[Richie Crouch]

Just wondering if anyone else has suffered from this:

After training indoors more than twice a week or bouldering on consecutive days I seem to get massive pain on both sides of the left bicep - the intensity of said pain is just above the elbow on the inside but also occurs on the outside of the bicep towards the top end (i.e. shoulder end). The pain is so bad that the arm feels very weak all of a sudden and any use of it hurts.

If I do nothing for about 20 minutes the pain goes away and it just feels a bit weaker but free of pain when moved around. If I try and climb again it hurts like hell.

I'm a bit worried it is some form of tendonitis as it has occured earlier this year around late Feb/ EarlyMarch and then went away after I took a 5 day break followed by deadhanging for a week and then avoiding any problems that required a lot of left arm locking/pulling/load.

After that it seemed fine (climbing in font twice 5 days a week and regular cave sessions) until about 2 weeks ago when it got real bad after a couple of indoor sessions.

I was contemplating having a full 2 week of doing nothing climbing related and then doing a few weeks of easy trad before easing back into bouldering and see if this cured it but am thinking there may be some rehab exercises that would help to avoid it getting quite so bad again in short time. I've regularly therabanded and warmup slowly before sessions and have done plenty of pressups/light weights exercises inbetween but they don't seem to curb the arm pain coming back.

Basically I don't want to get weak for a Switzerland trip in September by avoiding training or bouldering for too prolonged a period.

Any advice would be great.

[dave k]

Yes i think i have. Like tooth ache in your bicep above the crook of the elbow. Over about an 18 month period. Not had any symptoms for about 6 months now.

Key cause for me appeared to be a quite sudden increased intensity of bouldering and training (moved to the Peak and have a training wall 5 mins from my house). I also started taking lots of ibuprofen to mask the pain, which I regret. Ended up with it in both elbows

Bicep tendinitis/tendinosis - there is a difference, but I never really worked out which I had. Probably a bit of both

Tried lots of remedies  - ice , massage, physio (who recommended some exercises that seemed to aggravate it)

Managed it for about 12 months- one day climbing, followed by 2 or 3 days rest (normally pain didn`t appear until next day or even 2nd rest day, also pain would also tend to disappear when I was climbing!) But it did gradually get worse. I am sure that a better solution will be suggested.

Final solution was getting a pulley injury, that forced me to take 2 months off- then built up slowly again. Not had any problems since , although I have taken the training a bit easier and tend to use my feet more.

[shark]

Its probably not the bicep but the brachioradialis muscle underneath which is commonly strained by climbers. If so I found freezing water in yoghurt pots and pressing the ice into the source of the pain a few times before bed cleared it up.

Various stretches are also recommended where you twist the arm or lever the palm perpendicular to a wall to give it a bit of aggro so the body responds to cure it which you can find out about here: http://www.athlon.com.au/articles/ for further info.

Its a constant source of surprise to me Richie that you don't know stuff like this.

[SA Chris]

http://www.athlon.com.au/articles/

It's the "dodgy elbows" one. Sounds like classic brachioradialis stuff to me.

Look at your climbing style too - apparently deadpointing onto a straight arm really knackers it, esp on slopers.

[cofe]

Its probably not the bicep but the brachioradialis muscle underneath which is commonly strained by climbers.

Jaws beat me to it. When mine flares up (always the left arm) I tend to rest for up to a week until it feels better. Warming up the arms properly is key I find. I do have a good stretch which is hard to describe: hold arm out straight in front with palm facing down, rotate  wrist so fingertips now pointing down, support hand with other hand and rotate inner elbow inwards. Works a treat.

[Richie Crouch]

Thanks for all the replies.

I've never really suffered anything like this until this year. Always trained and bouldered fairly intensively and gotten away with it till now it seems. I think I've probably dropped the amount I do indoors this year and am quite lazy in general when it comes to training (I always feel I could be doing more and structuring it better). It seems odd that it has occured this year when I've mostly been getting outdoors and climbing/training no more than 3-4 days a week on average.

Have been trying to break a grade boundary in the last few months, so not sure it is just the having to try really hard or working the same sequence of moves that has brought it on.

Will read the athlon article and try out those stretching and icing exercises you suggested

[Fultonius]

http://www.athlon.com.au/articles/

It's the "dodgy elbows" one. Sounds like classic brachioradialis stuff to me.

Look at your climbing style too - apparently deadpointing onto a straight arm really knackers it, esp on slopers.

  I had very similar previously (although, BR doesn't normally go further up the arm than a few inches) how's your footwork? Mine was shoking - always popping off, shock loading the elbows.

When I got rid of the pain with rest/stretching i started doing some work on the brachioradialis by doing palm-down dumbell curls - take it easy though - it's probably overuse that's caused it!

[Richie Crouch]

I don't think I'm too shit at placing my feet. I guess I like to climb dynamically a bit when possible but am locking down on fairly big holds in the cave the majority of the time.

The pain is definitely on the inside just above the medial epicondyle and seems to run just under the bicep. I can feel it go tight if I fully crimp my hand and tense my forear.

i don't think I over crimp (which is one of the things suggested by said article). After reading it sounds very much like tendonosis with the dull constant pain during and after climbing but very much tendonitis with the sharp acute pain also occuring after stepping off a problem or throughout the day (also when not climbing).

I'm guessing it's all connected and hoping following the suggested regular stretching and icing in the article will have the knock on effect of sorting the upper arm as well as the elbow!

[SA Chris]

I've never really suffered anything like this until this year. Always trained and bouldered fairly intensively and gotten away with it till now it seems.

Here's some news - none of us are getting younger.

[erm, sam]

I do have a good stretch which is hard to describe: hold arm out straight in front with palm facing down, rotate  wrist so fingertips now pointing down, support hand with other hand and rotate inner elbow inwards. Works a treat.

Any chance of a couple of pics to demonstrate this, as I did indeed find it rather hard to visualise?

[douglas]

I too have a dull ache at the elbow end of my bicep deep in the joint which I think is probably the brachioradialis tendon. I don't quite know what this muscle does or where it it so does anyone know which climbing movement is likely to aggrevate it? Sidepulls, undercuts perhaps?

[shark]

Any chance of a couple of pics to demonstrate this, as I did indeed find it rather hard to visualise?

Page 2 of the Athlon article linked above.

I too have a dull ache at the elbow end of my bicep deep in the joint which I think is probably the brachioradialis tendon. I don't quite know what this muscle does or where it it so does anyone know which climbing movement is likely to aggrevate it? Sidepulls, undercuts perhaps?

From googling ...The function of the brachioradialis muscle is controversial......Conclusions...The greatest EMG activity recorded from the brachioradialis occurs during elbow flexion tasks regardless of forearm position indicating that the primary function of the brachioradialis is as a consistent elbow stabilizer during flexion tasks. During rotational tasks, more EMG activity was recorded during pronation compared with that during supination tasks indicating a secondary function of the brachioradialis as a pronator.
http://www.jhandsurg.org/article/S0363-5023(08)00624-2/abstract

The above would suggest that press moves will aggravate it more than undercuts but given that it appears to have a stabilising function for both rationing moves doesn't sound like a solution.

[mrjonathanr]

Here's some news - none of us are getting younger.

Not too sure about that. My missus reckons I'm becoming more juvenile every day I'm on this site.

Dunno about that quote Shark. Always thought primary function of biceps was as much rotation as flexion ( roll up sleeve with arm at 90* and rotate forearm, you'll see what I mean)...which leaves radialis doing a lot of the flexion work.

[SA Chris]

Here's some news - none of us are getting younger.

Not too sure about that. My missus reckons I'm becoming more juvenile every day I'm on this site.

Physically not mentally. I'm regressing as my son gets older, I reckon we will cross paths when he is about 11.

[douglas]

Thanks shark, that was helpful. I've had a quick google myself and now don't think it is the brachioradialis tendon. It's more likely the brachialis, and richie's problem sounds like it may be the brachialis or bicep tendons too.

If anyone's interested lay your left forearm, palm up on the desk. The brachioradialis muscle lies in the forearm on the left, it's the big one.
The brachialis muscle is deep in the upper arm below the bicep, and on the right hand side near the elbow. It's joined to the middle of the upper arm bone below the bicep and forms a thick tendon at the site of the elbow and then joins the ulna (the rh bone in the forearm). According to wikipedia the brachialis is the strongest flexor of the elbow and doesn't twist the forearm.

So it could be deep locks or undercuts aggravating that or the biceps tendon, don't know really.

[Fultonius]

I think the brachialis does most of the work (elbow flexion) when your hand is supinated (palm-down).

On undercuts your biceps share the work.

http://www.exrx.net/Muscles/BicepsBrachii.html

I'm sure Dave Mac said something about deep-locks and brachialis strains.   

[shark]

Thanks shark, that was helpful. I've had a quick google myself and now don't think it is the brachioradialis tendon. It's more likely the brachialis, and richie's problem sounds like it may be the brachialis or bicep tendons too.

Shit. I thought they were the same thing ie brachialis was short for brachioradialis  .

[mrjonathanr]

  Err.. wot Shark said. 

[clm]

font elbow

[legalhigh]

I Had this years ago, like before I was a climber.  Used to play competetive squash, and the elbow thing stopped me playing.  I was told that it was a bruised nerve, and told to put a thin strap (with climbing tape or similar) around my arm between the bicep and elbow (for those of us that have a 'between' area there).  Not sure about the science, but if you squeeze that area (on the sides of the arm) I could feel that the pain went, so I did the strap for about 6 months.

After that the problem went and never came back.  Now I climb I have such sore shoulders I probably wouldn't notice if my elbow fell off.

[The Sausage]

Personally, I doubt that climbers ever strain either their brachialis or brachioradialis. My opinion is that it is referred pain from shoulder instability causing impingement of muscles/tendons/nerves.

[erm, sam]

But didn't Paul B et al conclude convincingly that "Font Elbow" is typically brachialis strian caused by sudden overuse of vertical hand postion on aretes/slopers with compression? Sounded convincing (you know, in a not thinking about it too much way). Would shoulder instability flare up so suddenly?