Do you train heavy pull ups? Help w/ elbow pain.

Hi, I've done so much research on this, seen a dr, gotten an MRI, and asked a PT friend with no luck. I'm starting to wonder if it is two injuries. My dad told me to amputate, please save my arm.

When it hurts
Only deep lock offs, like a campus board (L1 - R4). I don't think it has ever affected my daily life, but climbing outside 2 days in a row or trad make it worse. Weighted pull ups definitely bring it back.

Where it hurts
I think I had lateral epicondylitis / osis, whatever. It's a very deep, throbbing pain. I've had it both arms, multiple times over the years and immediately after my last bad injury (outdoor bouldering) it was excruciating when climbing. Builds slowly and I ignore it for a bit, but An hour into climbing it's crippling before I realize I need to take a week off. No pain when climbing, only after I jump off and it debilitates me for 5 minutes. So I don't think it's lateral epicondylitis bc that's supposed to get better when warm. I think it was a tear.

Why I need help
I did the PT diagnostic tests for tennis elbow and there's no pain at all now. I did the standard tennis elbow eccentric exercises religiously for a year. Stretch, strengthen, rest/easy for a month multiple times and the tennis elbow spot seems better. Palm down eccentric bicep curls were the latest exercise that helped push through the last bit of day after climbing tenderness. A full month off did nothing, it came back the next day back. But climbed outside 2 days and today I felt pain again and I can't get back to training, weighted pull ups have been off the table for a year. My brachioradialis seems to be sore, and my distal tricep is where i feel the pain now. Very deep, only during lock offs, and a year after the major injury. But recurring. Thinking back it has been my weak spot for a long time.

I've done slow eccentric dips, no pain. Palm up bicep curls hurt a bit today, unusual for me, but mainly lock offs cause pain. Am I missing something? If I cover tricep/bicep/brachialis/brachioradialis and back of forearm is there really anything else I can rehab? Anybody training heavy pull ups with advice?

Thanks.

Thanks, I will look into supplements and fluoride. Haven't put much thought into that in the past.

As for triceps, train equally, not really. I do train at times though when I try to hit all antagonists. The pain seems to be distal upper arm, at the back, but only at the very edge of the tricep tendon... Slightly higher than lateral epicondylitis. I've never noticed any pain during skull crushers or weighted dips though. But due to my long term lack of focus tricep tendonosis would make sense after my first injury a long time ago.

Do you have any suggestions for tests or exercises to check it out? Or a good routine I could incorporate? It sounds like any of them using slow eccentric motion will do it. Kickbacks, dips, palm down bicep releases, french press. I'll try it for three months I suppose and then try some weighted pull ups again...

Any other ideas.

I trained heavy pull ups for years with no pain. About two years ago, I got back on the train and started up again, but added weight too quickly. I quickly developed elbow pain.

I ended taking a year off and the elbow pain did go away. I now train weighted isometric hangs. I still do pull ups, but no extra weight and stop at the first hint of pain.

I think the only solution is time off! If something hurts stop doing it.

Since you're already stretching every fiber in your forearms and performing some massage, and drinking PLENTY of water, I'd try the following:

First, COMPLETELY remove all sugar substitutes from your body: no saccharine, sucralose, aspartame, high fructose, et al. None. While you're at it, check the rest of your diet. Read all labels.

Second, if you're training high-rep (12-20), stop. Start training heavy/power (3-10 rep).
Stop doing pullups, and try body-weight chin ups (inside shoulder-width grip). Don't go to failure, just pull out a comfortable few sets to start.
Also, start compound exercises with strict form. heavier weight, but strict form. . . of course like everything, start light and focus on form and work your way up.
Check your ego at the door. No one but you cares how much you lift. Well, that one hot chic does, but f' her, she's shallow and indecisive anyway.

Back to compound movements:
Do deadlifts and squats and bent rows and flat bench and maybe widegrip barbell curls, and overhead presses, etc. If it hurts your elbow, stop and change your grip or change your exercise.
You may also want to try a fatter grip - make your own or you can buy "Fat Gripz".

I think you need to change it up. And again, check you diet.

I've had elbow issues, and these changes helped me immensely, and quickly.

Good luck

I had some deep throbbing pain as you did a few years ago. It would slowly build to a deep pain that hurt so bad my arms would be shaking at the end of a session. Bouldering, anything overhung, pullups & bicep curls really triggered it.

Ended up taking 8 months off consistent climbing (climb lightly 1x a month and stopped bouldering - only sport endurance laps), did the eccentric exercises, and focused on balancing the muscles (push ups after any climbing sessions, tri workouts, shoulders, etc). I also began to focus on more technique and balance rather than relying on strength.

I only occasionally have elbow pain, but I make sure to stop if I feel it coming. Been thinking about getting armaid. I hear that helps.

Try going to a PT who does ASTYM. It is a great therapy for any type of superficial tendinitis pain. Look up what is online and find a therapist near you. You probably also need to stretch the muscles attaching at the joint more thoroughly as well. Rest alone won't fix the problem, it just makes you lose strength.
ASTYM is awesome because it fixes the problem and keeps you climbing. Again you have to stretch out the muscles. I was crippled by elbow and wrist tendinitis but met a PT who did ASTYM and taught me how to do it. Now I treat myself when pain arises and climb 5.12 at age 42.

I am in the medial field so have friends who are arthropods etc. I did the steroid injections, I did rest for several years, tried plain old physical therapy, tried wrist splints etc. and missed out on some great climbing years in my early thirties. I have taught many people how to take care of their tendons with ASTYM technique. It basically uses a plastic tool to scrape the scar off the tendon by pressing down on the skin with a tool such as a pot scraper. I have not missed any climbing days since I learned the technique and now every friend who climbs uses the technique when they get some tendinitis. It works great for most types of scar related injury. Tendinits is basically micro tears in the tendon that heal with scar that is dysfunctional. Try it, I wish I had learned about it 6 years earlier than I did. Check the link below for more info

youtu.be/TKQQeG_Zi48?t=1m14s

Try this:
m.youtube.com/watch?v=we4Uo…

Steroid shots tend to be temporizing. I've seen mixed results in the literature with plasma injections. Tincture of time with adequate rest probably is the most effective treatment but it may not resolve for a couple of years.

Here's something simple to try that certainly won't hurt you, but could possibly help you. A lot of my clients and athletes present with elbow pain and think it's caused by something above the elbow (sometimes this true). They get frustrated b/c they think they need to do more pull-ups, upper body strengthening, etc, but sometimes this makes the problem worse. Quite frequently elbow pain is caused from below the elbow, by overworked forearm flexors and extensors. A few sessions of soft tissue work later the pain goes away. Disclaimer - I'm a Certified Strength and Conditioning Coach with 10 years of experience (and avid climber), but as always, please seek the advice of a qualified physician or physical therapist. Hope this helps, please keep us posted!

For sure an imbalance between tricep and bicep. Had the same thing when I was younger.

Sounds like golfers elbow or Medial epicondylitis.

Usually this pain is worse on lock offs, but surprisingly overhand routes where you keep your arms straight and do more drop knees won't cause the same pain. Seeing a specialist if the pain is severe is essential (preferably one who has worked with climbers before). Other issues can cause elbow pain such as shoulder mobility, and thoracic mobility (neither of which will get better by the larger muscle group movements others are recommending e.g. dips, etc.).

However, if it isn't terrible, there are exercises and stretches that can make it better. Also, if you know a route causes you to do alot of lock offs, try to avoid it for the time being.

summitmedicalgroup.com/medi…

Eccentric Wrist flexion with a weight that is tough up to causing a slight pain for 10-15 reps, 5-6 sets a day helped me. Also altering technique so that I used more dynamic moves instead of static locking off has helped.

The stretch below I try to do at least once a day for 60 seconds, and more often when I have time. There is anecdotal evidence from climbers that this has helped them.

tomrandallclimbing.wordpres…

A good read for more information on any climbing inury is Dave MacLeod's Make or Break.
amazon.com/Make-Break-Climb…

Best of luck.

For what its worth I am a licensed PT who has dealt with my own issues and treated others' epicondlye problems.

Fine recommendations above. To supplement mentioned suggestions:
Armaid - this thing worked great for me. Useful in treating extensors, flexors, biceps, triceps and any other underlying tissues/anatomy.

If you can perform without pain I would train/strengthen your finger extensors.

I would also look into doing nerves glides/flossing and maybe some gentle tensioning (radial, median, ulnar). Our nerves are supposed to slide and move as we move and can become restricted as surrounding musculature becomes more dense (hypertrophied) or tense. Restrictions could create some of your issues. Also performing self IASTM along nerve paths can assist in this. While your symptoms do sound muscular, adding this in couldn't hurt and ensures you are addressing all possible factors.

These are all things I found helpful in treating my own issues as well as patients of mine. And as mentioned, rest from from climbing is honestly gonna be the best for it. And then performing these as your symptoms allow. Still remain active but lay off climbing (or get your slab on). Do yoga and other cross training to keep you sane.

If you PM me your email I can send you some pictures of above mentioned things and some shoulder and thoracic exercises (posture, posture, posture...) that could be helpful.

I used to train pullups, max sets of bodyweight (~30 reps/set, non-kipping) in phases and heavy weighted (typically 3-4 sets of 6 reps at +50% bodyweight) in phases. And yeah, my elbows started hurting. At the time, I could not do a one-arm.

So I didn't do any pullups for about 3-4 years (well, no more than 3, at bodyweight, when warming up). I trained on a hangboard regularly, with very heavy (up to 2/3 bodyweight added) weighted hangs. Despite no pullup training, I could suddenly do multiple one-arms with either arm.

It is not simply a triceps imbalance. I have very good tri strength and would routinely burn off the military kids that I lift with(I'm 40s, these guys were mid 20s) on tri cable pushdowns and similar, despite them outweighing me by 50-60lb, and despite them training hard on pushing exercises.

My prescription for you is: STOP DOING PULLUPS. If you can do 10 in a set at bodyweight, there is basically no reason to train them (unless you are a world cup ice climber maybe). I coach a few girls who can't do more than maybe 8 in a set and they climb mid 13 and a couple of them have bouldered double digits. Pullups are wildly overrated as a training exercise for rockclimbing.

As always, IMO, YMMV,etc.

NickSch wrote:For what its worth I am a licensed PT who has dealt with my own issues and treated others' epicondlye problems. Fine recommendations above. To supplement mentioned suggestions: Armaid - this thing worked great for me. Useful in treating extensors, flexors, biceps, triceps and any other underlying tissues/anatomy. If you can perform without pain I would train/strengthen your finger extensors. I would also look into doing nerves glides/flossing and maybe some gentle tensioning (radial, median, ulnar). Our nerves are supposed to slide and move as we move and can become restricted as surrounding musculature becomes more dense (hypertrophied) or tense. Restrictions could create some of your issues. Also performing self IASTM along nerve paths can assist in this. While your symptoms do sound muscular, adding this in couldn't hurt and ensures you are addressing all possible factors. These are all things I found helpful in treating my own issues as well as patients of mine. And as mentioned, rest from from climbing is honestly gonna be the best for it. And then performing these as your symptoms allow. Still remain active but lay off climbing (or get your slab on). Do yoga and other cross training to keep you sane. If you PM me your email I can send you some pictures of above mentioned things and some shoulder and thoracic exercises (posture, posture, posture...) that could be helpful.

^ listen to this guy. You just described my life for the past few years. Nerve glides and shoulder exercises are what has allowed me to continue to increase my climbing difficulty level. For about 10 years, not kidding, I thought I had LE. I was wrong. I finally found a PT that was able to figure out that it was a pinched nerve in my shoulder that was making my elbow hurt. It had nothing to do with my elbow at all, it just felt like it was my elbow. Can't say for sure you're the same as me, but it certainly sounds like it.

Will S wrote:I trained on a hangboard regularly, with very heavy (up to 2/3 bodyweight added) weighted hangs. Despite no pullup training, I could suddenly do multiple one-arms with either arm.

This is interesting Will, and not the first time I've heard a story like this. Do you attribute your increased pulling strength to hangboarding? It doesn't seem like isometric hangs would translate that well into doing one-armers. Or is it a combination of things like bouldering, lifting, etc? Pullups always wreck my elbows too when I start getting over zealous, it would be nice to not feel like I need to do them. Thanks

KevinCO wrote: Collagen Type 1 & 3 are the building blocks for tendon and ligament repair. Use this recipe: _ 1 scoop Collagen Type 1 & 3 (Neocell brand, buy powder instead of capsules)

What happens when your body digests collagen? It is broken down into the same amino acids as any other protein product you eat. Don't bother wasting your money on expensive supplements, just eat a well balanced diet.

will ar wrote: What happens when your body digests collagen? It is broken down into the same amino acids as any other protein product you eat. Don't bother wasting your money on expensive supplements, just eat a well balanced diet.

I wouldn't waste your time arguing basic food chemistry with someone who talks about "structured water". Sounds like something straight out of homeopathy.

Gunkiemike wrote: I wouldn't waste your time arguing basic food chemistry with someone who talks about "structured water". Sounds like something straight out of homeopathy.

^+1

You might want to try reading or listening to one of the books by Dr. John Sarno...the Mind Over Back Pain guy. It's worked for me and for some friends, family members.
Not everyone buys into it, and some people are downright offended by it, but his theory is not restricted to back pain.

K Swisher wrote:You might want to try reading or listening to one of the books by Dr. John Sarno...the Mind Over Back Pain guy. It's worked for me and for some friends, family members. Not everyone buys into it, and some people are downright offended by it, but his theory is not restricted to back pain.

The issue with the statement above is that in science a theory involves a well substantiated explanation acquired through the scientific method and confirmed though observation and experimentation (1). Can you show me the research that confirms this information? I haven't been able to locate any real research in medical journals. The only real information I could find was a website and book that Dr. Sarno makes money from.

1. Science and Creationism: A View from the National Academy of Sciences, Second Edition ( 1999 ) nap.edu/openbook.php?record…

As I said, it's something that worked for me. If you are desperate for some relief, it's an idea you might want to try. It's up to you.
Yes, if you buy a book Dr. Sarno will make some money, but if it works for you it was money well spent. Just an idea like all the others offered here, take it or leave it, your choice.

Daniel Winder wrote: Do you attribute your increased pulling strength to hangboarding? It doesn't seem like isometric hangs would translate that well into doing one-armers. Or is it a combination of things like bouldering, lifting, etc?

Hard to know Daniel. As you suspect, I was also climbing, bouldering and training on a campus board occasionally. We always hear about how isometric doesn't translate to full range of motion, that strength gains are joint-angle specific with about 10degree carryover either side, etc.

I do attribute some (probably most) of the gains to the hangboarding, because the sticking point for many people, including me, on heavy pulls is at the bottom. Once you get around 90 degrees bend in the arm, most people could continue to the lockoff/top position and the hangboarding is all in that bottom part of the range of motion.

In any case, I remember a Will Gadd article from maybe 10 years ago where he talked about going to a climbing comp, being able to burn off everyone there on the pullup bar...and still getting his ass kicked in the comps by guys couldn't do 10 in a set.