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Inside of elbow pains

Original Post
scdance · · Provo, UT · Joined Dec 2011 · Points: 0

I recently got into climbing and didn't really know my limits until yesterday. I went climbing tuesday, then climbed again Thursday. The moment I started climbing thursday, i realized that I was not completely recuperated and still tight. But I kept climbing figuring it would just go away and I would be good as new. As I started bouldering my elbow really started hurting. It was hard to move at all and only felt better when I would rest it without putting any pressure of any kind on it. It hurts on the inside of the elbow and can't do pullups or anything without feeling the pains again.

Any suggestions on why this has happened and what I should do to get back to climbing as soon as possible?

Rob Gordon · · Hollywood, CA · Joined Feb 2009 · Points: 115

Search the forums for tendonitis. That's most likely the issue. As an overview... Don't overtrain, allow rest of up to 2 or 3 days after hard sessions till you build the muscle/tendon strength up slowly. Don't do campus or hangboard workouts for a long time. Work on your technique. Don't climb too much indoors. Always warmup then stretch your forearms in all directions before jumping on something hard for you. Do reverse wrist curls and other opposing muscle exercises often. That about covers it I think.

Rob Gordon · · Hollywood, CA · Joined Feb 2009 · Points: 115

Also your problem actually sounds a little like my IT band problem in my knee from running too much, so a stick roller might be good if you can find someone to use it on the top and bottom of your forearms.

scdance · · Provo, UT · Joined Dec 2011 · Points: 0
Rob Gordon wrote:Also your problem actually sounds a little like my IT band problem in my knee from running too much, so a stick roller might be good if you can find someone to use it on the top and bottom of your forearms.
Thanks so much, Rob. I will do all of that. I recently also had tendinitis in my knee and shin splints in a training program I was participating in. If you have any questions about that, I would be more than willing to help you out with it. It was a rough injury to say the least. Thanks!
Fat Dad · · Los Angeles, CA · Joined Nov 2007 · Points: 60

It sounds like medial epicondylitis. Take a good break, rest, work your antagonistic muscles and brace it when you start again, slowly. That bothered me for about 5 yrs. before it resolved itself. No joke.

Aerili · · Los Alamos, NM · Joined Mar 2007 · Points: 1,875

Could be medial epicondylitis but without giving us a lot more detailed location there is no way to say for sure. For instance, I get pain on the inside of my elbows from bouldering (or just pulling down many days in a row) but it is definitely not in a spot where m.e. occurs.

Please be more specific with your symptoms and location. Although to be honest, a diagnosis is not that pertinent since the treatment is virtually the same: scale back your climbing frequency, intensity and duration by a large amount or else really fuck yourself up. And if you are actively having pain right now that gets worse with activity, stop climbing for a couple weeks and then start again gradually and see what happens.

Suggestions of performing opposing muscle training is probably not a bad idea. As for stretching, it may or may not help but is probably not going to do much. But hey, it's free and easy, so try anyway.

Rob Gordon · · Hollywood, CA · Joined Feb 2009 · Points: 115

She's probably right about the stretching, but I used to have severe pain in my elbow area for a long time and the tips I gave are what have effectively made it nonexistent. Don't know what specifically was the healing tip, but my guess is the reverse wrist curls and not overtraining.

It's also why I suggested the forearm roller. You can't stretch out the tendons that effectively, but by applying pressure to them it might make them ever so slightly more relaxed and elongated. It doesn't take much to alleviate the issue. (I don't even use weights on the reverse wrist curls).

Also, pure rest was never all that helpful to me. Sure take a week or two off while working opposing muscles, but more important I found was to counteract/prevent the problem.

scdance · · Provo, UT · Joined Dec 2011 · Points: 0

So how long of a rest period do you think I should allow before returning to the gym? I'm pretty antsy about going again and would love to get back out there as soon as possible, but don't want to rush things.

And thanks so much for ya'lls help. I will definitely take all these suggestions into account as I go throughout my normal routine and climbing adventures.

Phalanges · · Unknown Hometown · Joined Aug 2010 · Points: 240

When I started to climb I developed pretty bad climber's elbow after pushing myself for long periods bouldering. I would generally continue to climb through pain, because I still had strength in my arms, and was addicted to my new found passion. From my experience, it's pretty easy to build muscles quicker than you can condition your tendons to handle the stresses of climbing. It took two or so years before I stopped having elbow pain after hard sessions. It's been probably 3 or so years since I had any pain in my elbows from climbing, granted I don't boulder in the gym nearly as much as I used to.

My suggestions would be these:
1.Listen to your body and take the rest that it's telling you to take. Having been through multiple finger injuries, it's better to rest an extra day or two, than not be able to climb for 3 months.
2.Stay out of the caves. Overhanging routes put a lot more stress on your elbows. Work on technique on vertical or less than vertical routes. The less I climbed in the caves the less my elbows hurt.
3.Try to do every move static. I know it's hard because you always want to climb the hardest problems that you can, but staying away from dynamic moves lessens injury risk, while improving contact strength.

Philip Lutz · · Akron, OH · Joined Jun 2010 · Points: 165

Sounds like what I had a year or so ago. I was climbing pretty much all in the gym because it was towards the end of winter, and the inside of my elbows started to feel somewhat sore. So...I did more antagonist training (3x per week shoulder presses/pushups/dips), took advice from Dave MacLeod on the issue and started doing the eccentric part of reverse wrist curls (I also think there was an article in Rock and Ice), and also took more rest days between the lower than usual intensity climbing that I was doing until my elbows felt better (probably like 2 weeks - a month).

Also, I do believe that overhanging climbing puts much strain on the elbows, but climbing statically is physically more straining than climbing dynamically (thus putting more strain on the elbows) and climbing dynamically would improve contact strength because you are forced to recruit the muscles faster (think about doing a big two handed dyno, the moment you touch the hold/holds you need to instantly grap it)

LeeAB Brinckerhoff · · Austin, TX · Joined Aug 2008 · Points: 10,268
Philip Lutz wrote: Also, I do believe that overhanging climbing puts much strain on the elbows, but climbing statically is physically more straining than climbing dynamically (thus putting more strain on the elbows) and climbing dynamically would improve contact strength because you are forced to recruit the muscles faster (think about doing a big two handed dyno, the moment you touch the hold/holds you need to instantly grap it)
It seems as if you have just argued that both dynamic and static climbing are going to be hard on your elbows...you stated as much as far as static climbing and implied it about dynamic climbing, as in dynamic climbing is going to make you grab harder which if the problem is from a muscle imbalance (requiring oppositional muscle training, ie: reverse wrist curls) would also make the elbow hurt....
scdance · · Provo, UT · Joined Dec 2011 · Points: 0
Phalanges wrote: My suggestions would be these: 1.Listen to your body and take the rest that it's telling you to take. Having been through multiple finger injuries, it's better to rest an extra day or two, than not be able to climb for 3 months. 2.Stay out of the caves. Overhanging routes put a lot more stress on your elbows. Work on technique on vertical or less than vertical routes. The less I climbed in the caves the less my elbows hurt. 3.Try to do every move static. I know it's hard because you always want to climb the hardest problems that you can, but staying away from dynamic moves lessens injury risk, while improving contact strength.
Phalanges, these are some great suggestions. I definitely will be using these in the next couple days or so. If I have to climb through the pain I will. Like you said, I just don't want to miss three months of climbing because I was too stupid to listen to my body and what it had to say.

Since I usually go to the gym, is there anyway that I could possibly tell that I am ready before I head to the gym? I don't want to get there, pay, then realize that I won't be able to climb but half an hour because of the pain in my elbow.
Aerili · · Los Alamos, NM · Joined Mar 2007 · Points: 1,875
scdance wrote:So how long of a rest period do you think I should allow before returning to the gym?
For my part, I already stated a couple weeks. That's not a very long time at all. Seriously.

Phalanges wrote:When I started to climb I developed pretty bad climber's elbow
What is climber's elbow?

Philip Lutz wrote:climbing statically is physically more straining than climbing dynamically (thus putting more strain on the elbows)
Let's not make vague assertions for which there is no concrete evidence one way or another.

Philip Lutz wrote:climbing dynamically would improve contact strength because you are forced to recruit the muscles faster
Improving contact strength isn't really a priority in light of the need for rehabilitation. Large, dynamic moves are probably a really bad idea when overtraining is occurring. Lots of static moves are also probably a bad idea.

scdance wrote:Since I usually go to the gym, is there anyway that I could possibly tell that I am ready before I head to the gym?
Not really unless you have pain with other activities of daily living or at rest that diminish with non-activity and give you an idea that you are improving. Hence why it is highly prudent to take at least 2 weeks off and then re-assess with some light climbing.
TimMoore · · NC · Joined Dec 2011 · Points: 5

Someone upthread mentioned eccentric exercises. Here is a link to an exercise that a few climbers have reported have success with. I've never had the problem so I can't vouch for its effectiveness but thought I'd post it in case you might get some value out of it.

ukclimbing.com/articles/pag…

Philip Lutz · · Akron, OH · Joined Jun 2010 · Points: 165

Yes, Lee, you are correct. I did not say that you should climb more statically or dynamically if you wanted your elbows to feel better.

And Aerili, I just wanted to say that I respect you very much, and information you have posted has helped me get through injuries. And yes, I probably shouldn't make broad statements about hard to prove and debatable subjects like climbing style. My response about climbing style and contact strength was purely to Phalanges suggestion to do every move statically and that static climbing would improve contact strength.

scdance · · Provo, UT · Joined Dec 2011 · Points: 0
muttonface wrote:http://www.google.com/url?sa=t&rct=j&q=dodgy%20elbows&source=web&cd=1&sqi=2&ved=0CCEQFjAA&url=http%3A%2F%2Fwww.drjuliansaunders.com%2Findex.php%2Fdownload_file%2F-%2Fview%2F28%2F&ei=IcUUT7aNL8mPsQLSmcGBBA&usg=AFQjCNEV4CdAsbYAcs5pOzXSNEC_BqUxLw It's important to learn and know the difference between tendinosis and tendonitis. Tendonitis is an injury that's brought on by trauma and/or overuse. Tendonosis occurs when the healing and subsequent shortening of the tendon due to scar tissue causes more microtearing of the tendon. It is a recurring degenerative condition of the tendon; not necessarily an injury. Thanks to ignoring my symptoms of tendonitis, I let it (forced it) to develop into tendonosis and I had to take four months off climbing and adhere to a very stringent rehab program. I'm not saying that's what you have, and I wouldn't try to diagnose someone's injury. I am saying however, that if tendonitis or tendinosis is what you have, don't ignore it, and don't try to "climb through it". You'll end up spending way more time in pain and out of climbing if you ignore it than you would have had you addressed it properly to begin with. Listen to your body's pain receptors! Good luck, hope you heal up. If that link doesn't work, google "dodgy elbows julian saunders". Tons of good info in that article.
This was GREAT stuff. I recommend this article to anyone who has ANY pain around the elbow. Dr. J seems to cover many aspects of elbow injuries that a climber might encounter. Good stuff. Thanks sososo much muttonface.
Phalanges · · Unknown Hometown · Joined Aug 2010 · Points: 240
Aerili wrote: What is climber's elbow?
Tennis elbow, golfer's elbow, a catch all for acute elbow pain. Most likely describing tendinitis, but like others said, could be some other more serious things.

Philip, I disagree about the static vs. dynamic argument. Obviously you need to work on both movements to be an effective climber, but throwing to a hold increases your chances of injury (granted probably talking more about pulley ruptures than elbow pain, but still). You are increasing the forces exerted on your body. I'm also a firm believer that trying to do every move static will make you a better climber, if not by increasing strength, certainly by refining technique.

Now your point about antagonist training is a great one, and can definitely help with injury prevention.

Oh, and for the record, scdance, I wasn't encouraging you to climb through pain, just stated that I did, but if your feeling pain, it's your body telling you that you should probably rest more.
Aerili · · Los Alamos, NM · Joined Mar 2007 · Points: 1,875
Phalanges wrote: Tennis elbow, golfer's elbow, a catch all for acute elbow pain.
Except tennis and golfer's elbow are two totally separate things and climber's elbow doesn't actually exist.
Fat Dad · · Los Angeles, CA · Joined Nov 2007 · Points: 60
scdance wrote: If I have to climb through the pain I will. Like you said, I just don't want to miss three months of climbing because I was too stupid to listen to my body and what it had to say.
I'm not sure if this was a typo. If it's not, then you haven't been reading very carefully. Better to miss three months than a couple of years.
Phalanges · · Unknown Hometown · Joined Aug 2010 · Points: 240
Aerili wrote: Except tennis and golfer's elbow are two totally separate things
Okay...inside...outside...lets just call it elbow tendinopathy. I think we're getting caught up in the semantics here. I think my advise is pretty much good for all elbow ailments we are talking about here. Just trying to help the guy out.

Aerili wrote: and climber's elbow doesn't actually exist.
Take it up with Dr. J, not me
Will S · · Joshua Tree · Joined Nov 2006 · Points: 1,061
Phalanges wrote: I think you are getting caught up in the semantics here.
The semantics are important here, and that's what she's trying to get at with a subtle prodding.

Golfers=medial="inside"
Tennis=lateral="outside"

Different mechanisms of injury, different (though similar) mechanisms for treatment.

IMO, excessive volume is the primary culprit in either case. Most people bouldering in the gym can easily have 2.5-4hr sessions before they are totally gassed. This is WAY too long for 98% of the climbing population.

Many train with the idea that you should push yourself as long and hard as possible to get good gains. This is counter to my exerience in over 20+ years of climbing with most of that time involving training on plastic in addition to actual climbing. I've been through many bouts of lateral and medial, yet have avoided any for the last 5 years or so through volume control and periodization.

I remember one of the very early climbing videos, probably Masters of Stone 1 or 2, where Scott Frye was talking about how he trained and it was basically to boulder until your hands were uncurling from giant jugs. This mindset sidelines more climbers than probably anything.

Unless you are specifically training for stamina, you should be walking out of the gym shortly after your performance starts to drop off. But the natural reaction is "I ALMOST had it, let me try again". It's tough to just walk away.

My best advice:

1. Do the antagonist exercises, but as a preventative. If you already have the pain, you've messed up elsewhere. (See: limit your volume, above)

2. Fuck pullups. There is no compelling reason to train pullups and IME they contribute to tennis elbow. You will get plenty of pull strength via your normal bouldering. And despite the lack of a range of motion or specificity, I've been the strongest at pullups I've ever been after not having done an actual pullup in several years. After a hangboard cycle that included lots of added weight on big holds for one of the sets in each workout, I could suddenly do multiple one-arms with either arm. When I actually trained pullups, I could never do one, and my elbows complained.

3. Train with a plan, and err on the side of too little. If anything feels slightly "off", go home. As soon as your peformance starts to drop a bit (unless training PE or stamina), go home. Take 2 days off between hard training bouts. Cycle your training through endurance, power, strength, power endurance to change the stresses around. Take at least 3 periods off every year, with each being 1+ week (I take 10 days after every training cycle and 25-30 after the final cycle of the year).
Guideline #1: Don't be a jerk.

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