the course of the year, things have worsened overall. Elbow pain had improved, but is still there. My shoulder has become very painful however. I do a manual job, very physical, as a tree surgeon. The pain is when my arm is extended out, usually above my head or with arm outstretched. Example being putting fresh bed sheets on, I reached out to tuck one corner in and lost my footing slightly and put weight down through my arms whilst they were both outstretched. The pain was intense!

I did have a session with an NHS physio who thought I had a shoulder impingement. I ended up going to see a private physio as the pain was unbearable and the waiting time was lengthy on NHS. I have been to the private physio a few times, by don't feel like I'm getting far in all honesty.

I miss climbing, and I worry I'm not going to be able to do it ever again! I'm stuck in a rut really, as I can't recover properly because of my job, but have to work as I'm self employed.

Any thoughts?


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Hi,it sounds like you have had a difficult year!
The onset of your problem is interesting in that you had sudden pain without any specific mechanism of injury. It doesn't sound like a tendonopathy such as tennis elbow. The fact that the elbow has now settled but the shoulder has become problematic with intense pain makes me think that the symptoms could be coming from the cervical (neck)or upper thoracic spine (upper back). Shoulder impingements should improve if managed well but can take at least three months to settle with progressive and specific exercises. Massage and ultrasound are not enough and I would ask if the symptoms are coming from a more central origin. If it is truely a shoulder problem then it should respond to exercises but they need to be progressed. More exercise less ultrasound. You will climb again but it sounds like you need a second opinion.
Let me know how you get on and if you have any other info please post it on.
Kind regards
Matt

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#39 Re: Online Hallamshire Physio Clinic
November 25, 2016, 08:50:21 am
Thanks for taking the time to reply Matt, most appreciated. I am going to seek out a referral to a specialist in Harrogate. A good friend of mine endured injured shoulder for ages, and got it sorted out by a man from the Wrightington. Bit far for me to travel, but a colleague of his now works at Harrogate, which is much more manageable. I'll keep updating my situation, but it's good to know you can see my getting fixed eventually!

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#40 Re: Online Hallamshire Physio Clinic
December 02, 2016, 12:06:18 pm
Hi, I pulled a hamstring about a week ago and would appreciate any advice for getting it back to full climbing use. It's not really noticeable in day to day activity and I can walk / run ok so I'm guessing it's a fairly minor injury.
When climbing I get pain when the leg is either out to the side or when toe-ing in on any steep moves, basically any time I'm pulling with the foot rather than just standing up on it. The painful area is a few inches above the knee on the inner side of the back of the leg. (it's on the bit of muscle / tendon that stands out very prominently when the leg is tensed).
Any suggestions for stretching / re-strengthening would be great, Thanks.

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#41 Re: Online Hallamshire Physio Clinic
December 06, 2016, 05:29:00 pm
[Hi Ali, if it is a mild hamstring strain then it should resolve over 2-3 week period. It makes sense that you feel discomfort with the manoeuvres you describe as you will be using your hamstrings to fix or bend your knee when pulling with your foot.
Progress the amount of load on the hamstring over the next 4 weeks as symptoms allow i.e. Back off the amount of heel use and grades and Increase as able. Mild discomfort is acceptable. If symptoms persist let me know.
Regards matt

quote author=Ali link=topic=27513.msg538627#msg538627 date=1480680378]
Hi, I pulled a hamstring about a week ago and would appreciate any advice for getting it back to full climbing use. It's not really noticeable in day to day activity and I can walk / run ok so I'm guessing it's a fairly minor injury.
When climbing I get pain when the leg is either out to the side or when toe-ing in on any steep moves, basically any time I'm pulling with the foot rather than just standing up on it. The painful area is a few inches above the knee on the inner side of the back of the leg. (it's on the bit of muscle / tendon that stands out very prominently when the leg is tensed).
Any suggestions for stretching / re-strengthening would be great, Thanks.
[]

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#42 Re: Online Hallamshire Physio Clinic
December 06, 2016, 05:32:41 pm
Hi, I pulled a hamstring about a week ago and would appreciate any advice for getting it back to full climbing use. It's not really noticeable in day to day activity and I can walk / run ok so I'm guessing it's a fairly minor injury.
When climbing I get pain when the leg is either out to the side or when toe-ing in on any steep moves, basically any time I'm pulling with the foot rather than just standing up on it. The painful area is a few inches above the knee on the inner side of the back of the leg. (it's on the bit of muscle / tendon that stands out very prominently when the leg is tensed).
Any suggestions for stretching / re-strengthening would be great, Thanks.

[Hi Ali, if it is a mild hamstring strain then it should resolve over 2-3 week period. It makes sense that you feel discomfort with the manoeuvres you describe as you will be using your hamstrings to fix or bend your knee when pulling with your foot.
Progress the amount of load on the hamstring over the next 4 weeks as symptoms allow i.e. Back off the amount of heel use and grades and Increase as able. Mild discomfort is acceptable. If symptoms persist let me know.
Regards matt ]

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#43 Re: Online Hallamshire Physio Clinic
December 07, 2016, 04:53:22 pm
Thanks for the reply, good to know I'm doing the right things.  Also useful to hear likely timescale for improvement as it hadn't seemed to get any better in the first week and I was starting to be worried about a possible trip at New Year. Climbed last night and was able to do a bit more with it than last session so on the mend now.
Thanks again, much appreciated.

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#44 Re: Online Hallamshire Physio Clinic
December 08, 2016, 01:25:08 pm
Hi, I recently popped my left wrist, first time I've had a joint pop, very strange.  No pain afterwards, no bruising, did it with an odd back hand move.  Did it about 4 weeks ago and have climbed on it since without really much problem.  I rested it a couple of days after it happened and then went to Font.  Anyways... today doing some strength rack pulls -max weight/low reps- it popped again.  I stopped. 

As there's really no pain and I still have full mobility without pain, should I rest it, be careful but carry on, see a physio, or?  If I have to rest it, roughly how long for do you think?  without any pain or discomfort its hard to know if it is better or not. 

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#45 Re: Online Hallamshire Physio Clinic
December 09, 2016, 03:21:55 pm
Hi, I recently popped my left wrist, first time I've had a joint pop, very strange.  No pain afterwards, no bruising, did it with an odd back hand move.  Did it about 4 weeks ago and have climbed on it since without really much problem.  I rested it a couple of days after it happened and then went to Font.  Anyways... today doing some strength rack pulls -max weight/low reps- it popped again.  I stopped. 

As there's really no pain and I still have full mobility without pain, should I rest it, be careful but carry on, see a physio, or?  If I have to rest it, roughly how long for do you think?  without any pain or discomfort its hard to know if it is better or not.
[Hi,
joints can sometimes make noise when a small gas bubble is released within it. It seems like the wrist is making the noise when you are at the extremes of load or when you are performing an awkward manoeuvre. This would make sense in that you are putting it at it's end of range and it is a release of pressure. The fact you have no pain or swelling is good. If you are generally have mobile joints then they may be moving excessively with large loads. Try a strapping the wrist to give it a little more support. Don't stop the climbing but perhaps avoid odd manoeuvres if possible over the next 2 weeks. If it persists or becomes more regular then go and see a physio.
regards Matt  ]

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#46 Re: Online Hallamshire Physio Clinic
December 10, 2016, 10:39:15 pm
Thanks Matt.  Climbed indoors today and didn't try anything where I thought it would be an odd position or strain and was fine.  Will keep climbing and cruise for the next week and look at strapping/ tapes.  Thanks for your work here!

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#47 Re: Online Hallamshire Physio Clinic
December 16, 2016, 03:34:31 pm
Perhaps a bit late to catch you guys today, but hoping to get some advice re my elbow.
It's very hard to describe and might not be something that it is useful to discuss this way but...
I basically get this feeling of tension in my elbow and wrist with tightness in the forearm (inside) also if I apply pressure there can also be slight soreness in the wrist and inside of elbow right on the joint. this is just on my right arm (I'm right handed).
The symptoms don't seem to change with respect to exercise (i.e they aren't worse during or after) but I think I can be more aware of the issue during exercise.
Occasionally I will have days where I don't notice it.
Let me know if you have any thoughts/suggestions, but I appreciate it if there is not enough here to go off!
Richard

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#48 Re: Online Hallamshire Physio Clinic
December 16, 2016, 04:29:20 pm
Perhaps a bit late to catch you guys today, but hoping to get some advice re my elbow.
It's very hard to describe and might not be something that it is useful to discuss this way but...
I basically get this feeling of tension in my elbow and wrist with tightness in the forearm (inside) also if I apply pressure there can also be slight soreness in the wrist and inside of elbow right on the joint. this is just on my right arm (I'm right handed).
The symptoms don't seem to change with respect to exercise (i.e they aren't worse during or after) but I think I can be more aware of the issue during exercise.
Occasionally I will have days where I don't notice it.
Let me know if you have any thoughts/suggestions, but I appreciate it if there is not enough here to go off!
Richard
[Hi Richard,
I suppose it is a good thing you aren't getting any pain and it isn't generally sore with exercise. The Ulnar nerve runs from the inside of your elbow into your lower arm and the inside of your wrist going on into the palm and fingers. Sometimes this can be irritated locally at the elbow and wrist through overstretching and direct pressure or at its origin in the neck. You don't always have symptoms in the neck. If it is just mild tension then it may be that you have overloaded the forearm if doing a lot of intense training. Recovery between intense sessions is important for progression.
Perhaps look at your previous few weeks or month and see if you have changed anything.
We would normally assess for patterns and reasons for this problem so maybe if it doesn't settle with reducing the grades over the/next two weeks then go and see a physio.
regards Matt]

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#49 Re: Online Hallamshire Physio Clinic
December 16, 2016, 04:35:08 pm
cheers for that I will have a think about my next few weeks of training