[moose]

A story of idiocy....

Just over a week ago (sunday 28/9/08) I fell awkwardly slapping on the Nose, cracking my elbow on the boulder below.  The elbow swelled up and bruised with much restricted movement.  The morning after it couldn't be bent more than 90 degrees with mucho pain localised near the inner bony lump (medial epicondyl?).  That day an X-ray intimated that there was no bone damage and over the following 6 days the pain diminished and I could flex my arm more easily.  Unfortunately hubris / idiocy / boredom then lead to a trip to Almscliff for a "gentle pootle" that ended up camped under my projects.  Predictably much of the recovery was undone: acute pain when I flex the arm, everyday movements like opening doors and putting on coats cause pain.

I have since had a follow-up appointment with a perturbingly youthful doctor who said that, in the absence of bone damage, I probably had golfer's elbow.  With the recommended course of action to "not do things that hurt" and take ibuprofen instead.  I asked for a physio referral, which was conceded, but with the acknowledgement that I'll be dead of old age by the time I see anyone.  Perhaps my imagination, but as soon as I said I was on the dole she became visibly less interested.  Mind you, to be honest I think I had plumbed the depths of her competance anyway - she kept disappearing to consult with a gruff, disembodied voice eminating from behind a curtain.... like The Wizard of Oz crossed with Holby City.

So.... throwing myself on the mercy of medically knowledgable / long-suffering cripples of ukb I have the following questions:

(1) Can golfer's elbow really be brought on by an impact with a boulder?
(2) Is rest the only decent treatment?  Would exercises such as those linked below be appropriate for a disorder more due to impact than overuse:
http://www.athlon.com.au/articles/r&i_dodgyelbow.pdf

(3) How completely should I let it recover before trying to climb again in order to avoid relapse.  I am tempted to leave it alone for at least a month as I have a sport climbing opportunity in early November that I'd like to maximise my enjoyment of.  Does this seem reasonable / realistic - just let it heal and do lots of cardio stuff to keep the weight off - hope that a month off won't undo the work of 5 years of dedicated cranking!

Any advice / answers / hope gratefully received.... I'm already bored with not climbing......

[GCW]

Yes, trauma can bring on golfer's elbow.  but it doesn't sound the case with you.
Essentially, the things that attach to the medial epicondyle are the flexor muscles for the wrist and fingers.  Hence, a prolonged bout of sloper pullling etc may annoy an already bashed elbow.

Presuming it ain't broke, I'd suggest early mobilisation, stretching, ice.  Then get going with some sensible, light bouldering.  But if it starts to hurt, stop the session.

I'm sure there's a physio or two that could give you more info.

PS  Was she fit?

[moose]

Cheers fella... so it looks as though working Underhand annoyed the bashed tendon insertions, producing golfer's-elbow-type symptoms?  With hindsight, I had been lulled by a short session two days before (5 days after the accident) that had passed without aggravation - not realising that numb fingers had protected my recovery by preventing me from trying anything too savage .  Still, it's hard to complain about the outcome of the more recent session, who'd have thought that a prolonged spell of whittling at a hard problem, featuring lock-offs and slaps would do that!? 

And re the Doctor.   Yes, she was quite nice, albeit in a slightly severe, no-nonsense school-marm way.  The look that encourages thoughts of: glasses off, hair down... "but you're beautiful"!  Definitely appealed to the side of me that found Morticia Adams and Lilith in Cheers oddly attractive!  That said, I'd have sacrificed any degree of pulchritude for a touch more expertise, or at least confidence.  Give me a warty navvy with tendon probing fingers anyday!

[GCW]

I won't discuss these young doctors, it's well outwith this thread. 

I would suggest active recovery would be better than full on rest.  Let us know how things go.

[AndiT]

Lots of ice. Make sure it's well warmed up before any climbing. Try and see a physio for some ultra sound.

[butters]

How long have you been dying to shoe horn the word "pulchritude" into a conversation? If it wasn't for the fact that I am now going to have to try use the word myself without appearing like a complete twat I would wad you for it.

bluebrad

[lagerstarfish]

Lots of ice. Make sure it's well warmed up before any climbing.

 

[i.munro]

I can tell you what my physio told me to do for golfers elbow if that's what you've got then it might help??
NB I had pain on the bony inside of the elbow particularly at the top.

Basically the eccentric 1/2 wrist curls shown in that Australian article with the slight modification that she got me to wrap something around the dumbbell handle to make it fat so that my fingers were actively gripping the bar (I used handlebar tape).

Instructions were to do a light upper body wam up, then stretch fingers (3 x 30s with bent elbow then 3 x 30s  with straight arm).
Place palm against wall slightly above shoulder height fingers pointing down arm straight.
She emphasised there should be no pain at this point. If uncomfortable stop.
Then 3 sets of 15 of the curls (lowering slowly , count of 10) enough weight to feel a slight twinge but no more & use different elbow angles.

Then repeat stretch &  then ice for 10 mins (ice/frozen peas in a damp cloth).
Do all this twice a day  morning & evening.

Start with very light weight & then increase slowly.

Things I added on my own or from the  advice of others that seemed to help but probably
it was just getting better anyway.
Take at least one day off from the rehab once a week.
Take  Glucosamine ,Chondroiitin & MSM (the MSM seemed to be the difference)
When you start climbing again I found  a tennis elbow strap but with the pad on the painful side helped a bit but try & wean yourself off this as soon as you can.
(A physio climbs at my wall & he laughs at my 'placebo strap'.)

Good luck. I found it slow going. I still have to leave more than 48hrs between climbing sessions or it flares up but then I'm ancient..

[moose]

Thanks - I'll give the exercises a go, although I suspect that I'll fail the "place palm against wall" test for a while yet.  My elbow seems to exhibit two different symptoms: a tendonitis type pain within the joint and a painful tenderness on the very tip of the boney bit.   Hopefully the latter is a legacy of the impact from the boulder and will fade away sooner or later (can bones bruise?).

[GCW]

(can bones bruise?).

Yes, and they take a long time to settle.  Think months more than weeks.
But you'd need to have given it a superb smack to get a bone bruise.

[Ferrito]

Got a mate who did this about a year and a half ago. Was told it was golfer's elbow and to rest it for 4 months - he started climbing after 3, and now can't climb due to elbow pain. This is a year and a bit later, and it still hurts - I'd sack off an active recovery, and leave it well alone for at least 3 months...... Bit of a shit gig though.

[moose]

Christ almighty ferrito... that's not something I wanted to read.  Although, I guess it's a possibility I needed to be made aware of.  Looks like professional expertise is in order.  Unfortunately, my NHS referral might take forever to come through. 

So, any recommendations for suitable physiotherapists in the York - Leeds area (I live in Selby, vaguely between the two, near where the M62 and A1 cross)? 

[tomtom]

Christ almighty ferrito... that's not something I wanted to read.  Although, I guess it's a possibility I needed to be made aware of.  Looks like professional expertise is in order.  Unfortunately, my NHS referral might take forever to come through. 

Hi Moose - are you the tall fella I've met a few times at the cliff lurking under/trying underhand?
Bad news about the elbow, sorry to hear that.
If its any help, gaining referrals and getting pushed up the waiting list can be helped (in my experience) by two things...

1. If having your arm moving/being able to climb on it/use it for work etc.. is a really important part of your life (which it is if its stopping you from bouldering) then play up the whole  - my life is terrible now I cant do this type thing, or - I cant work because its stopping me doing xyz etc.. type routine.. this may get your referral moved on. At the end of the day, the doctor doesnt want to have other problems caused by you not being happy...
2. Sometimes (not for this injury - both knees) I have two friends who have managed to see a consultant - been told the list to wait for a scan is ages - paid to have their own scan, then been bumped up the waiting list...

Not sure if this helps or not, but good luck with it all,
T

[moose]

Hi tomtom.... yep you have the right man (tall, lurking, unsuccessful at bouldering).   So, which one of the many witnesses to my ineptitude are you, I'm trying to put a face to the pseudonym.

Anyway, cheers for the advice.  My very perfunctory diagnosis of golfer's elbow was at a clinic in the same minor injuries unit I had my X-ray done at: basically a 5 minutes in&out slot (punctuated by a supervisor coming in and saying "get rid of this one, the queue's building up").  I played up the my-life-is-empty consequences of the injury (didn't take much effort as it's pretty true) and the doctor said she would put me down for physio but not to hold my breath. 

Rather than wait I am tempted to just pay for physio - get a proper diagnosis - and bugger the cost (not nice as I'm unemployed).  Though, after what you've said I think I'll get a GP appointment - if only to see whether they agree with the golfer's elbow diagnosis - and hope it gets me moved up the list for physio (or at least give me a clue as to the likely timescale).

[tomtom]

I'm the tall thin bloke with short curly hair - my usual cliff routine is to circuit around the v3-4's on the lower tier, then flail about on Demon Wall roof, convincing myself that each time I try I get 1cm closer to slapping for the final hold 
I work at Hull uni, and we have just had an email about a sports injury clinic.. pasted below...

THE DEPARTMENT OF SPORT, HEALTH & EXERCISE SCIENCE OFFERS A SPORTS INJURY & MASSAGE CLINIC FACILITY TO ALL STAFF, STUDENTS AND MEMBERS OF THE SPORT & FITNESS CENTRE

BOOKINGS ARE AVAILABLE ON:

                        WEDNESDAY 1.30PM-4.30PM
                        THURSDAY 4.30PM-6:30 PM

COSTINGS FOR THIS SERVICE ARE AS FOLLOWS:

SPORT MASSAGE - £8 (30 MINUTE SESSION)
** Conducted by Sport Rehabilitation students**

ASSESSMENT/TREATMENT/REHABILITATION  - PRICE BELOW
** Conducted by qualified member of staff**
 
- STUDENTS - £10
- STAFF - £15
- GYM MEMBERS - £18
 
 *Cash or cheque only*

FOR ALL BOOKINGS AND PAYMENT PLEASE CONTACT CATHERINE DETTMAN DIRECTLY ON 01482 466404, C.DETTMAN@HULL.AC.UK  OR TO MAKE A BOOKING IN PERSON PLEASE VISIT ROOM  013 LOCATED IN THE LOTEN BUILDING

CLINIC IS LOCATED IN BIOMECHANICS LAB.
(Please report to Sport & Fitness Centre reception)
 

Now, I dont know if Leeds Uni has a similar thing (they used to when I worked there) or whether or not its worth a blag with the Hull folk along the lines if 'I was a student there two years ago... can I still get in type of thing...' could be worth a call?  - dont know how these rates compare or what/who would be doing it...

Best of luck with the old elbows... my hunch, (I've no medical skills whatsoever) for what its worth, is that its most likely caused by the impact, and you may well just need to let whatever swelling/bruising caused by that to go down - which could take a few weeks. I would have thought that rubbing/massaging said area would do no harm.... also, if you do go out and use it, keep it warm..

T

[moose]

Cheers tomtom for the physio information.  I am pretty certain that the Leeds Uni's have a similar facilities - my brother is studying there so I'll ask him.  I suspect / hope you're right that at least some of the problem is impact trauma that might clear up if left alone.  I've an appointment with a GP tomorrow that I'm hoping will result in a speedier physio referral , or at the least a more informed diagnosis and some constructive advice. 

I am resigned to a fairly lengthy lay-off but determined to enjoy and make use it: went on a 13 mile Peak walk yesterday, got another planned (hopefully for tomorrow after the ridiculously early GP appointment), and I joined the local sports centre today - get some CV fitness and maybe lose a bit of weight to compensate for any strength loss.  Hopefully though I'll see you at Almscliff sooner rather than later though!