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the shizzle => diet, training and injuries => Topic started by: ghisino on December 03, 2016, 12:27:11 pm

Title: tip of elbow
Post by: ghisino on December 03, 2016, 12:27:11 pm
I've been battling for a few weeks with an unusual kind of elbow problem...(my usual kind being the occasional golfer's elbow)

the pain is located exactly at the tip of the elbow, it is painful at palpation, some (but not all) deep lockoffs, and especially when pushing gastons on sideways, "wide span" moves.

so far the only semi-successful treatment has been icing and massage with essential oils. It also got better during 6 consecutive days of moderate mp in verdon.

i suspect the tricep is involved in some way, problem is i have no clue how to properly do tranverse massage and eccentrics for this region.

i also have no clue wheter routesetting (impact driver's vibrations and twisting of the wrist) have any role in this.


any clue/related experience???

thanks!
Title: Re: tip of elbow
Post by: Nibile on December 03, 2016, 01:25:01 pm
Climb Faster™.
Title: Re: tip of elbow
Post by: Nibile on December 03, 2016, 01:26:35 pm
Seriously now.
Climb Faster™.
Title: Re: tip of elbow
Post by: Nibile on December 03, 2016, 01:27:18 pm
No, really.
Any pics with the exact spot of the pain?
Title: Re: tip of elbow
Post by: user deactivated on December 03, 2016, 02:55:24 pm
I had something similar and stopped leaning on my elbows then it settled down. Prob some sort of bursitis / tendinitis.
Title: Re: tip of elbow
Post by: DAVETHOMAS90 on December 03, 2016, 04:06:19 pm
Hi,

this won't be a medically technical reply, but hopefully useful.

I've been battling with this problem for about 12 years. I've seen a number of consultants and physios about it, and went back to my GP last week to arrange another referral.

The tip of my elbow can become so inflamed that it disturbs my sleep.

There is a bony spur at the elbow tip which impinges on my elbow joint/triceps tendon when I'm at near full extension. I'm trying that now, and it's painful.

The proposed remedy is to have an operation to remove the bone spur. About 15 years ago I had a spur removed from my middle finger (right hand). The symptoms were very similar. At hyperextension, the bone spur would be painful, as it restricted movement of the finger joint. The resulting inflammation was caused by aggravating the bony growth with restricted movement. In the end, I had the spur chopped under local anaesthetic. I was climbing again - albeit on large holds - four days later.

Very occasionally I still have problems with the remains of the spur on my finger, but it's very much better, and I'm hoping that surgery on my elbow will produce similar results.

I'll let you know how things go, and get a bit more technical information. I was very seriously considering an operation last year, but it settled down a bit. Stronger triceps/shoulders seem to have helped - presumably by relying on improved musculature rather than joint biomechanics, though that's a guess.

Good luck with it. PM me if you want a bit more info.

Dave.
Title: Re: tip of elbow
Post by: Doylo on December 04, 2016, 10:39:12 am
I had this years ago and press ups helped sort it out. I've been doing weighted hangs recently and worryingly can feel it coming back a bit.
Title: Re: tip of elbow
Post by: cheque on December 04, 2016, 05:47:00 pm
I get it if I haven't been stretching my triceps.
Title: Re: tip of elbow
Post by: duncan on December 05, 2016, 09:47:43 am
I've been battling for a few weeks with an unusual kind of elbow problem...(my usual kind being the occasional golfer's elbow)

the pain is located exactly at the tip of the elbow, it is painful at palpation, some (but not all) deep lockoffs, and especially when pushing gastons on sideways, "wide span" moves.

so far the only semi-successful treatment has been icing and massage with essential oils. It also got better during 6 consecutive days of moderate mp in verdon.

i suspect the tricep is involved in some way, problem is i have no clue how to properly do tranverse massage and eccentrics for this region.

i also have no clue wheter routesetting (impact driver's vibrations and twisting of the wrist) have any role in this.

Triceps tendon insertion would fit all of the above, including using an impact driver. Alternatives would include bursitis: any redness or constant soreness? Banged the tip of your elbow recently?

As well as focal management it's useful to consider the bigger picture. Any idea why this has occurred now? Change in training? Change in work? Trying a particular problem a lot? Can you modify any of these?

Tendon insertion problems tends to do less well with eccentric exercises than mid-tendon issues - in Achilles tendons at least - but still worth trying in my view. Assuming tendon, press-ups (US: push-up) would be a good eccentric-concentric exercise. You may need to adjust the difficulty of the exercise to get an adequately heavy load to achieve the desired moderate pain during the exercise. Single-arm press-up for example but numerous others.
Title: Re: tip of elbow
Post by: ghisino on December 05, 2016, 09:05:05 pm
As well as focal management it's useful to consider the bigger picture. Any idea why this has occurred now? Change in training? Change in work? Trying a particular problem a lot? Can you modify any of these?

two things i can think about:

-a significant increase in my routesetting activity. Especially 4 consecutive days right before my issue started.
-trying a quite specific handjam roof problem. Only 3 sessions, but it was around the time my elbow issue started.
Title: Re: tip of elbow
Post by: duncan on December 06, 2016, 08:27:00 am
As well as focal management it's useful to consider the bigger picture. Any idea why this has occurred now? Change in training? Change in work? Trying a particular problem a lot? Can you modify any of these?

two things i can think about:

-a significant increase in my routesetting activity. Especially 4 consecutive days right before my issue started.
-trying a quite specific handjam roof problem. Only 3 sessions, but it was around the time my elbow issue started.

Without taking a proper history - usual diagnosis by internet disclaimers apply - routesetting would be the strong suspect. Are you routesetting regularly? If so, you need to reduce the moderate level highly repetitive load on your elbow for now: manage the overall workload, take more breaks, perhaps use the driver in your opposite hand, set cooperatively (get someone else to wield the driver), or investigate different tools. Percy B has some useful advice on drills here (http://ukbouldering.com/board/index.php/topic,27542.msg536476.html#msg536476). I don't know your work situation so have no idea if any of this is realistic. In the future, perhaps avoid 4 hard days consecutively?
Title: Re: tip of elbow
Post by: DAVETHOMAS90 on March 30, 2017, 11:15:48 pm
Hi Folks.

Yesterday, I went in for the op on my elbow.

The original diagnosis from July 2002 (!) was:

"RIGHT ELBOW (24 Jul 02)
There is calcification in the triceps tendon insertion into the olecranon
consistent with chronic trauma. No other abnormality."

(See post from Duncan above.)

This developed into a bone spur and bursa over the next 15 years. The bone spur impinged on my triceps tendon at full extension, and was often very inflamed and painful; I couldn't really press out properly on my right arm, or slap for stuff.

This is what it looked like:

(https://c1.staticflickr.com/1/536/31226448943_cd3f4183d9_b.jpg)

I had a general anaesthetic for the operation, but it was in and out on the same day.
I'm going to be well bandaged up for the next couple of weeks, but I'm hoping for a good recovery. Some stitches in the tendon apparently, so I'll try to be uncharacteristically careful. First thing I did when I got home was to smack the bathroom door with the elbow tip  :clap2:

I'll provide an update. Hopefully it's just a case of waiting for the soft tissue to heal.

Lovely nursing staff and care environment, up at the Claremont hospital (Sheffield) too, and the food was distinctly "un-Northern General"  ;D  :

(https://c2.staticflickr.com/4/3790/33614388041_4ae816c592_b.jpg)
Title: Re: tip of elbow
Post by: lagerstarfish on April 01, 2017, 08:00:16 am
has the surgeon given you any indication about when you might be able to resume your tree hugging activities?
Title: Re: tip of elbow
Post by: mrjonathanr on April 01, 2017, 09:40:18 am
Moderate Maypole Dancing rehab for the next 2 months apparently. Morris bells to be worn on knees only.

Hope you're back in action soon Dave.
Title: Re: tip of elbow
Post by: DAVETHOMAS90 on May 28, 2017, 02:17:57 pm
Here's a quick update, following surgery on my own "tip of elbow" surgery. The operation - to remove a bone spur - was on March 29th, and I was given the go ahead to resume activity 8 weeks later, on May 24th. In reality, I've been able to flail around on the odd sport route, for about a month, always trying to improve mobility. There were stitches in the triceps tendon, where it was separated to gain access to the bone spur, so easy routes - mantelshelves etc - were more problematic. Popped to Chee Dale yesterday, to try a move involving a long reach right to a side-pull, with elbow fully locked out. This move used to be excruciating, but yesterday, no pain! Amazing :-) There's still some scar tissue, loss of strength, and some discomfort under flexion, but I'm still being careful with rehab, and things are improving all the time. I decided to have the operation, because I was losing mobility, and the elbow had been painful for about 15 years. I was nervous about going ahead with the op, and the bone spur hasn't been completely removed, but it looks as though, on balance, it's been a success, with only limited discomfort/inconvenience.  :-) Thumbs up. Hope that's useful info for anyone in a similar position.
Title: Re: tip of elbow
Post by: Nibile on May 28, 2017, 10:54:52 pm
Jesus, how could I miss this!
Best of luck with the recovery Dave!!!
 :dance1:
Title: Re: tip of elbow
Post by: DAVETHOMAS90 on May 29, 2017, 02:05:05 am
Hi Lore, and thanks! I've heard of others with the same problem (Percy B?), so thought it was worth the write-up. (Apologies to the OP for hi-jacking.) Couldn't really straighten my arm, doing front levers etc, painful latching holds at full reach (my fault for being slappy) but already some major improvement. Back on the campus board soon! Hope you've had decent weather for getting out for some "log" rides on the beast :-)  :thumbsup:
Title: Re: tip of elbow
Post by: SA Chris on May 29, 2017, 09:48:58 am
Thumbs up.

Full pain free range of motion thumbs up!
Title: Re: tip of elbow
Post by: Nibile on May 29, 2017, 11:03:21 am
Hey Dave!
Yes, we've had excellent weather as of late, with Sun and temps up to 28 degrees...
I've ridden a lot, and that made up for the poor fingerboarding conditions!!! I've also bought a racing leather suit, can't wait to go back on track with the GP0 bikes!
Stay strong!!!
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