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the shizzle => diet, training and injuries => Topic started by: Fiend on December 08, 2018, 02:10:05 pm
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Those biggish striated muscles that flex if you wiggle your fingers, sort of on the opposite side to traditional golfers elbow. I have a fair amount of pain / ache in those, actually in the muscle body rather than where the muscles / tendons join the bone (which is what I am used to with golfers).
I had two days bouldering in the cold. Then gym and weighted pull-ups. Then TCA and dynamic movement felt a bit iffy so I did some max hangs on small BM edges and combos with front two BM pockets. After those 4 days my arms - and elbows - felt well worked overall but not particularly tweaky.
Rested a day, then warmed up, and tried to do some campussing before bouldering. As soon as a tried 1:3:5 and my left hand left the lower run and shock-unloaded, my bicep and outer forearm felt tweaky and I stopped. I did a gentlish bouldering session but still sore.
Rested two days, went out to Bowden. Was about -30'c and spent two hours on easy stuff failing to warm-up. Then top of forearms definitely felt sore in the muscles, and also my left thumb had stabbing pains in it (nerve issues?).
Rested two more days, gentle gym session including eccentric wrist curls the other way, stretching and massaging and vitamin I, and they're STILL sore. My usual golfers elbow is almost completely absent and my shoulders feel okay.
Help :please:
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Its these: https://www.youtube.com/watch?v=eiOp3hxJVkw
Forearm antagonistics.
I get trouble with them. Tried the exercises in the vids - seems to ease them up but may have over done them!
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similar to tt's reply. This pdf is good: http://drjuliansaunders.com/wp-content/uploads/2015/08/ri_dodgyelbow.pdf
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Cheers TT and BIH. That video is good and clear at explaining those muscles and I can certainly do those exercises (in fact I kinda do the pinch one regularly getting weights for deadlifting).
HOWEVER.
Why would I injure those muscles when I've never had any issue nor susceptibility in those muscles before?
Are there any more suitable exercises to do for rehab?
I don't seem to have an issue with either pinching nor crimping on them (and my pinching / squeezing strength has always been pretty good and reliable), more with dynamic moves off holds / crimps, is that symptomatic of something else?
What sort of schedule should I be on given they seem to be injured?
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Oh okay I read the full pdf (an initial scan put me off!). I do massage and stretching, I will incorporate the proper stretch now.
Edit: Tried the proper stretch - makes those muscles really ache in the OTHER arm, the one that's pulling the stretched arm - you can see them tensing in the photo. HUH.
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So I do the exercises in the vid. Open hand lifting of kettlebells (blunt end not handle) and reverse are you being served hand curls.
My painful hand can out perform my normal one by 20 percent in reps and weight. But hurts during. But not after.
It’s still very much an ongoing niggle for me.
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I got bad tennis elbow last year and again this year (other arm).
Just to be clear - do you mean here:
(https://www.doctorarthritis.org/wp-content/uploads/2017/12/screen-shot-2017-12-12-at-12.30.23-pm.png)
If so, I have found the best things to be:
Stage 1: Acute (0-6 weeks). Reduction of load to "non painful". Gentle (non-painful) stretching of flexors and extensors. Light eccentrics. Diamond press-ups. - You shouldn't be producing any pain during or after the exercises. I have a hunch that climbers who get tennis elbow are suffering from short, strong, tight forearm flexors and weak, tight and inflamed extensors.
Stage 2: Chronic. If you fuck up the acute stage, you'll be in the chronic zone (tendinosis) where there's pain, weakness but no inflammation (heat, swelling, tenderness). If you get into this zone, you'll need heavy eccentrics, it should produce noticeable (4 to 6 out of 10) pain during the reps, but nothing after. I found that the first set would be sore, second less so, third ok. Low reps (5-10) and 2 or 3 sessions a day as you are trying to "remodel" the collagen.
Listen to this: https://www.trainingbeta.com/media/esther-smith-elbows/
* my first dose of tennis elbow was chronic, 3 months into it and "heavy" eccentrics with low reps worked amazingly. My second dose of tennis elbow was acute and I thought "I've fixed this before, easy...same protocol" - WRONG! For acute you need maybe a week of rest/much reduced volume and intensity, then light (0.5-1kg) eccentrics with NO pain, during or after.
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What sort of schedule should I be on given they seem to be injured?
It's been a few years since I had a persistent tennis elbow problem. I think doing the exercises when you're a bit warmed up is a good idea and probably only 4-5 times a week. I do the around 3 sets of 12 reps of exercise in the pdf. Remember to raise the weight with the other hand. Definitely only stretch when your warmed up.
If you're still going climbing its really important to warm up slowly and thoroughly. Climb on nothing steeper than vertical until you feel warm as I think big holds on steeper ground combined with cold dodgy elbows is a recipe for disaster. I also do something that I call the rapid grip exercise, hold your arms straight out in front of you and spread your fingers and then clench a loose fist and repeat as fast as you can for about 20-30 secs and you should feel a slight tiring of the muscles originating from the medial epicondyle, I have found this a pretty useful warmup. I have never heard of anyone else doing this so not sure if it will be of benefit to everyone but it works for me.
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With regard to the exercises in the video, I am not sure they are a good idea if you are already injured. I think they are good for prevention of tennis elbow when done regularly with healthy elbows but may worsen your problem if already injured. I would stick to eccentric exercises.
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This is covered quite nicely in Dave Macs make or break book if you can get hold of a copy.
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This is covered quite nicely in Dave Macs make or break book if you can get hold of a copy.
It's really not. In fact, tennis elbow and the subtle differences between tendonitis and tendinosos are some of the the book's biggest weaknesses.
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The pain is in the muscle belly, about 2/5ths along the coloured area in that diagram above.
There is less tenderness at the actual tendon / tendon-bone join.
This is the opposite of my golfer's elbow where the pain is quite clearly at the tendon-bone join and almost none in the muscle belly.
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The pain is in the muscle belly, about 2/5ths along the coloured area in that diagram above.
There is less tenderness at the actual tendon / tendon-bone join.
This is the opposite of my golfer's elbow where the pain is quite clearly at the tendon-bone join and almost none in the muscle belly.
+1. Same here. Not in join - about 5 cm further towards fingers - but at elbow end.
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Sounds like the pain might be coming from the Brachioradialis, this originates on bottom part of the Humerus (on outside of bicep) crosses the elbow and attaches down onto the thumb side of the wrist. So not only does it extend the wrist, pronate the wrist/elbow but it also flexes the elbow, which is why you may have felt some pain on the bicep. its probably just tired and weak as is put under a lot of stress in climbing.
I've strained this a couple of times. took a step back from the board, fb and campus board then started off with some eccentric pull ups (on rings, so your wrist can move natural way avoiding causing more stress) and eccentric reverse wrist curls. low intensity to begin with then increased the intensity and reduced the reps. After this just did the whole moments, concentric and eccentric as prehab.
always best to get it checked out by a physio, sports therapist or doctor :)
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This is covered quite nicely in Dave Macs make or break book if you can get hold of a copy.
It's really not. In fact, tennis elbow and the subtle differences between tendonitis and tendinosos are some of the the book's biggest weaknesses.
When I had tennis elbow the stretches and exercises described worked very effectively so just based my opinion on that. It fixed me so couldn't really ask for much more!
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Was going to link to Dr Julain article too. The brachioradialis stretch is the shit, due to a badly set broken wrist in my youth, it always gives me grief. I find a foam roller in the trigger point really helps too, plus stretching it.
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Currently suffering from a bout of tennis elbow at the moment. My physio has me doing isometrics, holding a low weight palm down for a minute at a time, two to three times a day. I also do a lot of work on the forearm with both a ball and a mini foam roller about 10-15cms long which is just great for this. So far it's been pretty effective as long as I don't go overboard with the weights or foam roll too close to the elbow itself. Hopefully moving onto eccentrics soon...
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Thanks guys.
I can definitely do the usual procedures of: Keeping area warm, massage, stretching, eccentrics for acute injury.
I have a hunch that climbers who get tennis elbow are suffering from short, strong, tight forearm flexors and weak, tight and inflamed extensors.
Hmmm. Extensors are the brachiothingy right? Not sure mine are particularly weak.
I presume it is feasible that someone who has never been the slightest bit susceptible to brachiothingy damage (despite semi-chronic golfer's elbow) could damage that area by a combination of cold, pulling hardish, slight overtraining and incorporating new exercises (deadhanging - even though there was NO brachiothingy pain at the time of deadhanging, unlike my golfer's elbow which started with a distinct tweak)??
+1. Same here. Not in join - about 5 cm further towards fingers - but at elbow end.
So is this likely to be different to standard tennis elbow then? Or are they two variable symptoms of the same sort of injury?
Sounds like the pain might be coming from the Brachioradialis, this originates on bottom part of the Humerus (on outside of bicep) crosses the elbow and attaches down onto the thumb side of the wrist. So not only does it extend the wrist, pronate the wrist/elbow but it also flexes the elbow, which is why you may have felt some pain on the bicep. its probably just tired and weak as is put under a lot of stress in climbing.
I've strained this a couple of times. took a step back from the board, fb and campus board then started off with some eccentric pull ups (on rings, so your wrist can move natural way avoiding causing more stress) and eccentric reverse wrist curls. low intensity to begin with then increased the intensity and reduced the reps. After this just did the whole moments, concentric and eccentric as prehab.
Thanks, that also might explain why my thumb had shooting pains and a bit of numbness. The bicep pain was more in the lower muscle belly and not in the tendon - and the bicep pain was noticably acute when I unloaded the bicep on long campus moves.
I can do eccentric pull-ups on rings. I had a gentle session at the wall recently and found static stuff was fine, anything dynamic felt.....like I shouldn't be doing it and backed off straight away. I hope TCA Maryhill has some nice easy circuits instead of the juggy thuggy TCA normal bollox.
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Brachioradialis is the muscle, tennis elbow is usually at the point where it is connected. In my view anyway.
I ended up seeing a sports masseuse when my tennis elbow was bad, and he really went to town on my forearms, and I'm sure that was what was needed to break the cycle of injury / inflammation. I've thought about getting an armaid, but I've been pretty disciplined with stretches etc and it's been OK for a while now.
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sounds like you're on the right lines. This is only my opinion or thoughts from what I've gathered from the past couple weeks of lectures on elbow/wrist anatomy and injury. Would be interested to hear what a therapist thought.
If it is a strain in the Brachioradialis then it's different to tennis elbow, but they're commonly confused.
With tennis elbow the pain is around the lateral epicondyle (bony bit on outside of elbow) which is where the extensors originate from. They're used far more than you'd think in climbing, when crimping the wrist is extended and when squeezing like in the horst video. So its not as simple as tight flexors/weak extensors.
whereas like you said you have strong extensors and the pain is coming from elsewhere.
Brachioradialis is the main flexor of the elbow (working with the bicep) when in a pronated position, which is hands facing the rock. it's highly likely that you simply strain this by being cold or just general overuse.
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It's interesting how the discussion has come round to problems with the brachioradialis.
This thread seemed to appear in a quantum mechanical sort of way, when I went looking for it - thank you Fiend!
I've strained something (L arm) following a fingerboard session after climbing in the cold, and in my case it seems to be related more to elbow flexion/brachioradialis/bicep but with discomfort as described by the OP.
Similar problems on my right arm responded very well to eccentric loading - as in negative one armers - instead of doing lower load pull-up type exercises.
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Brachioradialis is the muscle, tennis elbow is usually at the point where it is connected. In my view anyway.
This might be a bit misleading. As I understand it tennis elbow is a result of injury to the tendons and muscles originating from the lateral epicondyl. The pain may be near to the distal attachment of the brachioradialis but not necessarily caused by brachioradialis damage. Tennis elbow and a strained brachioradialis arent the same thing.
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Thanks, i didn't say the were the same thing though (or did I? anyway i didn't mean to).
otherwise i agree with what you say, just using less verybiglongwords.
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So which the hell one have I got then?? :-\ :-\ :-\
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Beetroot juice injections. Got to work.
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Those biggish striated muscles that flex if you wiggle your fingers, sort of on the opposite side to traditional golfers elbow.
That description sounds like tennis elbow to me.
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Cheers. I'll order some beetroot juice from the local hippy shop.
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If it's at the specific bony point of the elbow it's tennis, if it's the muscle itself it's just a strain?
I strained both of mine quite badly carrying two very heavy concrete blocks, by gripping the sides. it was really sore for a few days, but went away in a week or so.
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If you're getting a numb/painful thumb this points to nerve irritation. Things to looks for are compression of the radial nerve as it passes through the forearm muscles (radial tunnel syndrome) or you could have issues with your lower cervical spine. I'd try some cervical and thoracic mobility exercises and some radial nerve flossing.
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Cheers. The thumb was really painful at the time, but that hasn't come back.
The arm pain is weird. The muscles are still sore, but the pain has now also migrated into the bony spurs typical of tennis elbow. There has been no improvement after 4 days rest (since a light / careful wall session on sat - only done gentle massage since then) and the areas are still very tender to the touch. This is totally different to my golfer's elbow which would feel tender during and immediately after sessions, and then feel mostly fine at rest. Not really sure what to do about that...
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Along with most others, sounds like Tennis elbow to me.
Been rehabing it again recently myself, always reach for the flex bar thingy. This treatment was recommended by notable heart doctor saltbeef.
https://www.youtube.com/watch?v=M2OaShUO-S8 (https://www.youtube.com/watch?v=M2OaShUO-S8)
Works for me.
Oh and I've found that massaging the tricep really helped with tennis elbow, loosening it up on a foam roller.
Usual advice about shoulder imbalance, over use etc that always applies to the elbow tendons; the pain is manifestation of a bigger problem, not usually local.
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Biggest Q for me with all the rehab is how often - for how long - and how this weaves into going climbing...
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Biggest Q for me with all the rehab is how often - for how long - and how this weaves into going climbing...
Well you should go climbing.
The flex bar exercises i was doing ten 'reps' x 3 sets, morning and evening. Long term, incorporate other shoulder/balancing exercises into the training you are doing.
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Which one did you use if you don’t mind? At £20 a pop.... right one etc...
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I got the green one which is called 'medium' but is actually second toughest of four.
Seems right for me. Pretty subjective though?
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There's also one with interchangeable inserts which give you three different resistance levels. The brand is Simien. I thought it was pretty good - worked up to using the toughest one with no pain.
This one: https://www.amazon.co.uk/Simien-Sports-Flexible-Rubber-Twist/dp/B019FZ48VW
(Just to be clear though, my issue was golfer's elbow, and I also combined with exercises using increasingly heavy dumbbells. I have no experience rehabbing tennis elbow.)
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From the video, the twisty bar thing looks like it's doing exactly the same as eccentrics with a dumbbell, but more conveniently. I might get one.
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Still fucking sore. Have been keeping the worst one (right) warm with heatpacks etc.
Did eccentric wrist curls and rotations with about 5kg. Almost no discomfort at all, just a very faint sense they were being used.
Tried the twisting STRETCH as shown in the Horst video. This is problematic as it stresses the pulling arm a lot more than the one that's being actually stretched. Both arms hurt a lot more after this.
I will stick to the conventional pull the fingers downs stretch as I feel this one in the stretched arm and it doesn't aggravate the other arm.
Booked a physio for next week, cheers for the recommendation Puntonious. Fuck knows what's going on as the general feeling is different to every other injury I've had.
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Yours sounds bad Fiend. Mine is very much a niggle (bit achy in the morning and the odd twinge). Got amazon sending me a bendy bar - see if it does anything... or may (like the foam roller) become another baby toy,,,
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Still fucking sore. Have been keeping the worst one (right) warm with heatpacks etc.
Did eccentric wrist curls and rotations with about 5kg. Almost no discomfort at all, just a very faint sense they were being used.
Tried the twisting STRETCH as shown in the Horst video. This is problematic as it stresses the pulling arm a lot more than the one that's being actually stretched. Both arms hurt a lot more after this.
I will stick to the conventional pull the fingers downs stretch as I feel this one in the stretched arm and it doesn't aggravate the other arm.
Booked a physio for next week, cheers for the recommendation Puntonious. Fuck knows what's going on as the general feeling is different to every other injury I've had.
5KG is waaay too heavy for an acute injury. I started on 0.5kg or 1kg. (note, I started on about 5kg with the CHRONIC tendinosis, 2-3 months after first injury with no tenderness). You really want to avoid any aggravation in the initial stages. You just want to make sure you get *some* loading while it heals, but any discomfort (in my experience) is too much.
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This treatment was recommended by notable heart doctor saltbeef.
He's the most injured man on earth and you took his advice? Dangerous.
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How about no discomfort which was what I was getting?
I get plenty of aggravation in non-specific movements and at rest - but not when doing the eccentrics. I could feel the area working, that's all.
I don't really see what 0.5kg will be doing?? I probably load it with more force than that just moving my arms around normally.
TT, it's just plain fucking weird that's what it is. I've had my fair share of injuries, but an injury that seemed to have a clear cause event BUT wasn't particularly aggravated at the time of that event (and only a bit generally, not specifically tired/achey) afterwards, that is getting worse with rest (including warmth, light massage, very light usage), where the most notable events coincided with bicep pain in the left arm but now the pain is more prominent and non-bicepy in the right arm?? It makes no fucking sense at all.
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Waits for someone to say shoulder imbalance :)
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Quite possibly. My shoulders are incredibly inflexible although I have done a bit of stretching and mobility every gym/wall session this autumn/winter, and plenty of antagonist work. I've had shoulder impingements regularly in the past, but none this year.
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5KG is waaay too heavy for an acute injury. I started on 0.5kg or 1kg. (note, I started on about 5kg with the CHRONIC tendinosis, 2-3 months after first injury with no tenderness). You really want to avoid any aggravation in the initial stages. You just want to make sure you get *some* loading while it heals, but any discomfort (in my experience) is too much.
But surely if 5KG isn't making it hurt, then it's not too heavy.
Fiend, hope the physio can help. I don't know what's going on with your arm, but here are my experiences with a basic tendon injury. Perhaps they will be of interest to you or someone else reading.
I've had golfer's elbow, not tennis elbow, but... Having had elbow problems since my early twenties, I've seen the theories and advice change a lot. Once upon a time it was all stretching and massage, based on notions of breaking down scar tissues and realigning fibres. This did nothing for me but make my elbows worse. It lead to me taking a year off, then finally climbing again even though it still hurt. I managed my climbing and gradually healed.
Years later, I had more problems. The new trendy thing was the eccentric exercise protocol with lots of reps and tiny weights. Again, no help. I ended up doing progressively harder campussing (seemed like the most controlled way of increasing intensity) and gradually healed.
More recently, ramping up training over last winter brought me more problems. This time, I managed to join together current rehab ideas and other people's experiences in a way that has actually helped me. Some of the new ideas which made a difference to me:
1) Tendons need to be stimulated to heal. This requires a discomfort level of around 3/10 when doing exercises.
2) Progressing to heavy weights is important. There is some evidence to suggest tendons respond better to heavy loading. I progressed to doing eccentric bicep curls with 20kg, and wrist curls with 12kg.
3) You might feel no pain doing exercises like the wrist curls and bar twists with your elbows at 90 degrees, but what about straight arm and locked off? Do them all. Seek out that 3/10 discomfort.
I did eccentric bar twists, eccentric bicep curls and the flexbar thing. The flexbar was a good warm up for the other stuff. I know this is golfer's elbow stuff rather than tennis elbow, but maybe some of it is useful. My problem was probably in the chronic rather than acute stage (it got gradually worse over a few months until I decided it wasn't going away and I had to do something about it).
Rant time... It is a bit of a minefield trying to find answers on the net. So many youtube videos are filled with confident explanations of elbow physiology, and often from outdated trends in rehab theory. Even the modern ones often say "eesentric" instead of eccentric (it's not a bloody word! Not in English or American!) which doesn't exactly suggest mastery of the subject. And as far as I can see, the science behind eccentric protocols is all based on a fairly limited study of achilles tendon rehab in runners. People really don't understand tendons yet, let alone climbing tendon injuries.
Anyway, just some thoughts.
By the way. Not sure about body imbalances. Sounds reasonable, and I bought a book on it once. But the exercises did nothing for me. Perhaps I was doing something wrong. Seems to me though that the most obvious explanation is more likely for most people. Your elbow hurts because you hurt your elbow. Climbers put a lot of force through the elbow - it makes sense that this can lead to damage. If there are studies that show imbalances to be the root cause *most of the time*, I'd be interested to hear about them.
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Cheers r-dawg.
I have had chronic golfer's elbow which was relatively comprehensible and manageable. Initially gentle climbing, icing, avoiding complete rest, then regularly warmth, massage, stretching, taping, avoiding slopers and compression if it was feeling tweaky, and regular eccentrics all worked for me. It's been vaguely persistent but very manageable over previous winters - except this winter, when my golfers is almost completely absent.
I recognise that this is for chronic rather than acute, and that my "possibly tennis elbow" is probably in an acute phase. But again it's a very strange acute phase.
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Fiend, rest up boss. Someone commented earlier about acute and chronic phases. These overlap in my experience. Rest and ice at first.
Eliminate all tension you can in your shoulders arm and then do isometrics. Do that for a few weeks then get on the twisty bar.
Paradoxically I found the bar thing worked well on left arm, right has responded much better to the upside down kettle bell holds.
Hope it helps. Tennis elbow is a bastard.
Re diagnosis try the extended finger test for tennis elbow- have a google. If this replicates pain then it’s probably the diagnosis I reckon. I found mine was really diffuse pain over forearm.
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Cheers Beef. I have been resting. 6 full days now. I'm raging. The last time I actually pulled hard was....over two weeks ago, admittedly that was pretty hard by my standards. Are you allowed to deadlift while resting elbows?
Good point about the ice. I've started doing that. I'll focus on it as if it was an acute injury that actually hurt when I did it or right after I did it, instead of not hurting so much then and getting more painful as I rest it. Twatting thing.
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any chance of you posting a photo of your face demonstrating how angry this is making you?
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No evidence that ice will do anything other than numb the area - no effect on inflammation. If in fact it is an inflammatory condition as opposed to elbow tendinopathy.
I don't think there is any one particular method that works for 'tennis elbow' but I would not advise total rest. Do any exercise that doesn't really hurt. When I had mine I just did kettlebells/push ups etc until it calmed down and I could climb again. I also have found Volker Schoffl's taping technique really beneficial and can climb now without pain and next to no pain post climbing.
https://www.epictv.com/media/podcast/climbing-tips-%7C-elbow-taping-101-part-3/605522
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As regards the classic eccentric loading exercises such as twisty bar thing. Patients report a mixed response. In my own experience it just made mine worse. I just did things like kettlebell swings, cleans, presses and turkish get-ups all with a fairly 'relaxed' grip.
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Fiend: print out and laminate Fultonius' post about the difference between acute and chronic/persistent pain. You can add a postscript to the effect that most people do too much in the early stages of an acute injury and do too little when the injury is chronic.
Some mechanicial stress after day 2-3 of an injury is nearly always beneficial for tissue healing. Judging the right amount of mechanical stress is a challenge and may involve a certain amount of trial-and-error. As a rule of thumb, acute injury loading shouldn't hurt, chronic/persistent injury loading should hurt when you exercise (but it it's worse the following day you've over-cooked things a little). There are plausible theoretical arguments, and some evidence, for doing eccentric rather than general exercises for leg tendinopathies but not so much in the arm. I'm not surprised sheavi benefited from non-specific exercises. Some people with chronic/persistent problems may need to be more specific about 'hitting the spot' and provoking pain.
Taping helps some people and isn't cold and wet; ice helps others and is free. It's unlikely either are affecting tissue pathology.
(https://pbs.twimg.com/media/DuT5J0oUUAA14Cs.jpg)
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As regards the classic eccentric loading exercises such as twisty bar thing. Patients report a mixed response. In my own experience it just made mine worse.
Likewise. As someone said earlier, do everything you can to release the tension (stretching, rolling, massage) then start rehab. Otherwise i think all you could be doing is causing more irritation.
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Got my twisty bar thing and it certainly works the tweaky feeling bit. But guess I’ll have to persist and see if it helps or not. Reverse wrist curls seemed to. Who knows!!
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For Lagers, as requested:
(https://scontent.fman2-2.fna.fbcdn.net/v/t1.15752-9/48377250_1943152719326574_6962664443817754624_n.jpg?_nc_cat=107&_nc_ht=scontent.fman2-2.fna&oh=b81a61d68c6102ffdd88f3158c3f57bc&oe=5CB17A13)
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You could have at least eaten that bogey before posting that.
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Have you had your teeth whitened Fiend?
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7 days of rage now. I've been for a run two days in a row. Appalling.
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Some mechanicial stress after day 2-3 of an injury is nearly always beneficial for tissue healing. Judging the right amount of mechanical stress is a challenge and may involve a certain amount of trial-and-error. As a rule of thumb, acute injury loading shouldn't hurt, chronic/persistent injury loading should hurt when you exercise (but it it's worse the following day you've over-cooked things a little). There are plausible theoretical arguments, and some evidence, for doing eccentric rather than general exercises for leg tendinopathies but not so much in the arm. I'm not surprised sheavi benefited from non-specific exercises. Some people with chronic/persistent problems may need to be more specific about 'hitting the spot' and provoking pain.
Thank you Duncan. The mechanical stress is what I'm curious about with my question to Fultooon: What sort of stress is 0.5kg going to produce?? I put far more stress through my elbows wiping my arse (especially with my guts), let along tossing yet another fucking chicken and veggie stirfry around... 5kg felt like it was vaguely working the areas, but didn't produce any discomfort.
Running produced a bit of discomfort slightly further in the elbow joint and towards the bicep.
I think I'm going to start gentle exercising and climbing on it, as sheavi said total rest doesn't seem to be helping. Stimulation, blood flow etc. Unlike my golfers when I kept pulling despite the pain, I'm going to try not to totally spanner it this time.
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I know how you feel Fiend. My rotator cuff blew up out of nowhere. Pretty intractable so I finally bought some new running shoes.
Now my leg hurts >:(
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As regards the classic eccentric loading exercises such as twisty bar thing. Patients report a mixed response.
Thankfully, I found my flexbar in a skip! Wondered when I'd get to use it.
My forearm is still sore, though now more a chronic ache. Pronounced "click" from my elbow when I flex it.
I trained yesterday, and the feeling is a little more akin to post training soreness, which I'm viewing as a positive.
One thing I did discover yesterday was a pronounced weakness - more than usual ;) - in my scapula/shoulder area, and clear discomfort/tightness (shoulder) when pulling my arm across my chest.
My injury may very well be different, but I think that some weakness in the shoulder/scapula has contributed to overloading of the brachioradialis/bicep.
When you're injured, it's very easy to focus on what you can't do, and that's probably because you don't feel in control of it. If you'd had a mega hard session and were really sore as a result, you'd just let your body recover.
When we're injured, isn't it the feeling that we don't know what the reason/cause is, that we find upsetting?
Maybe thinking about the soreness as an unusual response to training - and thinking about everything else you can do while recovering may help somewhat?
Timing is also interesting. After a good summer, I was quite light for me, climbing quite well, but overall, a bit weaker. I think I've tried to hold onto the sense of performing well, and I know that that generally leads to injury!
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Fiend, the 0.5kg/1kg thing was just personal experience. When mine was bad picking up a cup of coffee, or getting my phone out my pocket were pretty sore! 0.5kg was all I could manage.
If 5kg is not producing discomfort, then it's possibly an ok weight - I think the key is minimising irritation. Whereas, once it's been 6-8 weeks or more the aim of the exercise is totally different, it's all about remodeling the collagen and promoting some form of inflammation to kick start the healing process.
Your injury seems not to fit easily into the usual pidgeonhole.
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thanks for the picture, Fiend
made my Christmas
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A pleasure to give something back, given how helpful people have been on this thread (including your latest post, Fultonio).
Gym today.
Bench, overhead press, and dips - felt nothing (i.e. not just no pain, but no usage of the area).
Light rowing - very mild discomfort almost entirely due to wearing compression supports (mostly for warmth and to remind me I'm tweaked, I know they don't give any actual support)
2 x 10 eccentric pull-ups - mild discomfort at the bottom of the motion, again probably a lot due to compression supports.
Tried - very carefully and only once with each weight, preparing to stop at the slightest sign of real pain - eccentrics with increasing weights to test what felt like working the area and what felt aggravating:
1-2kg - felt nothing at all
3-5kg - felt like I was working the area, but no discomfort
6-7kg - mild discomfort in the muscle body near the elbow
8-10kg - slightly more discomfort and a bit more near the tendon / bony spur.
5 felt like a sweet spot. 6-7 felt essentially fine. 8-10 felt like I wouldn't do them unless professionally instructed at that weight.
They feel a bit tender now but slightly better than when at rest the previous days. I know the eccentric testing will have aggravated things but I judged it was worth a small setback to find out a suitable level and analyse the discomfort involved (I'd do the same with stretching and massage too).
I can pick up a coffee cup fine.
The facial expressions were similar to usual and I was wearing a Gorgoroth vest with a pentagram on which might have helped.
P.S. JonathanR sorry to hear you're having to run as well. Ghastly activity. We're chimps not fucking gazelles.
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Muscles feel noticeably better this morning. Elbow tendons / bony spurs a bit more tender (or possibly I'm noticing them more as not distracted by muscle pain), which is sort of what I'd expect after a session like that.
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What angle is your elbow at? When I did them, 90 degree bend meant I didn't really "hit the sport". 20-30 degrees was good, and, rather than up the weight too much I progressively straightened the elbow.
I have a sneaking suspicion yours is a strain rather than tendonitis, but who knows. Did you got to the phsyio?
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Physio booked for Wed. Arm was a 90' aye, can certainly experiment with that. Today I definitely feel it on the bony spur. It's starting to feel more like a comprehensible elbow injury now.
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Standard tennis now.
Physio recommended by Spunktonius was helpful and fairly positive. He was pleased I was getting help within a matter of weeks rather than months.
General advice: keep climbing at a low level, avoid complete rest (to stimulate healing), keep gymming, avoid pull-ups curls rows etc, full arm eccentrics with a super-light weight even if I can't feel any discomfort with that weight, massage muscle body, stretching, etc. Standard stuff. I can do that, grudgingly.
Cheers for all the advice guys :-*
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Sounds like a helpful prognosis Fiend. I’ve got one of those green twisty bars and have mostly been using it morning and evening (for twisting) - and may have seen some slight improvement. Hard to say for me as it’s been a niggle rather than a chronic injury.
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So I think I’ve found the cause of my arm strain....
Lifting our toddler. Been fine this morning until I picked him up and swung him onto my right hip (usual carrying method) and that movement pressed all the wrong buttons in my left forearm.
Only the left as that’s the one I use more (carrying on right side) and getting in and out of car (seen the other thread).
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Okay. I'm struggling a bit with this.
I'm pretty much sticking to the plan, (as confirmed / reinforced by a 2nd appt with physio):
Easy, non-stressful climbing every 2-3 days
Gentle massage and stretching.
Very light (<2kg) palm down eccentric bicep curls.
The level of pain isn't decreasing at all. Sore in the morning, sore on various motions (apart from antagonist work), sore-ish climbing, sore afterwards. I get a mild burning pain quite often, I'm going to email the physio about that - it might be part of the healing process.
The level of climbing I'm capable of IS decreasing. I overdid it before Xmas so now I'm being more careful, and backing off any moves that feel at all risky. I'm down to Font 6A / F6b on vertical / gently impending, Font 6B / F6c on slabs, if they're the right style and I'm careful. Nothing steeper ofc.
I've been told clearly to keep the climbing going REGULARLY at an easy level. This is proving quite a struggle. I hate easy stuff indoors and am bored out of my fucking tits. Unfortunately climbing for me is fundamentally a genuine pleasure-driven passion, and that applies to training too (even something as boring as hanging can have some pleasure through pushing myself, but I absolutely cannot push myself in any way at the moment). Doing very easy climbing purely as rehabilitation is....completely alien to me (as a contrast, last year with a spannered leg I could still push hard on upper body work). I "get" eccentrics and stretching and arm cycling and whatever. I just don't "get" 2 hours on vertical ladders.
I am TRYING to make it tolerable, travelling over to Eden to get the most slab options, lapping stuff and trying to focus on footwork and poise. I'd get outside more but, well, Scotland. I'd focus more on general fitness and CV but, well, legs.
:boohoo: :boohoo: :boohoo: etc. Any ideas to work around this would be appreciated.
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Core? I find it mind numbing but it’s somethjng?
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Core, as TT suggested, and some low level fingerboarding? Might be a bad idea as I haven't read the whole thread. Stretching, general flexibility, pull ups, pushups etc?
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I could do core aye. Thinking of joining a yoga class. It's that desperate.
I should do stretching too. Again I'd rather go for a run (a truly horrible experience for me) than do stretching. I dunno why. Maybe I should investigate more fun stretches.
Very strictly banned from even thinking about pullups - that's partly what got me into this mess in the first place, actually trying to train hard and get stronger instead of being fat and weak and coasting along on my ability to place RPs and pretend choss isn't going to fall down all around me.
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Okay. I'm struggling a bit with this.
I'm pretty much sticking to the plan, (as confirmed / reinforced by a 2nd appt with physio):
Easy, non-stressful climbing every 2-3 days
Gentle massage and stretching.
Very light (<2kg) palm down eccentric bicep curls.
The level of pain isn't decreasing at all. Sore in the morning, sore on various motions (apart from antagonist work), sore-ish climbing, sore afterwards. I get a mild burning pain quite often, I'm going to email the physio about that - it might be part of the healing process.
The level of climbing I'm capable of IS decreasing. I overdid it before Xmas so now I'm being more careful, and backing off any moves that feel at all risky. I'm down to Font 6A / F6b on vertical / gently impending, Font 6B / F6c on slabs, if they're the right style and I'm careful. Nothing steeper ofc.
I've been told clearly to keep the climbing going REGULARLY at an easy level. This is proving quite a struggle. I hate easy stuff indoors and am bored out of my fucking tits. Unfortunately climbing for me is fundamentally a genuine pleasure-driven passion, and that applies to training too (even something as boring as hanging can have some pleasure through pushing myself, but I absolutely cannot push myself in any way at the moment). Doing very easy climbing purely as rehabilitation is....completely alien to me (as a contrast, last year with a spannered leg I could still push hard on upper body work). I "get" eccentrics and stretching and arm cycling and whatever. I just don't "get" 2 hours on vertical ladders.
I am TRYING to make it tolerable, travelling over to Eden to get the most slab options, lapping stuff and trying to focus on footwork and poise. I'd get outside more but, well, Scotland. I'd focus more on general fitness and CV but, well, legs.
:boohoo: :boohoo: :boohoo: etc. Any ideas to work around this would be appreciated.
I don't mean to be an arse but acceptance of the fact that you're injured and that recovery from this takes time. Months & months if not longer. Once you accept that it will be easier to cope with mentally. Find something else to beast yourself in the mean-time. Ashtanga yoga can be a great workout, amongst other things, and will help even out any muscular imbalances. It should help your climbing.
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I'm trying!!!
It's a bit frustrating having had digestive / depressive issues last year (during which I could at least keep vaguely strong/fit), then 3 months grace where I felt myself again (Sept - Nov), then once I try to progress physically, this bullshit. More :boohoo: I know I know....
On the plus side I do actually like slabs ::)
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General aerobic exercise and yoga (ashtanga sounds good for you) should really help with the mood side. There must be loads of strengthening exercises you can do to stay relatively strong for climbing that don't aggravate your elbow? Just experiment a bit over a week and assess how your elbow responds. Best wishes
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Physio told me last night that it wasn't surprising my shoulder was still weak/painful after 3 months as their rule of thumb is 6-12 months for a shoulder injury to heal fully (if ever :jaw:).
So be grateful for the opportunity to develop the virtue of patience Fiend. Or just find some displacement activity to keep sane while you go through rehab. Ashtanga is great but I'd be cautious with your elbows, it may not be as gentle as you think.
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I would think that any slab that requires anything other than pure padding will put strain on your elbows. I find that you often end up very strange strenuous positions on slabs.
I would have thought vertical stuff would be better.
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I would think that any slab that requires anything other than pure padding will put strain on your elbows. I find that you often end up very strange strenuous positions on slabs.
I would have thought vertical stuff would be better.
Yup. Most slabs I seem to do end up with you pushing down on your tips from above - aggravating those muscles on back of hand.
Go road bike shopping with Shark?
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Or just find some displacement activity to keep sane while you go through rehab.
Don't hold your paintbrush too hard!
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Thanks for the replies guys:
General aerobic - big problem for me due to DVTs. I am keeping up with the running (20 mins max). I'm considering swimming again which I despise.
Strengthening exercises - based on my experience with weights etc, I think my overall body strength is okay. It's my climbing-specific power-to-weight ratio that is the main area to improve, which is exactly what I was trying when I fucked elbows. Core/flexibility is the other one. I'm on the verge of booking a yoga class.
Virtue of patience - you must be fucking joking ::)
Yoga - on the verge of booking a beginner's class.
Slabs - in my recent experience / experiments they've been absolutely fine. After a day out doing slabs at Garheugh my elbows felt the best they had for weeks, probably a combination of usage and constant overall activity without any stress. The pushing down thing seems okay, it's more dynamic movement, unloading and catching things, rotating too, that feels bad.
Road biking - not being able to do that is one saving grace of leg issues.
Paintbrush - hah yes, unfortunately there is a direct correlation between getting sucked into painting toy soldiers again and rapidly loosing all climbing fitness.
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Do more slabs then. Pressing exercises were fine when I had my elbow problem. Press-ups, shoulder press etc. Everyone is different. I could do pull-ups, within reason, if I didn't engage my thumb too.
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Slabs - in my recent experience / experiments they've been absolutely fine. After a day out doing slabs at Garheugh my elbows felt the best they had for weeks, probably a combination of usage and constant overall activity without any stress.
And because you were enjoying yourself, doing something important for you, in a lovely place. Not a trivial consideration, especially if you've been at a low ebb.
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Slabs - in my recent experience / experiments they've been absolutely fine. After a day out doing slabs at Garheugh my elbows felt the best they had for weeks, probably a combination of usage and constant overall activity without any stress.
And because you were enjoying yourself, doing something important for you, in a lovely place. Not a trivial consideration, especially if you've been at a low ebb.
I don't think Gresh enjoyed Indian Face but reported that his elbow problems disappeared after doing it.
My preventative is cranking out 30+ dwarf press ups when elbows start playing up which I see Ive mentioned to you before (https://ukbouldering.com/board/index.php/topic,16390.msg286918.html#msg286918)
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Cloggy's not in nick tho FFS. Neither is Dyer's Lookout (Dave_Mac elbow recovery plan).
Duncan, gorgeous weather and setting and good company etc might have helped matters yes. Even so I was heeding the physical symptoms quite a lot. In a more controlled environment i.e. indoors, I can feel what feels tweaky and what doesn't - most slabbier stuff definitely doesn't.
Physio advised against doing press-ups. I told him that bench had been absolutely fine (omitting that I cracked out the usual 80kg 1RM, also did a 50kg overheard press 1RM PB). He still thought it might aggravate the area.....I am still not sure. Tossing a wok pan around produces some discomfort, bench doesn't. I think more antagonists might help (not that I'm usually slack on them). Duncan Disorderly is too tall, too fucking skinny, and injures himself just looking at boulders, but also seems to recover miraculously quickly for such a punter, so I will have a look at the Dwarfs.
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Get another physio I'd say or simply exercise within relative comfort. No reason particularly why press-ups or bench press will necessarily aggravate the condition - especially if you've tried them without issue. Disclaimer I'm a physio btw.
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I’ve given up on my twisty bar (toddler has hidden it somewhere) but find the reverse wrist curls (palm down) work well. I use c.4kg. And can do about 20 reps before I’m pumped. Yes - pumped.
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So - Hope your elbows are getting a bit better Fiend - mine are maybe on the mend - though it feels more like just reasonably manageable at the moment.
General ramble/update/thoughts below.
Anyway - I've been thinking over the last few months about what actually hurts or causes my tennis elbow. Rather than try and hurt it (the stick your finger in the bullet wound and wiggle it about until you scream the loudest method) I've tried to cause and effect it during every day climbing. And to be honest its hard to pin down. Maybe lock offs, maybe big pinches.
I've been doing reverse wrist curls (palms down) with c.5kg for the last few weeks every other day or sometimes more often.
However - yesterday I did some fingerboarding for the first time in ages (due to wonky back..) and two things made it twinge straight away (as opposed to ache or feel ummm which other exercises had).
1. Half crimping instead of open handing. Straight away felt like I shouldnt be doing this (even on larger holds)
2. Pulling up past (less than) 90 degrees. Even on big holds - once I got to start lifting my shoulders above my elbows the outside of my left arm started to scream,
So no campusing for me (no big loss!) and I suspect I often knack my way around #2 or just avoid problems that have such moves... Not sure if its ever going to be completely fixed. Doesnt really feel like it at the moment...
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3 years later, (un)welcome back tennis elbows. Christ I was blissfully naive back then. The idea of these aches and pains just being aches and pains rather than acute injuries rapidly evolving into chronic injuries. And probably the equally ridiculous idea that they might heal up reasonably quickly (I seem to recall I didn't regain anything near full strength until mid-summer).
Anyway. Was doing decent stuff that was okay for golfers / LCL on the Depot 30 board, and feeling a bit better. Last week (after steadily increasing the effort over the previous 10 days) I did 2 board sessions and 2 gym sessions in 3 days, and made two clear mistakes of firstly doing some arm stuff at the gym rather than using it as arms rest in-between the board days, and secondly not stopping the second board session when I realised the fatigue wasn't going and I was getting a bit of discomfort in my elbows.
So now I've got a persistent niggle, mostly in the right elbow (and a bit in the left), right in the joint where the tendon joins the bone. It's not as bad as it was previously* and this time I've actually taken things gently since the aggravation rather than campussing and bouldering in an arctic gale. Instead I've rested a day, then 2 days of mostly rest but some dumbbell rehab, then a rest day, then easy non-aggravational mileage, then a rest day, the more EN-AM. I've also booked Process, and re-read this thread (useful stuff!) and dropped the dumbbell weights so low the things are almost bloody floating in the air they're so light. Will also get a proper massage to try to loosen shoulders. In the mean time I'm trying not to panic too much...
(* - Conversely, this time I'm coming from a position of already exceptional lack of form (last time I was at a relative peak). And I'm 3 months behind in terms of time of year / seasons. And 3 years older....)
So be grateful for the opportunity to develop the virtue of patience Fiend.
:furious: :furious: :furious: :furious: :furious: :furious:
I think my overall body strength is okay. It's my climbing-specific power-to-weight ratio that is the main area to improve, which is exactly what I was trying when I fucked elbows.
...
that's partly what got me into this mess in the first place, actually trying to train hard and get stronger instead of being fat and weak and coasting along on my ability to place RPs and pretend choss isn't going to fall down all around me.
::) ::) ::) Nothing's changed huh. Realise how disproportionately weak I am. Try to get strong. Get injured, get weaker, and lose more time that I could have been maintaining / potentially getting stronger.
Thinking of joining a yoga class. It's that desperate.
This hasn't changed either. Incidentally I did join a yoga class back in 2019, it wasn't too horrible and a I learnt a nice glute stretch (that I haven't be able to do for the last 3 months due to LCL of course).
Edit: Could a mod / cartilage-based underwater predator please change the thread title to "Acute / chronic tennis elbow" or something similarly informative and easy to search for, ta x
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I've been meaning to put this video up for a while. When my tennis elbow was bad, this "stretch/massage" was really beneficial:
https://youtu.be/o5RlX6UeM9c
I think it was more beneficial when I had full blown tendinosis but I'm pretty sure it helped the second time with more acute tendonitis.
The main difference for me was that the second time (tendinitis) I need to do more gentle wrist curls and more reps.
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Cheers. The forearm muscles are feeling really....achey to massage, although the real pain is in the joint area. I will try that technique too.
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I've been meaning to put this video up for a while. When my tennis elbow was bad, this "stretch/massage" was really beneficial:
https://youtu.be/o5RlX6UeM9c
I think it was more beneficial when I had full blown tendinosis but I'm pretty sure it helped the second time with more acute tendonitis.
The main difference for me was that the second time (tendinitis) I need to do more gentle wrist curls and more reps.
Makes sense - that looks analogous to one of the exercises that are recommended with Armaids. And for all they resemble something sold on QVC, occasional sessions of those exercises, whenever I've felt niggly, have kept my elbow tendonitis/ tendonosis under control for years.
This also seems to help ease the bouts of elbow tenderness.
https://tomrandallclimbing.wordpress.com/2012/11/23/golfers-elbow-a-possible-solution/ (https://tomrandallclimbing.wordpress.com/2012/11/23/golfers-elbow-a-possible-solution/)
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Cheers. The forearm muscles are feeling really....achey to massage, although the real pain is in the joint area. I will try that technique too.
Mine used to be really sore to massage, the whole muscle body, when my elbows were bad.
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Same here. Anything to loosen off that muscle, massage like in the vid, or pinching anywhere across all parts of the forearm. If mine gets niggly I go full force with a roller (foam or a rolling pin) on that whole muscle pushing with whole body weight against a wall.
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I've been meaning to put this video up for a while. When my tennis elbow was bad, this "stretch/massage" was really beneficial:
https://youtu.be/o5RlX6UeM9c
I think it was more beneficial when I had full blown tendinosis but I'm pretty sure it helped the second time with more acute tendonitis.
The main difference for me was that the second time (tendinitis) I need to do more gentle wrist curls and more reps.
Yep muscle blocking to protect/take the strain off, the owie tendon when teaching the muscle whose boss.
It seems a lot of body maintenance is basically couples therapy between a meathead jock (the muscle) and a spirited but frail pensioner (the tendon)
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I've been meaning to put this video up for a while. When my tennis elbow was bad, this "stretch/massage" was really beneficial:
https://youtu.be/o5RlX6UeM9c
I think it was more beneficial when I had full blown tendinosis but I'm pretty sure it helped the second time with more acute tendonitis.
The main difference for me was that the second time (tendinitis) I need to do more gentle wrist curls and more reps.
Makes sense - that looks analogous to one of the exercises that are recommended with Armaids. And for all they resemble something sold on QVC, occasional sessions of those exercises, whenever I've felt niggly, have kept my elbow tendonitis/ tendonosis under control for years.
This also seems to help ease the bouts of elbow tenderness.
https://tomrandallclimbing.wordpress.com/2012/11/23/golfers-elbow-a-possible-solution/ (https://tomrandallclimbing.wordpress.com/2012/11/23/golfers-elbow-a-possible-solution/)
Buying an Armaid for 40 quid was the best purchase I made during lockdown. Brilliant. Highly recommended if you struggle with anything between elbow and fingers.
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https://vimeo.com/146360120 (https://vimeo.com/146360120)
This has always worked well for me, both for maintenance and fixing. It's all about the positioning of the hipbones onto the back of the forearms.
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Cheers guys. I've just tried the stretch / massage thingy. I'm quite happy to dig deep into aching / stiff muscles as they're a lot less worrying than tendons and ligaments. Anyway. I carefully found the muscles that connected the most prominently to the sorest bit of the tendon injury at the joint, then I found the bulkiest bit of that muscle, dug deep into there and wriggled my fingers and wrist a bit - definitely a sore or tight spot. More so on the more injured arm and more so than any of the surrounding muscle areas. Seems like it's a useful thing to do. Spidermonkey90 do you have a well-used Armaid for sale for, say £35??
P.S. The Randall golfer's elbow stretch, tried that decades ago when he just discovered it and before he was the coolest coach on the planet. It's for golfer's not tennis and TBH it never worked for me. Apparently reflexology did for chronic golfer's, YMMValot
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P.S. The Randall golfer's elbow stretch, tried that decades ago when he just discovered it and before he was the coolest coach on the planet. It's for golfer's not tennis and TBH it never worked for me. Apparently reflexology did for chronic golfer's, YMMValot
Same here. Recently had a bit of grumbly brachialis (font elbow?) and it got recommended. No matter what position I got into it just felt like it wasn't doing any useful stretching, but did feel like it was hyperextending my elbows in a unsafe feeling way so I binned it. I've got mates that had other bicep/elbow issues and swear by it, so it's clearly good in some cases.
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Never worked for my golfer's either, and also felt like it was hyperextending my wonky right arm to a point where it was unsafe.
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Really severe at the moment, after too much bouldering volume and overhanging fingery cranking in Wales a couple of weeks ago. Heavy cleaning of Egerton route top-outs hasn't helped.
Any more pro-tips would be welcome (apart from see a physio which I am soon, really ease off on things which I have been, and don't clean Egerton route top-outs which I'm not doing any more).
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https://thepowerfingers.com/
I reluctantly bought some of these 5/6 years ago after not having any luck with other exercises to get rid of tennis elbow.
I guess the same thing can be achieved with elastic bands or something cheaper but they’re quite convenient
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I bought one of those too, but it was weirdly tight, I didn't know what to do with the other holes, and the lube started to corrode it.
Good plan. I suspect these are more in the prehab / warming up once mostly recovered area though.
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No tips but I'm sorry to hear your elbow is in a sad state Fiend, that's bloody rubbish
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Mine have got steadily worse since February (tennis elbow).
A few friends are suffering and it seems that physios are prescribing lock offs to force the tendon to strengthen. 6 x 30 secs on a bar or rings. I’ve been doing that on and off and it seems to help a bit, but top roping Scarab in the rain the other evening self-belaying with a grigri was probably not a great idea.
Grit trad is fine and even short boulder problems and deadhangs, but circuits and getting pumped makes them worse.
Weirdly they can be agony one day and ok the next for no apparent reason.
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Good plan. I suspect these are more in the prehab / warming up once mostly recovered area though.
Maybe, but it totally fixed mine.
Went from being so bad it was impacting non-climbing related things - picking up cups of coffee etc to being able to climb with no pain during or after
I don’t find them useful at all for warming up, just use them after climbing.
n=1 etc etc
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Thanks T_B
I can imagine that shunting harder routes at Stoney in bad conditions would rank quite highly as one of the worse things for it!! It wasn't something I was planning. I found steep, thuggy, but easy-ish gritstone bouldering at some god-awful moorland scrittle-fest that Fatneck dragged me to the previous weekend was quite good for it - all open handed or jugs, no ratty crimps or tight locks.
Process Physio has prescribed me a "pipe of power", a sort of wrist curling thing that I'm doing 3 x 30 second holds on it, 3 times daily. I suspect he'd probably approve of lock-offs on a similar protocol. I might give them a tentative try. The pipe of power does target my particularly injury area alarmingly well, and it's really tender even pulling gently on it (more so that during most climbing).
Thanks arast.
That does sound promising, especially since yours obviously got bad too. I can pick up coffee cups fine, although squeezing toothpaste is a bit tender, as is swinging a mattock around and hoiking out gorse routes for 2 hours.... I think maybe those power finger thingers could be worth a shot then. Hmmm actually I just tried opening my hand out against resistance from the other hand and it didn't hurt....
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Process Physio has prescribed me a "pipe of power",
Sounds like a book by Carlos Castaneda tbh, I’d go easy on that stuff Fiend. Hope your elbow relents soon!
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Ain't no room for Castaneda,
in Fiend's Frontline library. (https://www.youtube.com/watch?v=0hhzAgAzSr4)
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https://www.physioroom.com/product/PhysioRoom_Resistance_Twist_Bar/2334/42589.html (https://www.physioroom.com/product/PhysioRoom_Resistance_Twist_Bar/2334/42589.html)
Been using the resistance bars for years. Definitely helped, and much cheaper here than the thera-brand
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https://www.physioroom.com/product/PhysioRoom_Resistance_Twist_Bar/2334/42589.html (https://www.physioroom.com/product/PhysioRoom_Resistance_Twist_Bar/2334/42589.html)
Been using the resistance bars for years. Definitely helped, and much cheaper here than the thera-brand
Yeah assuming this is what Fiend is talking about, has definitely helped out my elbows in the past.
Mine have got steadily worse since February (tennis elbow).
Weirdly they can be agony one day and ok the next for no apparent reason.
This potentially sounds like more of a nerve impingement thing rather than tendon damage? I had similar before and found that stretching and massaging around the shoulder, in particular tight traps and chest helped no end.
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I’ve just finished up clearing my golfers elbow after 5 months of rehab and consistently doing isometric 90 degree lock offs on a bar for 30 seconds x 5 - other thing I was told to do during my warmup was to jump into a lock off and then drop off to warm the elbow up before climbing. Safe to say I woke up one morning and the pain had disappeared.
Anecdotally I did lots of isometric lockoff training Iast year and my elbow pain appeared a few months after it was removed from my plan so I’m thinking the strengths I got through isometrics was useful I staving off the golfers elbow
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Cheers.
The Pipe Of Power is a bit of plastic pipe with a loop of cord that's drilled through near each end. Wrap the loop around the pipe a couple of times so that it provides some resistance against pulling the wrist back up. Stick foot through the loop and gently start to pull the pipe towards you, maintaining wrist angle. This targets my tennis elbow very specifically indeed, is loaded incrementally to start, and is an isometric hold.
I do wonder if there might be a bit of nerve issues exacerbating mine as well. I've occasionally had some mild pain going down the forearm towards thumb and finger, and also a tiny bit around triceps. My right shoulder is permanently mildly impinged and sometimes flares up more than others. I've been doing tricep stretches and shoulder stretches as well as a bit of shoulder exercise to try to alleviate that possible issue.
The TE was particularly bad Sat night and Sunday after gorse clearing. I went to the gym yesterday, initially fucking hating it because I wasn't out climbing, but did 50 mins weights and 55 mins stretching. I did bench press, shoulder press, light lat pulldowns, and medium rows (these seem counter-intuitive, but I remember I checked last time, and even with heavy weights, the forearm extensors connected to my TE site aren't actually loaded with dumbbell rows!) with no pain whatsoever. I felt a mild twinge lifting a bar off the sit-up bench/rack with my palms facing towards me, that's it. My TE feels a lot better this morning than the previous morning.
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Literally just been having a conversation about injuries with a guy at TCA and I was saying I think climbers have a bad habit of ticking just under the injury level, then on a "rest day" throw themselves into some form of manual labour (sanding, sawing, pulling out gorse) and treat it like a marathon effort! This additional loading is often what sends you over the edge.
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I've knackered mine building a trampoline and putting the springs in using a pair of pliers, and previous to that moving concrete slabs around carrying them by reverse gripping the sides. In hindsight both very stupid.
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Literally just been having a conversation about injuries with a guy at TCA and I was saying I think climbers have a bad habit of ticking just under the injury level, then on a "rest day" throw themselves into some form of manual labour (sanding, sawing, pulling out gorse) and treat it like a marathon effort! This additional loading is often what sends you over the edge.
Yesssss :guilty:
A couple of weeks ago, I was like "Fuck, this elbow is fucked, I'm going to have to ease off on the training and bouldering, what else can I do?? Okay....Easy Trad (great), stamina training / falling practise (fine within limits), more involvement with guidebook work / checking / cleaning (partly fine but then....)". So of course I take the latter and get carried away with it because it's kinda rewarding in it's own way, and then push that too far. What a knob.
With the cleaning stuff:
Sawing - fine, it's quite gentle with the saw I have
Moving cut trees down - risky, have to avoid any sharp / bent arm pulls
Secateurs - bad, pinching
Hauling rocks to make swamp bridges - fine, just like easy deadlifts
Pulling out brambles / fern stumps - bad, too much pulling and jerking
Digging out dirt - okay as long as it's methodical
Hacking out roots / stubborn plants - bad, too much force and gripping
Brushing / scrubbing - fine, quite gentle
Naturally it's the movements that are fairly high load PLUS fairly dynamic (loading/unloading) that are the problem, along with changing of arm angle and gripping something tightly. I do think using a spade might be okay with the angle of my back arm (right arm) and how it would be pushing.
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I know i've mentioned it before but just to reiterate for newbies etc
To treat the outside forearm tennis elbow the Theraband Flexbar has been successful for me through several iterations of the problem.
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Literally just been having a conversation about injuries with a guy at TCA and I was saying I think climbers have a bad habit of ticking just under the injury level, then on a "rest day" throw themselves into some form of manual labour (sanding, sawing, pulling out gorse) and treat it like a marathon effort! This additional loading is often what sends you over the edge.
- Exactly this. I built a woody in my garage on my own over lockdown, and managed to knacker my elbow drilling holes in a concrete ceiling (with a rubbish drill) like an idiot. I had to stop climbing totally for 3 weeks and even after that it hadn't really improved with all that rest, plus stretching, theraband and massage.
I then splashed out on an armaid and it got better in a week. I would strongly recommend this thing. It is expensive but the way it works is so good and might save you money in the long term on professional massage/medical consultations etc.
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Sorry to hear the elbows are still wonky Fiend :(
Number of solutions = number of people you ask....
I've tried the finger spoke things (did nothing) and the theraband flex bar (did nothing) for a while - and in the end I found that regular TRX-ing (esp Prone I T) seemed to really help it.
I've a green theraband flex bar in a box somewhere (post house move) that you're welcome to pick up if you want to try it.
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Maybe semantics but TRX feels like treating the cause rather than the acute pain...?
Obviously long-term, yes; you should be treating the likely weakness/ imbalance/ overuse that has caused all this and I advocate it wholly in my capacity as whim driven non medical professional.
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This article is likely to be useful. https://physioclinician.medium.com/management-of-tennis-elbow-vs-actual-tennis-elbow-de508bfbd803
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Mine have got steadily worse since February (tennis elbow).
Weirdly they can be agony one day and ok the next for no apparent reason.
This potentially sounds like more of a nerve impingement thing rather than tendon damage?
That was my first thought when I read that, but I’m no physio.
To pick up on Tomtom’s point, having suffered with elbow issues (mostly golfers) and taken a visceral dislike to them, I decided to work on shoulder strength and stability once a week this autumn and winter, because all the force gets transmitted through the shoulder downwards. Anecdotal, but so far, so good.
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Mine have got steadily worse since February (tennis elbow).
Weirdly they can be agony one day and ok the next for no apparent reason.
This potentially sounds like more of a nerve impingement thing rather than tendon damage?
That was my first thought when I read that, but I’m no physio.
Yes could be as last time I had this some kind of shoulder impingement was involved. I’m hunched over a desk all day/using a mouse too.
I get a tiny bit of numbness coming through to my fingers/shooting pains when warming up.
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Thanks all, this is really appreciated how many people have chipped in with their
wildly differing n=1 anecdotes genuinely helpful and supportive ideas and advice.
Joel - I am considering an armaid. What does it do in terms of muscle / tissue massage that I can't do myself with some fairly brutal application of the other hand (that's talking about dealing with the TE arm, not any other appendage)
Tomtom - yes plenty of ways to skin a cat, depending on: severity, location within the tendon area (my previous one that I started this thread about was further in on the arm, towards the bicep), previous injury history, acuteness vs chronicness, strength / training history, influence of the rest of the chain, nerve issues etc etc. Although there are general core principles of stimulating and retraining the tendon without aggravating it, and sorting out root causes if they can be determined.
The one thing I think everyone agrees on is fuck DIY and fuck gardening. (actual experience from GE 16 years ago too)
Cowboyhat - you make a good point. I'm not bothered about the level of pain in terms of discomfort, more for the level of injury and tendon damage it represents. If someone could scan it and say (very hypothetically) "Yeah it's 95% intact and functional, but there's inflammation and nerve impingement causing excess pain", then that would be fine. The current level of pain is worrying me in terms of how much injury it implies (and I've been avoiding painkillers to avoid masking it).
What I'm aiming for is doing the most suitable rehab, exercise and therapy to stimulate healing as quickly as possible without reaggravating it - BUT also doing whatever I can to tackle the root cause, because that obviously needs to be done, and it gives me another beneficial physical thing to focus on.
Sheavi - thanks, will read.
Mrjr - yes I'm going to tackle shoulders more. I have been doing stuff this winter, mostly IYTs with light dumbbells, but that might have not had enough effect. I think I have fairly strong, bulky, and highly immobile and probably quite imbalanced shoulders - prone to mild impingement. Give the stuff that really kicked off my TE was steepish burly crimping, it could well be shoulders letting me down. Again, something useful to focus on whilst I'm once more not on the Depot 30.
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Don’t know how much you time you spend at a computer but I found a regular mouse really aggravated my elbow tendon issues. Got an ergonomic one which was much better:
https://www.amazon.co.uk/dp/B009D9CZ5C/ref=cm_sw_r_cp_api_i_S7Y3HV0P75TRM6N1BJ5S?_encoding=UTF8&psc=1
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Fiend, again, I’m not a physio, but from my own reading round I’d hazard that the level of pain and amount of damaged tissue may not correlate neatly. ie you may have a tiny volume of damaged tissue but tons of pain- for now, at least. And the volume of tissue which is dysfunctional may not be very important in terms of recovery anyway ie eventually you’ll compensate and recover, whatever.
In my mind healthy functioning of shoulders and everything downstream depends on strength for stability but also good mobility, both are important.
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Joel - I am considering an armaid. What does it do in terms of muscle / tissue massage that I can't do myself with some fairly brutal application of the other hand (that's talking about dealing with the TE arm, not any other appendage)
For me, i need to hit the "trigger point" where the exact injury is centred. I have an armaid (only because i grabbed it second hand here) and it does it well, but have achieved similar results pushing against a foam roller against a wall, or you could use a rolling pin or similar. You can't (well I can't0 apply enough pressure in the correct place to have effect.
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Fiend, again, I’m not a physio, but from my own reading round I’d hazard that the level of pain and amount of damaged tissue may not correlate neatly. ie you may have a tiny volume of damaged tissue but tons of pain- for now, at least. And the volume of tissue which is dysfunctional may not be very important in terms of recovery anyway ie eventually you’ll compensate and recover, whatever.
In my mind healthy functioning of shoulders and everything downstream depends on strength for stability but also good mobility, both are important.
Agree with all of this. Pain can be too subjective like trad grading to be of much use in knowing how bad an injury is. One person’s e5 is another’s e7. Then there are issues around how chronic niggles that stop someone doing what they want to do can cause stress/anxiety/depression, and stress/anxiety/depression can increase perceived pain. Plus those articles describing how the brain adapts to chronic pain and starts mistaking pain signals.
I think most climbers get hurty elbows and they come and go mostly despite all the treatment not because of it. My n1 is shoulder strength and mobility is my go-to along with some mildly painful loading and massage of the area. No idea if it helps or if the tenderness would have subsided by itself.
Aggravating by diy/manual labour a common story for climbers with hurty joints - ask doylo.
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Fiend, again, I’m not a physio, but from my own reading round I’d hazard that the level of pain and amount of damaged tissue may not correlate neatly. ie you may have a tiny volume of damaged tissue but tons of pain- for now, at least. And the volume of tissue which is dysfunctional may not be very important in terms of recovery anyway ie eventually you’ll compensate and recover, whatever.
Well in terms of volume and mass, the damaged tendon area is going to be very small - but also very important and having a lot of force put through it.
If the proportion of damaged tendon compared to healthy tendon is small, then that would be less worrying. But I can't rely on that guess!
In my mind healthy functioning of shoulders and everything downstream depends on strength for stability but also good mobility, both are important.
Definitely happy to focus on this. Hit me with some shoulder exercise pro-tips....
For me, i need to hit the "trigger point" where the exact injury is centred. I have an armaid (only because i grabbed it second hand here) and it does it well, but have achieved similar results pushing against a foam roller against a wall, or you could use a rolling pin or similar. You can't (well I can't0 apply enough pressure in the correct place to have effect.
Well the exact injury seems to be centred on the extensor tendon, where it meets the lateral epicondyle bone, and slightly down the tendon from that, but not into the muscle body. I can very easily apply enough pressure there for it to be very painful - Process Physio has advised against doing too much of thise (something to do with squeezing too much fluid out of the tendon - apologies if I have mis-quoted that). I have also been massaging further down into the muscle body to try to loosen any tightness there (which is what I've seen an armaid used for) and again I seem to be able to squeeze in a lot of pressure with my other hand. Of course if there's some methodology to the armaid / foam roller other than "digging in really hard and moving the pressure around" then that could be useful.
Petejh: Trad grading is entirely objective as any fule kno, being based on objective facts about the route such as existence of protection, existence of rest points, actual rock quality, exposure, how clear the line is, etc etc. Sport and bouldering obviously are more subjective (i.e. morpho).
hen there are issues around how chronic niggles that stop someone doing what they want to do can cause stress/anxiety/depression, and stress/anxiety/depression can increase perceived pain.
This is very very likely. Plus reduction in climbing / training making my body feel worse (sluggish, stiff, etc) overall. I'm trying to focus on other exercises and mobility stuff to help.
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I don't have much to add other than to say joints in general and tendons in particular don't appreciate sudden changes in the amount of loading. Fixes usually include some kind of gradually increasing loading whether it be a twisty bar or Easy Trad.TM Finding what works best for you usually takes a bit of trial and error.
Pain is an indication of threat. Tissue damage is obviously a threat but the context can make a similar amount of damage a much lesser or greater threat. There are many many examples of where pain is not a good indication of the amount of damage and this seems to be more common when a problem is long term or recurring. If you've had a similar problem before and it meant you couldn't do something really important to you, threat levels go up to red. Clever people also talk about neuroplasticity at this point: crudely speaking we get better at experiencing pain the more practice we've had at it.
General advice is pain when you're doing something is not necessarily a bad thing; if it hurts a couple of hours later or the following morning you've probably over-cooked it a bit.
Hang in there Matt. It might be a small consolation that it's good there was a clear reason why your elbow flared up again. Probably frustrating that it was self-inflicted and done with all the best intentions.
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For me, i need to hit the "trigger point" where the exact injury is centred. I have an armaid (only because i grabbed it second hand here) and it does it well, but have achieved similar results pushing against a foam roller against a wall, or you could use a rolling pin or similar. You can't (well I can't0 apply enough pressure in the correct place to have effect.
Well the exact injury seems to be centred on the extensor tendon, where it meets the lateral epicondyle bone, and slightly down the tendon from that, but not into the muscle body. I can very easily apply enough pressure there for it to be very painful - Process Physio has advised against doing too much of thise (something to do with squeezing too much fluid out of the tendon - apologies if I have mis-quoted that). I have also been massaging further down into the muscle body to try to loosen any tightness there (which is what I've seen an armaid used for) and again I seem to be able to squeeze in a lot of pressure with my other hand. Of course if there's some methodology to the armaid / foam roller other than "digging in really hard and moving the pressure around" then that could be useful.
The catchall here is as others have mentioned, n=1, and depending on whether the injury is chronic and what stage of the healing process you are at will yield very different results.
I believe with a chronic injury (or one where you have repeatedly injured the same thing) that part of the healing is a build up of scar tissue along with a high sensitivity to pain in the area to prevent repeated injury. Direct massage /presssure will break down the scar tissue and desensitise the nerves. My understanding anyway.
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Hang in there Matt.
Or don't hang in, as the case may be :)
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Hang carefully on in there? Definitely don't compression on in there Matt.
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It might be a small consolation that it's good there was a clear reason why your elbow flared up again.
Yes. It was getting increasingly susceptible / minorly aggravated over previous sessions bouldering, but I think it was this combination over an evening and following day that was the final straw (on the last problem I was tired from a whole day out and I did feel wary of this move).
(https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbGqB67q3KP_Ax_g3Yp6ooTpqTRYTjzjcDi3RweY1wt40BGnDlAR3taJ-MPElyJ6-Dk4e-alg_aLe_R0vw7MmZFePByvmUPa8DpdrPBWc0F2lEZOsS64UAmhKuOAf-ow0uSz_BPHKK6dGeA6TkkMJPiRozGDbLcWP2JbQux-g4sH2nMlFFwdYcFhRHLA/s16000/fiend_elbowrisk.jpg)
Hanging seems okay. Compression seems definitely okay. Locking in on crimpy holds, especially with my arm close to my body (more bodily rotation around that pivot point so more stress locking the wrist to compensate for that, amongst other factors) seems very bad. Dynamic pulls with that arm bad, dynamic catches with that arm okay. Etc etc.
SAChris, your logic there about the injury stage and benefits of massage makes sense.
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pic 2 looks like waving a red rag to elbow pain; steep crimps, elbows waving, tape!
btw, has tape ever actually helped anyone with an injury like this? I would have though it provides way too little support /pressure.
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As always matt, purely personal experience, but my video above worked for me but plain massage just aggravated things. I felt like it really helped smooth out the rough damaged collagen and make the tendon / muscle joint more supple. Plain massage gave me no relief and often made things worse.
Have you tried it?
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SAChris - I've found tape to be consistently helpful for alleviating stress on the GOLFER's elbow over various sessions with / without it. Something to do with restricting how much the muscle can pull through that tendon?? I've been using on the TE on that basis but maybe haven't had enough comparative sessions to judge effectiveness.
Fultonious - a while ago I did do that massage on the muscle belly, rather than the tendon injury site, and found vaguely stiff / knotty bits that I managed to soften up. I haven't tried it on the exact injury site but will do.
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SAChris - I've found tape to be consistently helpful for alleviating stress on the GOLFER's elbow over various sessions with / without it. Something to do with restricting how much the muscle can pull through that tendon?? I've been using on the TE on that basis but maybe haven't had enough comparative sessions to judge effectiveness.
Fair enough, have you tried the tennis elbow straps from decathlon? If tape helps a bit, i expect these would be better. Mine is not needed right now, can post f you want a try.
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Cheers, I did try the epi-clasp thing (as the specific things were called then) when I had bad GE, hated it, really uncomfortable.
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If you have a listen to Jill Cook (not specifically this podcast, but any of her podcasts tbh https://podcasts.apple.com/gb/podcast/05-tendons-and-tendinopathy-with-jill-cook/id454714085?i=1000420118732) you might find it illuminating. In one podcast she talks about Achilles tendon ruptures often being preceded by zero pain despite significant damaged tissue and how similar damage can be symptomatic or asymptomatic with no one knowing quite why some patients have pain and some don’t.
In another- this bit may resonate, Matt- she talks about patients who get better once they get fed up with ‘repeatedly putting their hand in the fire’ ie stop aggravating the tendon by repeatedly overloading it.
She repeatedly makes certain specific points:
pain is because you are loading the tendon beyond its capacity
the solution is to increase its capacity
Tendons like heavy loads
Tendons don’t like fast movement
The solution is slow, heavy resistance training
Eccentric programmes don’t have superior outcomes (the opposite, in fact) to normal eccentric- concentric loading ie bar raise and lower movements
the sweet spot seems to be 3 sets of 6-8 repetitions at 80% 1 rep max, 3 x weekly, increasing load over time, done slowly eg 5s up, 5s down
None of this is a diagnosis of your elbow pain of course, just her experience of what stimulates tendons to heal.
Alarmingly, she says damage never heals. Think of all the bits of tendon you - or I- have knackered over the years: they haven’t got better. The surrounding tendon compensâtes just fine. So don’t stress about damage is my takeaway; just get stronger :)
*disclaimer: talk to a proper physio*
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In another- this bit may resonate, Matt- she talks about patients who get better once they get fed up with ‘repeatedly putting their hand in the fire’ ie stop aggravating the tendon by repeatedly overloading it.
Do you mean in terms of rehab or management when it's niggly - in which case, yes definitely.
Or do you mean in terms of overloading it when in normal uninjured / barely-injured climbing training - in which case I'm not sure how one gets stronger without heavily loading the muscle-tendon chain?!
Your summary of the general principles of what she recommends goes along exactly with what Process says and indeed with what I've been doing for various injuries.
Alarmingly, she says damage never heals. Think of all the bits of tendon you - or I- have knackered over the years: they haven’t got better. The surrounding tendon compensâtes just fine. So don’t stress about damage is my takeaway; just get stronger :)
Yes most of that makes sense. My LA GE was chronically but manageable injured from 2008 until 2018 (when it cleared up a week after reflexology), during that time I pushed often to my limits when it was manageable. Since it cleared up I've pushed again to my limits (including very GE-sensitive stuff like max bicep curls) with minor reaggravation doing hangs out of the blue in 2021, then major reaggravation being a fucking tool and trying to boulder beyond my limit on steep limestone in the freezing cold in Sept 2021. The point being I concur that these things can "never heal fully'" but heal to a state that is manageable and perhaps completely uninhibitve as long as one is sensible (a theoretical concept for me!!).
As for getting stronger, I seem to bugger it up each and every time I try, despite sage advice from UKB, John Kettle, mrjonathanr, my own self-analysis, etc etc. Evidently not glacially paced enough ::)
Anyway I just went to the gym again and again it felt fine. Curiously enough, the arm overall feels really pleasant doing barbell overhead press - hard to describe but it just feels "right" on it. Maybe that sort of opposite loading is alleviating some pressure or something...
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Do you mean in terms of rehab or management when it's niggly - in which case, yes definitely.
Or do you mean in terms of overloading it when in normal uninjured / barely-injured climbing training - in which case I'm not sure how one gets stronger without heavily loading the muscle-tendon chain?!
Well, yes, quite! Tendons need both appropriate loading and time to recover. Massively ramping up loads and not having the patience to rest sufficiently is what she means, whether as rehab or just doing sport. Iirc that comment followed a discussion of pre-season training in athletes, who by definition were in a relatively untrained state, but thought they could just bust back into peak season levels of exertion. Doesn’t take long for tendons to start letting you know they aren’t ready.
So I took her meaning as: failing to increase loads slowly and not backing off when there were warning signals that it was too much, too quickly.
The point being I concur that these things can "never heal fully'" but heal to a state that is manageable and perhaps completely uninhibitve as long as one is sensible (a theoretical concept for me!!).
We might be at cross purposes here. She is saying that really injured tendon tissue does not heal at all, it’s trashed and stays that way. The healing we experience is healthy tissue nearby gaining sufficient strength to take over the load. So actually they can, and normally will, ‘heal fully’, it’s just that the damaged tissue just stays damaged. (There are degrees to this, some tendon damage is reversible in early stages, but not once it’s got lots of disorganised cells.)
*Again, disclaimer, this is my understanding of her views, so it’s second hand*
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Joel - I am considering an armaid. What does it do in terms of muscle / tissue massage that I can't do myself with some fairly brutal application of the other hand (that's talking about dealing with the TE arm, not any other appendage)
Others have already answered this somewhat, but for me (with tennis elbow for clarification) it was incredibly targeted and powerful (with the thing you have a choice of attachments for contact with the arm, going straight to the most rigid one orange ball one was best for me), the trigger point massage was more effective with this device than anything else. The clamping system means that there's nowhere for the painful part of the elbow to hide if that makes sense, it can't squirm around and avoid the pressure being applied. Also it feels like you can apply a lot more force through it than leaning against a wall.
I was kind of tempted to make one myself as it's a lot of money, but in the end I didn't have time or enough skill if I'm honest. It would be possible I think.
Sorry this isn't very scientific as I'm not really like that! - there's plenty of scientific explanation and evidence posted on this thread which is excellent, and thanks to everyone for sharing experiences and tips, it's ended up being a great resource. Good luck with your recovery!
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One interesting titbit of info gleaned from a Lattice Elbow pain video (sorry - I watched one) was where their resident/interviewed physio suggested that some people get TE/GE when they STOP doing regular exercise that loads the elbow.
This resonated with me - when they have flared a little when I've gone away on a non-climbing holiday for a week or two...
Just to throw into the already confused mix. Sorry.
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I've had a serious bout of Tennis elbow recently that progressed over 6-8months and got worse and worse despite doing various rehab exercises couple times a week it still lingered. It was really getting me down and frustrating. I'm no expert but I can share some tips that help me recover and I did quite a lot of research from various places to get anywhere with it. I have also had it in the past in same elbow which I rehabbed easily with the flex bar but this time that wasn't enough it was so stubborn. What is worse is part for me is that most of my working day my wrist is in an extended position so hard to rest Mon-Fri.
Anyway here goes it may help someone apologies if this details have been mentioned before in the thread
My Symptoms
Classic tennis elbow I had pain pinching whilst climbing, twisting water bottles open and lifting my cast iron frying pans while cooking. It got worse that I lost quite a significant amount of strength in that hand and had to address it and take a rest from climbing to get it sorted once and for all. Arm bent on my 50 degree board aggravated to so sounds fairly similar situation.
I continued to train to keep sane with a bar, rings, core exercises and careful finger boarding with hands close together on the fingerboard to avoid the bent elbow which cause strain into the elbow joint. If the fingerboard is aggravating drop this for a while.
Adjustments / preventions
-Avoid lateral raises or lifting weights with extended straight arms. You can still do these exercises but have thumbs point up rather inwards but best to avoid for a little while.
-Push ups with neutral grip position on rings.
-Try to do any weight, rings or TRX exercise with modified neutral grip position where possible.
-Use computer mouse in the other hand to the one with the injury
- Avoided pinching all together whilst climbing / training and minimise in daily life where possible
-Avoid icing
-Avoid Ibroprufen
What worked for me
Massage (aggressive and regularly)
-Aggressively massage of the tendon area. Regularly I massaged the tendon where it was most painful at the elbow and down towards wrist but mainly focussing 90% at the painful bit near the bone. Standard cross friction in two areas one near the bone on outside of elbow and one just above the crease at elbow on the top near the bone. My weapon of choice was a wooden spoon using the spoon end with a little oil or cream to get into the bit on the outer side of elbow and the pointed handle end to dig into the area just above the crease of the inside of the elbow (this was the area that was painful when arm was bent on wall locked off and doing rotator cuff exercises). Massage along the extensor muscle from elbow to wrist to relax that area to.
- Pin and stretch exercise
https://www.youtube.com/watch?v=P5k2b71pAEI
-There is another version of pin and stretch where you hold the painful area of the tendon and just rotate your wrist back and forth like turning a door knob.
Eccentrics
Now this is the area which caused the most confusion for me and lack of progress. The key take aways with this is to really read Dr Julian Saunders article very, very carefully as I spent time doing wrong.
http://drjuliansaunders.com/ask-dr-j-issue-223-dodgy-elbows-revisited/
We all know of this article but the devil is really in the detail to get this sorted. One thing he doesn't mention is that you need to do this a lot I mean a lot for it to work if your injury is stubborn and been around for a while. 3 sets every other day isn't enough. To make head way with my injury I was doing 9-12 sets (morning, midday, evening) 6 days a week for 3 weeks before I broke a plateau so you just have to stick with it diligently. Whilst in this article he shows you one exercise for tennis elbow which was my bread and butter but I decided to add others and I found that helped to in different way. Again eccentric loading method at various angles to maximise benefit.
Wrist Deviation – (The “hammering” motion)
And Wrist Extension – (The “ringing-out-wet-towel” motion or the direction of opening your hand if your wrist follows your fingers backwards)
Key take aways
-Adjust elbow angle to get the most benefit. I got most benefit from my arm bent almost at 90 degree
-Don't start to lower the weight with it pointing directly up (12 o clock) but it needs to be pointing at 10 o clock for right hand and 2 o clock for left hand. Lower from there slowly 5 seconds
- Do way more sets than directed but keep the weight heavy
-Aim for failure on the last either 3rd or 4th set using heavy weights
-Keep increasing the weight as you feel your not reaching failure and getting stronger
-Try the other wrist motions wrist deviation and wrist extension to hit other areas.
-Once you get stronger add in the concentric portion and lift the weight back up. Go heavy
Power fingers
-6 sets 3 morning 3 evening 20 reps almost failure on last set
Other exercises that weirdly helped me (day after elbow felt better) not sure why.
-Kettlebell swings
-One arm ring rows again neutral grip
Apologies for lengthy post hopefully someone will get something out of it to help them.
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@DavidM
Many thanks for your helpful post. I've read the Sanders article and tried to relate your words to it but still failing to clearly understand the eccentric exercises you've described. If it's not too much bother, could you possibly add video links showing the specific exercises? I think my visual brain might comprehend a little better :doubt:.
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Cheers for the further replies.
Joel - I can massage strong enough to get quite a bit of actual pain (not discomfort / tenderness) from the pressure at the injury site itself so I might be able to do enough, if massage is right for it, without an armaid.
Tomtom - it isn't a sudden decrease in general loading this time, although I'm wary of that, (using mrjr's "keep weekly load withing 80-130% of previous week" - badly paraphrased I know - principle). Obviously I have to now decrease the load as the previous overload (~2 months of probably okay load on aggravated elbow culminating in ~2 weeks of overload when it had got too much). I'm still trying to figure out a point when I should have just stopped / eased off, it's actually quite a bit harder this time compared to when I initially aggravated both elbows on the board-gym-gym-board debacle.
DavidM - that's some interesting information, although I am wary of the amount of loading there (in the context of talk about overloading risks above). I will be raising all options when I see Process next.
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larger uk
One being the standard wrist extension exercise here
https://www.youtube.com/watch?v=ZQLMz8-Kpg
Second being the one outline for tennis elbow in the Saunders article
The other one helped me is the hammer style motion here label radial deviation. This one hits the right tendon but not as directly as the two above so it nice complementary exercise that builds strength but doesn't overload.
https://www.thepronator.com/how-its-used/exercise-chart/
The difference is these exercises are done with arm pit against the table as described by Saunders in his article and varying the angle of the arm from straight to 90 degree. For a long time I was doing them sitting down with elbow on my knee and they didn't work. Really find the elbow angle that cause aggravation and start working there. I ended up doing them on the sofa with my elbow resting on the horizontal sitting part at head level and legs laying beside me half laying down if that makes sense. Hard to describe but I had more pain when pinching for example with a bent arm so I worked a lot with a bend arm during the exercises. Second important tip is not to let gravity hold the weight up at it's starting position. When you use the other hand to pull the weight back up don't pull the weight all the way back so gravity isn't assisting its starting position. Bring it back 60% so when you start the rep the tendon is already under tension. This way the tendon is under tension a lot more during your reps and sets.
In terms of the power fingers I even do the power fingers with bent arm with wrist extension for specificity to. On training days in between core exercises and strength training I did more sets and next day it feel even better.
Fiend
I think my breaks through came when I stopped over loading it with climbing which is a lot less controllable and concentrated on this directly and loading it frequently to start with lighter weight high reps and as it gets stronger heavier weights less reps and adding in concentric portion with the eccentrics. You have to get past the first couple of weeks where nothing feels like its happening even feels slightly worse at times and trust the process. You have to overload it in a sense for it to rebuild and get stronger but in a controlled manner. As I said continued to train around it using strength exercises that didn't make things worse.
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Youtube video not sure why it errored
https://www.youtube.com/watch?v=ZQLMz8-KpgU (https://www.youtube.com/watch?v=ZQLMz8-KpgU)