UKBouldering.com
the shizzle => diet, training and injuries => Topic started by: Paul B on December 05, 2010, 11:48:43 pm
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I've started having elbow woe's of late:
I hadn't really been doing any training during the summer (or properly for a while) so when the weather deteriorated and I ended up going indoors a lot again I acted sensibly and took it fairly easy. After a while things were improving so I kept upping the intensity, deadhanging and using my weight belt.
I can't really pinpoint anything specific that may have caused the current problem, one day I did hit a hold straight armed and it twinged a bit but not terribly so (not enough to warrant more than a few minutes of rest) but last session; a beastmaker session, my right elbow was in agony.
I've got discomfort on the inside of my elbow (palm up) around the brachiadialis/Golfers elbow. Since it started bothering me during the climbing (and periodically doing other tasks such as DIY or using a computer) I haven't climbed and I've tried to ICE as and when but it doesn't seem to have improved much at all.
A few people have suggested that this kind of problem can often be referred from shoulder/back problems or postural issues (I spend a long time at a computer spinning a scroll wheel). Are there any stretches or anything else I can do to help myself as much as possible?
I've been trying to sort out an appointment with a Huffy approved physio but its proving hard.
Has anyone got any recommendations on who's worth seeing about this (Sheffield) or any other useful advice?
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for fucks sake paul just stop climbing
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I saw John at the clinic, sorted me out, gets my recommendation. My problem sounds the same as yours, classic golfers elbow. Don't think elbow problems can be referred from back/shoulder i.e. the pain your feeling is an elbow prob not a back/shoulder problem - but tightness in back/shoulder can impede recovery and could be a possible factor in the injury. All the advice I'd give is summed up in the Athlon article that is always posted when elbow problems come up. I'd see a physio and get it sorted. Felt like a lot of money at the time but now I'm fixed and pulling harder than ever seemed like very well spent money.
Stay positive it can be fixed and return to normal.
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Second the recommendation for John - he has always been very good at sorting out whatever random injury I seem to have inflicted upon myself.
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for fucks sake paul just stop climbing
the thought never crossed my mind :wave:
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I've started having elbow woe's of late:
I can't really pinpoint anything specific that may have caused the current problem, apart from using a weight belt.
A few people have suggested that this kind of problem can often be referred from shoulder/back problems or postural issues (I spend a long time at a computer spinning a scroll wheel). Are there any stretches or anything else I can do to help myself as much as possible?
Ashtanga yoga, straightens everything out and puts it back into place. And it's arduous, definitely not a soft option. There are comments sometimes that stretching makes you weaker. Maybe if you do 20 hours a week. A 1.5 hr class a week will just do you some good.
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I take it you think its the belt?
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Kim Thompson in Hathersage.
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Kim Thompson in Hathersage.
that one's noted thanks Cofe, not that easy to get to midweek what with her blasting around in our new wheels ;).
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Actually I don't know anything on account of not knowing you personally and not being a physiotherapist.
I do think that applying an increased training load when your tendons aren't happy might be the first thing I'd change, at least till things get better. I also think that the way loads are distributed by the body is impacted by posture, so some intelligent stretching - which is what yoga does- might be worth a punt. Good luck.
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I managed to see somebody tonight, the diagnosis was Tendonosis, so Pronator curls etc. to sort out the imbalance. I'd seen some good re-gains in strength so an imbalance doesn't suprise me. I'll do as recommended and see what happens.
The belt was ditched as soon as I started having the slightest awareness of a problem.
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See john.
If yr neck or back is an issue he has the skills to tell you.
If he can't fix it, he will tell you.
Very honest man.. Some of my injuries he is the only man I will trust with...ESP imbalances
The butcher of woodseats also has his place...
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I've started having elbow problems myself recently despite hardly climbing.
Unfortunatey my weight belt is a lot harder to remove.
A session at the cave tomorrow should sort things out :-\
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Maybe something easy as a warmup Jim? Possibly lou ferrigno?
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You can join me on the new standardised warmup circuit Jimbo ;D
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Icing really worked for me, but it's a pain in the arse to do properly.
It supposedly has to be an "ice bath" on the affected area (applying ice to the skin doesn't work), and for at least 20/30 minutes. Like i say it's a faff to do but the increased blood flow following it really seems to help, take advantage of all that snow out there and get a load in a big plastic bucket!!!!
There's loads more on past posts on Dave McLeod's website.
Word
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Icing really worked for me, but it's a pain in the arse to do properly.
You're supposed to apply it to your elbow.
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Icing really worked for me, but it's a pain in the arse to do properly.
You're supposed to apply it to your elbow.
Ha. :lol:
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my ostheo gave me this stretching.
right side to a wall, at arm distance. place right hand on the wall, thumb up, fingers pointing backwards. press the hand against the wall, making an active full surface contact with the wall. now straighten your arm fully and start rotating your chest leftwards, until you feel the complete stretch of the full arm, forearm and hand.
keep applying active pressure against the wall.
2-3 mins for each arm, 4-5 times a day.
hope this helps Paul, I want to meet you at full power in feb!
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Submission date for me is the 31st of March and I can't really convey just how much work thats going to be.
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A brief discussion with Reeve earlier has left me questioning my direction:
Basically I rested somewhere between 7 and 10 days icing as I went. Returned to climbing but dropped the intensity i.e. no deadhanging, no belt and a great deal more care!
I've also started doing exercises:
Brachiodialis stretches
Reverse wrist curls
Pronator and Suppinator curls
Also, I've recommenced doing dips and press-ups for any added benefit they might have
The article (http://www.athlon.com.au/articles/r&i_dodgyelbow.pdf) suggest only doing negatives of the exercises concerned as that will give maximum stimulation to the tendons whilst not doing 'that' much for the muscles BUT surely if you're trying to redress an imbalance, flexors/extensors or Pronators the muscles NEED balancing up to fix the problem? I'm way out of my depth here so if anyone would care to offer an opinion I'm all ears and a lot of my direcit on is based anecdotally on what a number of other people have told me worked for them.
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Paul, a) there is no such muscle as Brachiodialis (there is a brachioradialis, and b) this is situated on the outside of the elbow i.e. the thumb side.
Highrepute, please don't offer advice which is completely uninformed - unless you have a very specific tender point on the bony prominence on the inside of the elbow, the pain is almost certainly due to some sort of instability at the shoulder causing impingement and referring pain to the elbow. I'm not going to go into any detail as you can find what I've previously written in the 'shoulder instability' thread from a while back.
My advice is that you must incorporate shoulder stabilty exerices into any elbow rehab routine.
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Sloppy spelling/
Do you have any specific physio's you'd recommend Sausage?
This Post I assume (http://ukbouldering.com/board/index.php/topic,10847.msg182899.html#msg182899). I don't struggle to believe that my posture and activation of my postural muscles is bad, after all, the amount of time I spend curved in front of a PC is vast.
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Second the shoulder advice above. From my own experience (usual caveats), it seems a more holistic approach helps elbow problems in some climbers - a few rotator cuff exercises, some normal and 'extended' push-ups (maximully protract and retract from the shoulder without flexing at the eldow) can't hurt, at least!
Just a guess, but my own laymans interpretation of the article is that the point of the eccentric exercises is to help the tendon 'catch-up' whilst still stimulating the weaker muscle - if only to a lesser extent - and slowly but safely redress the imbalance. Would be interested to hear from someone who knew what they were talking about!
Hope there's some improvement soon!
Al
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Re only doing the eccentric part of the movement:
The Saunders article says that an eccentric contraction stimulates the tendon more, relative to the muscle, than doing the full concentric/eccentric combined movement. The thinking is that in many cases tendinosis arises due to a sudden increase in training load which the muscle responds to faster than the tendon, creating injury to the collagen fibers that comprise the tendon at the muscle-tendon juncture. The collagen fibers need to be loaded as they heal, and the eccentric-only training brings you back to a "balance" where the muscle and tendon join while appropriately loading the fibers of the tendon so that they heal in alignment rather than a much weaker patchwork structure that is likely to re-tear.
The other "balance" issue is that of the surrounding muscles - so for medial epicondylosis (flexor and/or pronator teres issue)that means wrist curls for the extensor muscles and possible bicep, tricep and shoulder work. I think it makes sense to do the regular, full-rep concentric/eccentric combo for these exercises and do the ones specifically targeting the injured area as eccentric-only.
I've seen medical study articles for achille's tendon pain that strongly supported an eccentric-only treatment protocol for tendon pain with much better results than any other therapy. For what it's work, both my dad and I quickly and easily got rid of long-term achille's tendon pain with a few weeks of one-leg lowers on a stair.
I've found that my climbing-related elbow problems responded best when I combined the eccentric exercises with ice baths and light climbing. Once the pain was manageable I incorporated bicep curls, various presses and more stretching.
Hope that helps.
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Highrepute, please don't offer advice which is completely uninformed - unless you have a very specific tender point on the bony prominence on the inside of the elbow, the pain is almost certainly due to some sort of instability at the shoulder causing impingement and referring pain to the elbow.
I've read back through what I posted and see your point, perhaps phrased what I wanted to say wrongly.
Don't think elbow problems can be referred from back/shoulder i.e. the pain your feeling is an elbow prob not a back/shoulder problem - but tightness in back/shoulder can impede recovery and could be a possible factor in the injury.
perhaps I should clarify: Meant to suggest that although there is likely to be a shoulder problem here, at the moment this shoulder problem has caused an injury in the elbow (hence pain in elbow) and treating the shoulder now won't address the elbow problem. Treat the elbow but be-aware that shoulder problem is very likely and needs treating.
but maybe you disagree with the statement?
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I certainly do...
...there are (I believe) 2 varieites of elbow problems frequent in climbers:
1) Straightforward elbow tendonitis - I don't actually think this is particularly common. It is characterised by a definite point of tenderness on the bony prominence of the elbow; This problem, although can be more likely with poor shoulder alignment/mechanics, really has nothing to do with the shoulder. It should get better with the usual R.I.C.E. management.
2) Elbow pain that is characterised by generalised lateral arm pain, difficult to locate any point of tenderness. It generally comes on with squeezy/mantle-y moves (Font' elbow). This pain is caused by lack of stability at the shoulder causing impingement of structures that cross the shoulder joint, referring pain further down the arm. And this is the key - although the pain is located close to the elbow, there isn't any injurous processes occurring at the point of pain. All structures (Nerves, muscles,bones) can refer pain along their length - people with knee replacements will often have quite severe ankle pain, for example.
With nerves, this is even more pertinent. Take a lumbar disc bulge - it will likely refer pain down the sciatic nerve, which may only be felt at the calf or ankle. It is the same with the shoulder. The radial nerve runs along the outside of the arm - and if this is aggravted as it crosses the shoulder joint, it will cause pain further down the arm.
Thus, treat the cause of the problem and in this case, the origin of the pain.
Incidently, this problem is often lazily 'diagnosed' as brachialis tendonitis.
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Nice one. :) Thanks for taking the time to reply, pretty much answers all my questions.