Weird pain in upper arm / elbow

I have the weirdest thing going on in my left arm. It seems almost always like bouldering is what entices it. Beasically I get a strange pain feeling above my elbow and the inner side of my bicep and my arm becomes weak, my fingers tingle, etc... I can't climb without making it worse, but the pain totally subsides within a few hours and I can't even determine where I was feeling the pain. I don't see any inflamation or notice any tenderness. I usually have to take a couple days off before climbing again, and need to remind myself to stretch and warm up properly.

This first occurred a couple of years ago while working a boulder problem I had no buisness working, it got so bad I couldn't raise my arm to grab the steering wheel of my car while driving back home from the crag.

I managed to get pretty strong this past year, definately reaching a personal peak in performance, but I always felt limited because I could rarely train on consecutive days without "the pain" returning. I took a couple of months of from climbing this summer and now that I'm returing the pain is appearing after climbing easy, juggy, terrain. Even offwidths and chimneys are bothering it.

Pull-ups dont seem to bring it on, I can do push-ups all day with no pain. Climbing ice never caused it either.

WTF? Pinched nerve?

Any help would be greatly appreciated,

I am fortunate enough to have health insurance at the moment and will be scheduling a doctors appointment asap. Would like to hear if anyone's struggled with a similar injury.

Sounds like tendonitis...tennis/golf elbow. Grip strength gets weak sometimes the pain radiates. Not tender to the touch or inflamed that you can see.

Well if you go to the Docs let us know what they say. Many doctors dont know the forces involved in climbing and what a beating climbers can take.

Ran into the same problem a few weeks ago, with my right elbow. Im just working my way back into rope climbing first before heading back to bouldering.
Icing, ibuprofen, rest and stretching till the pain is gone, i took about a week off. Then dedicated strength training on opposing muscles (i.e. push-ups, bicep curls, reverse wrist curls). Open hand training on a hang board is helping a lot, the intense lock off on crimps seemed to always hurt me the most.

Here are some sites i found info on.

nicros.com/archive/climbers…

podclimber.com/audio/pclb_T…

I would think it's a pinched nerve, either the median or ulnar nerve (or both). It's common to hear of median nerve entrapment down near the wrist. ie. carpal tunnel. But this sort of sounds like a so called 'high median nerve entrapment' But that's more or less a shot in the dark . Let us know what the doc says. I'm curious.

John Neathawk wrote:I would think it's a pinched nerve, either the median or ulnar nerve (or both). It's common to hear of median nerve entrapment down near the wrist. ie. carpal tunnel. But this sort of sounds like a so called 'high median nerve entrapment' But that's more or less a shot in the dark . Let us know what the doc says. I'm curious.

Ditto: I did this to my forearm last year by reaching around awkwardly to hold a sheet of plywood and pulled the tendons, etc. all the way up. Weakness hits all the way up to the bicep some days. Took forever to get it working nice again, but then again I didn't rest it long any time.

I had nearly the exact same issue myself a couple of years ago. For me it turned out to be worse than a pinched nerve in the elbow. After going through the same cycle the pain became unbearable through my left shoulder blade down the arm and this was coupled with numbness in my thumb, index and middle finger. I let it go on for a couple of months before seeing my doctor.

Turned out that I had a herniated (which is now just "bulging") disc in my cervical region. Between C5 and C6 I believe. I now have to get epidural injections every six to ten months to bring the inflammation down. Basically the nerve running through my vertebrae in the area was pinched because of the swollen disc. Portions of my left arm atrophied (sp?) and I have yet to regain strength completely.

Get it checked out asap, I wish I didn't let my problem go so long without care because I'll never get the strength back in my arm they say. At least I have a decent excuse for my climbing as of late. Good luck to you Kevin, I hope it's not serious.

Hey Kevin,

Go see a doc and get it checked out right away. What you're describing sounds like tendonitis, but after what I've gone through over the past 2+ years, it could be something entirely different.

From my experience, I'll give you this piece of advice: Find an orthopedic surgeon who specializes in sports medicine and knows climbers. If you walk into the waiting room and you see a bunch of old people, just leave and find another doctor. Also, if you are prescribed PT, do it all and don't start climbing again just because you're feeling better. Spend the time to rehab and you'll thank yourself later.

If you're interested, I can PM you the name of a very good doctor.

Good luck with this.

Have you tried those "shake-weights"---
They're awesome.....

mountainproject.com/v/gener…

Thanks for all the feedback guys, I'll bump this thread after I visit the doc in a couple of weeks.

Hey Bob, I only use my Shake Weight with my right hand, so hopefully that's not related. :)

Push Ups!!!! I get this regularly if I don't work on "counter" muscles to climbing. It hurts and takes for ever to get rid of. Just start doing 100 push ups a day. Start with 10 push up sets. Its really easy, and for me, it solved that issue completely. 10 push ups at a time really is quite simple, and if you spread them out through the day, its not hard at all.

I'm suffering from tennis elbow from a combination of climbing and biking. Tyler twist exercises have really helped me. Google it.

I have it on my right arm. Saw the doc on Friday.

He said take anti-inflamatory and stay off it until it heals. Showed me how to use my arm in ways that does not stress it. (same diagnosis as 2nd post above) If you put a velcro strap around your forearm while climbing and working it will take stress off the tendons in that area.

He said if I was 22 it would heal fast but since I'm 52, it will be a looong time.

If its the thumb, first and second fingers that are tingling, you are probably experiencing a peripheral median nerve entrapment originating in the pronator teres muscle. Closed kinetic chain exercises are not bothering it bc you are not pronating the hand (action of the pronator teres muscle). Press hard on the upper inside forearm near the elbow (or check the internet for where the pronator teres m. is). If its super painful, thats prob what is going on. Get a rolling pin or a strong pair of thumbs from a friend that likes to inflict pain on you and rub is out. Cross friction at the origin of the muscle. Let me know what you find and well go to plan B if that doesnt work. btw, Im a chiropractor, we can get this solved for you!

Hi Kevin,

Hope things have worked out with you. If not, you may want to consider seeing a really good Certified Hand Therapist (CHT). A CHT is a physical therapist that deals exclusively with the upper extremity. If you happen to be traveling through Boulder, I have been very happy with John Lewis @ BCH who has always been spot-on with his diagnosis (before the docs could say what was going on), and he used to do a little climbing.

Tingling in fingers is frequently tied to a nerve impingement or entrapment -- that can be local to the issue or entirely somewhere else between the pain and the spine. If muscular control/strength was affected, then that is an advanced stage to be extremely cautious with (i.e. I wouldn't go do 100 pushups a day until you know what's going on).

While climbing may be a strong contributor to the issue, these issues can also stem from other activities (typing, posture, etc) or things you're entirely unaware-of (e.g. sleeping with your arms bent at night).

There are tons of conservative treatments are available, and sometimes they're successful... but they do take time.

Take it from someone who has had related surgery and dealt with nerve issues for years... nerves are very sensitive and once aggravated take a really long time to settle down again.

Best of luck with your recovery.

en.wikipedia.org/wiki/Tinel…

Well shit, I finally got around to seeing a doctor regarding this issue.

My doc's feeling is that of Ulnar Nerve entrapment -

I'm going to get a second opinion and persue an MRI, to rule out other issues, but I hesitate with nerve response testing because ultimately it's just an attempt to justify surgery, which could potentially take me out of climbing for six months at the very least. I feel like if it is entrapment around the Ulnar Nerve, I may be able to continue progressing and training despite the occasional flair up of pain - which I've done successfully now for the past few months. My concern is that if I continue climbing the entrapment issue could get worse? My doctor seemed pretty confident that I would continue climbing - but my concern is that of a build-up of scar tissue where ever this entrapment may be (if that's what it is...) could potentially make things worse?

All doom and gloom aside, I'm climbing/training four days a week on average, reaching a personal peak in performance and fitness, and generally feel like I've gotten a handle on how to train/climb with this injury.

Any thoughts on how to proceed, or input from other climbers with entrapment issues?

Thanks everyone -

Hi Kevin -

Before you consider surgery you should get a nerve conduction study and an EMG and also try conservative management if you haven't already (ie; PT). Depending on what the cause is, you may be able to treat it conservatively with success, but you need a good PT (there are several in the Ft. Collins area, PM me if you need a recommendation - I am on faculty in the PT School at Regis U).

Here is my story: I am currently in the process of scheduling ulnar nerve transposition surgery with a possible ulnar collateral ligament reconstruction (waiting for results from another MRI to decide that). My original injury was almost 10 years ago with a ski accident (I had a partial UCL tear, radial head fracture and tore the ligaments that hold the ulnar nerve in place in the groove), but it got better after about 6 months of PT at that time. It would bother me off and on over the past several years, but I was able to manage it with stretching and exercise.

This past summer I amped up my climbing a lot (3-4 days/week, more overhanging stuff). This combined with an awkward fall where I caught a rope behind my arm and hyperextended the elbow again has made it unmanageable. After 4 months of trying to fix myself (I am also a PT), I sought help.

My nerve conduction/EMG study showed slowing in the nerve at the elbow and my ulnar nerve is unstable from the original injury (won't stay in the groove). I would not even consider surgery if it wasn't for those 2 things. ie; as long as the nerve is popping over the bone, it is going to be getting traumatized and I have signs of nerve damage which may still be reversible at this point if we can stop the repeated trauma. PT still helps for symptom control, but it can't correct the mechanical damage and I can't participate in any of my sports (climbing, cycling, rowing...).

I guess my point is, you may be able to calm the nerve down and manage it for a very long time without resorting to surgery if you do not have a structural defect in the elbow anatomy. From your post it sounded like you did not have a clear traumatic event, so you may be a good candidate for conservative management.

One other thing - get a second opinion. Surgeon #1 was deadset on doing a subcutaneous transposition on me and wasn't interested in the possible UCL damage (my elbow is unstable). I was uncomfortable with that and surgeon #2 told me he would never do a subcutaneous transposition on someone like me because I am thin (the only thing that protects the nerve with that approach is fat under the skin and I don't have much) and because I rock climb (very superficial nerve on the forearm + edge of crack = more nerve damage). So he is going to do a submuscular approach - much longer rehab but much better outcome for someone who is active. He also recognized that an unstable elbow is still no good, even if the nerve issue is fixed, hence the repeat MRI (he couldn't tell from the 1st one because they used the wrong settings!).

Sorry for the lengthy post - I have just been shocked by some of the advice I have been given (by some not-so-good PTs as well as surgeon #1) and my experiences being on the 'patient' side of things. People have to be very proactive in their care, and research options as well as medical providers.

Good luck, and please keep us posted - I am interested in how these injuries are treated - never realized how common they are in climbers.

Hey Kevin,

Ditto what Erika said besides the elbow instability. I've been recommended Submuscular Ulnar Nerve Transposition, but have put it off and kept climbing in the meantime. If I avoid strenuous overhanging pitches I can climb all day, so it's not an absolute climbing killer for me. I do have the ulnar nerve 'subluxation', the phenomena that Erika referred to when the nerve comes out of the groove. Did your doc try to recreate the problem and see if the nerve subluxates? If the nerve isn't physically moving out of the cubital tunnel, you might be a candidate for a much simpler ulnar nerve decompression which means less recovery time :)

I would say always get at least a second opinion when the first doc recommends surgery.. Most of the orthos I've been have seemed quick to cut.