Elbow osteoarthritis

[harrison]

I'm 35, and in the last month or two was diagnosed with elbow osteoarthritis on both sides.

The orthopaedic specialist advised me to avoid loading them significantly (eg climbing), and to take up swimming.
He made it pretty clear I should want them to last another 30 years before replacements should even be a consideration (they're not good - limited to lifting 2-3kg, often need revisions, don't last as long as knee/hip replacements).
From that obviously my main concern is not trashing them early, and I assumed climbing was totally off the cards.

I went swimming - definitely not as good as a dyno - but I noticed you still put some force through your elbows.
And a lot of the advice is keep using the joint, and strengthen it.
So I wonder if there is room for some easy bumbling.

I'm interested if anyone has elbow arthritis themselves or knows anyone who does.
It would be really useful to hear their experiences.
I expect most people who have it will be older, but it would good to know about how it progressed or the effect of climbing on it.

My understanding is you really want to avoid compressive forces, and particularly high impact compressive forces.
I'm thinking I could shuffle up amazon crack without much elbow exertion.

I have to add the diagnosis only started because I went and saw Paul Houghoughi, and I'd massively recommend him to anyone. I had issues with a finger for 3-4 years and in less than 20 minutes he'd identified a clear issue, and within a few weeks it was improving. Sadly not good news about the elbows, but if it wasn't for him I'd probably still be doing tendinitis rehab and wondering why they weren't feeling better. I saw two other physios in the year before seeing him.

I have to sort out a few more hospital appointments etc, and after that I'm sure I'll seek his opinion on the above, but no doctor can say what it'll be like in 5 or 10 years, so if anyone has been managing it for that long, it would be great to get their perspective.

Thanks!

 

[Fiend]

I don't have any knowledge / experience / etc, apart from "climb slabs". But just want to express sympathies for what sounds like a very shitty issue, even by the already shitty standards of climbers' elbows, and best of luck with it.

 

[oldfella]

I have quite significant osteoarthritis in my right elbow. Diagnosed about 4 months ago. I had post on here somewhere.
I have lost significant range of movement. 90degrees flexion and around 150 extension.
I’ve had a CT & X-ray. I’m having an operation in late January to clear out my elbow and remove some of the bone formations.
I’ve been climbing as per usual. Just can’t do certain positions now. Such as mantles and deep locks.

 

[webbo]

I broke a bone in my elbow joint in 1981 doing the classic putting a hand down to break your fall on landing. Since then I have never been able to straight it fully, I had it cleaned out about 10 years ago as it was clicking and locking at times, the surgeon removed various float bodies.
He causally mentioned post op that I shouldn’t lift anything heavier than a bag of shopping.
So I just carried on as normal
Currently it is clicking very loud at times and it does lock but in general I can still climb. My wife keeps telling me to get it looked at. However it’s probably third on the list behind my shoulder and my arthritic wrists.
Given your age you have my sympathy.

 

[sheavi]

I work as a physio and have OA in my hip. From what we know of OA and exercise, it can be protective and reduce/limit progression on the condition. In terms of climbing I would be guided by your symptoms. Don't just stop climbing! Start off steadily and see how your symptoms respond. There is no one size fits all. Initially I would refrain from steep stuff, hanging from locked out elbows and hard mantles etc.
Although the below link is for OA knee it offers some excellent advice that could be transferred to your elbows and climbing.

https://www.howardluksmd.com/walk-exercise-run-knee-arthritis/

 

[harrison]

Thanks Fiend - thankfully my knees are ok, so slab padding is in!

I have quite significant osteoarthritis in my right elbow. Diagnosed about 4 months ago. I had post on here somewhere.
I have lost significant range of movement. 90degrees flexion and around 150 extension.
I’ve had a CT & X-ray. I’m having an operation in late January to clear out my elbow and remove some of the bone formations.
I’ve been climbing as per usual. Just can’t do certain positions now. Such as mantles and deep locks.

Ah shit that sucks man! How long ago did you first notice it? Is the limitation of ROM the only symptom or do you get pain from it as well? Did the CT scan show anything about the condition of the cartilage?
I definitely have some cartilage damage either on the capitellum or the RC joint, but have pretty widespread bone spurs/growth (quite interesting to see how the bone has basically made the joint wider on the capitellum and humeral articulating surfaces).
Im trying to decide if the same sort of operation is worthwhile, my ROM is not particularly restricted, but there are definitely bits and pieces flloating about and I get some catching every now and then - and I imagine that is not good for the remaining cartilage.
If ROM limitation is your main symptom that's good. I was reassured a bit by this guy saying in treating 1500 elbows he had only had to do 3 or 4 replacements and repeating the debridement to remove the bone spurs once a decade or so generally works - youtube.com/watch?v=ci8Sj_S7M90.

I broke a bone in my elbow joint in 1981 doing the classic putting a hand down to break your fall on landing. Since then I have never been able to straight it fully, I had it cleaned out about 10 years ago as it was clicking and locking at times, the surgeon removed various float bodies.
He causally mentioned post op that I shouldn’t lift anything heavier than a bag of shopping.
So I just carried on as normal
Currently it is clicking very loud at times and it does lock but in general I can still climb. My wife keeps telling me to get it looked at. However it’s probably third on the list behind my shoulder and my arthritic wrists.
Given your age you have my sympathy.

Kind of not bad going if its still working 40 years later! What are the wrists like to deal with btw? Dr asked if I had any wrist pain when he was looking at my elbow x-rays, and said they might develop it too. Not got any imaging of them, so living in ignorance for now.
How bad has your elbow been pain wise?

For both of you, did you have to avoid any exercises, styles etc? I haven't done a pushup or pullup for like 18 months or maybe 2 years. Both of them cause pretty unpleasant crepitus, and discomfort/pain. The sound is enough to make you think, I need to stop that.
Thanks both of you for posting as well - definitely nice to hear people are still climbing with janky elbows.

Strangely, as they were getting worse I found I could still do hard mantles, whereas basic pulling was more problematic.

I was getting like twangy shooty pains down my arm while resting (down radial nerve, and something would twang at the bicep insertion), and a deep soreness in both brachioradialis muscles, and the outside of the left bicep. It started like once a fortnight or once a week, and it got more frequent until it was like most days. Just slightly sore forearms while climbing.
Most of those have subsided, particularly the radial nerve thing. I assume there is like some tendinitis / tenosynovitis in my forearms because they are still pretty sore, probably like a constant 3-4/10. My actual elbows only hurt if I keep them still for a long time - like for the the MRI it knacked to keep them extended for 20-30mins.

I work as a physio and have OA in my hip. From what we know of OA and exercise, it can be protective and reduce/limit progression on the condition. In terms of climbing I would be guided by your symptoms. Don't just stop climbing! Start off steadily and see how your symptoms respond. There is no one size fits all. Initially I would refrain from steep stuff, hanging from locked out elbows and hard mantles etc.
Although the below link is for OA knee it offers some excellent advice that could be transferred to your elbows and climbing.

https://www.howardluksmd.com/walk-exercise-run-knee-arthritis/

Thanks for commenting, sorry about your hip! Thanks for the link it is helpful. Before stopping climbing the following were less aggravating:

• slabs without really using arms
• climbing on gentle overhangs on decent holds with relaxed arms
• kilterboard v1+2s with relaxed arms, using excessive leg beta to never pull
• bomber hand and fist jams less bad than pulling on / holding onto holds.

So that's good stuff to know although I'm slightly wary of being guided by symptoms.
With it being the elbows, it feels like you have one chance to not wreck them.
I also did a lot of climbing while being pretty oblivious to how bad they were which doesn't bode well for that approach.

As far as I understand, you can't feel cartilage being damaged, so you are feeling the resulting inflammation. So you'll get the message afterwards, not before or during. If you're trying to preserve cartilage, that's too late really.

Low impact exercise with low-moderate cyclical loading through a large ROM for 10-15 minutes in theory stimulates cartilage to repair (with caveats). Moderate is based on healthy cartilage, so low load might be wiser for unhealthy cartilage.
That sounds like climbing could fit the bill, but with RC joint damage, the combination of pronation and pulling seems like its going to put a multiplied load on the cartilage there, which is where mine seems worst.

Oh yeah, its probably worth saying, back in July my left elbow was bad, but my right elbow was alright (or so I thought at the time). I made up some problems on my board that were easy/comfortable for the left hand, but challenging for the right side. Did a good problem flicking off a 2f pocket for the right hand, and pretty much as soon as I was standing on the floor again my right elbow cained and over the next day or two inflated with swelling.
After that the right elbow was the "bad" elbow, and that incident seems to have caused acute damage - so that's a factor for not climbing (or reducing/constraining the intensity dramatically).

Guess the whole point of asking around is to see what the experience of other people has been, and if they tolerated climbing well or it destroyed their elbows. Not found anyone in the latter group so far, but I've asked climbers, who likely still climb, so there is probably a selection bias there!

 

[webbo]

My elbow is currently clicking a lot and occasionally locks but it’s fairly pain free. My wrists are stiff and often quite painful so doing a press up would be quite difficult. I had steroid injections in both about 4 years ago and they were all right for 3 years. I had this done privately through health insurance I could have had up to 3 but just within a six month period. I saw a consultant who said I could have wrist replacements but they wouldn’t cope with climbing.
So I will get them looked at again when I’ve sorted out my shoulder( just had my first physio session on it today)

 

[sheavi]

"So that's good stuff to know although I'm slightly wary of being guided by symptoms.
With it being the elbows, it feels like you have one chance to not wreck them.
I also did a lot of climbing while being pretty oblivious to how bad they were which doesn't bode well for that approach.

As far as I understand, you can't feel cartilage being damaged, so you are feeling the resulting inflammation. So you'll get the message afterwards, not before or during. If you're trying to preserve cartilage, that's too late really."

You're to be guided by your symptoms more afterwards than during activity unless of course things really hurt. So therefore go easy and see how you pull up the day after etc. If you choose to still climb.

OA pain usually happens once the cartilage is well worn and the underlying subchondral bone, with nerve endings, starts to detect 'noxious' stimuli. Then a cascade of biological processes starts with of course inflammation.