Proactive ways to keep golfer's elbow/medial epicondylosis from coming back

There are loads of threads on here (some of which I've responded to) about golfer's elbow aka elbow tendinitis/osis aka medial epicondylitis/osis but nearly all of them seem geared toward treating and rehabbing the elbow. My question is a little different. I recently purchased a gym membership for the first time since 2011. Not coincidentally, in 2011 just a couple months after purchasing the membership I developed elbow tendinosis which lasted for 2+ years. After it finally improved I've been pain-free since 2015 and climbing as hard if not slightly harder than before (trying routes up to 12b). However, up to this point I have only very rarely climbed more than two times a week, and have never climbed more than once a week in the gym. Now that I have a membership again and am climbing up to three times a week regularly I'm hoping to proactively avoid developing elbow tendinitis/osis but I haven't been able to find much information about what people do to keep it from coming back when they've been pain free for a long time (or perhaps to keep it from ever occurring in the first place).

I am curious about and open to any suggestions anyone has, and especially curious if anyone does the Dodgy Elbows regime purely as a preventative measure, and if so, do you tweak it at all? I'm also open to any suggestions of medical professionals to consult in the Boulder-Denver corridor regarding preventative measures with this particular issue.

Thanks!

I had a similar issue with my elbows. I used a 5 lb dumbell and did both regular and reverse wrist curls. This seemed to work very well for me. Whenever they start to hurt again (usually if I step up my sport climbing or gym climbing) I start doing the curls 3 times per week and the pain rapidly goes away.

The best way to get rid of it (and keep it away) is to simply do the eccentric exercises that apply to your particular case (FCU or pronator teres). Besides that and regular stretching there isn't really any other way to keep it away that I know of.

The only other recommendation would be to improve your climbing form (if only it were as easy said as done) and avoid locking off in excess

Tricep workouts and bench press. Tricep should be 2/3s of the mass of you upper arm. 

Yup; PT for recovering is good PT for prevention. I had a physical therapist get really (pleasantly) surprised when I said I was doing eccentric hammer lowers for my elbows. They also recommended the reverse wrist curls that Cory Brooks mentions above.

You'll have to do the legwork to confirm it, but I've heard a sports doctor say on a podcast that whether your wrist is frequently in flexion or extension on holds (instead of straight) will determine which side of your elbow gets fucked. Maybe focusing on good wrist form is preventative?

For medial tendonitis that is scalable from rehab --> prevention/strengthening my go to exercise is using a unilaterally loaded dumbbell to do eccentric work. You can buy "threaded dumbbell handles and three 5lb plates. Only load one side with the appropriate weight (should replicate the pain you feel, but not be excruciating. use a table, workout bench etc... rest your forearm on the surface with approximately 2 - 4 inches of your forearm off the surface with your arm in a neutral grip position. Slowly.... Very slowly rotate your wrist to the palm up (supinated) position. THEN use your free arm to lift the weight back to the neutral grip position. This is all about eccentric loading, so remove any concentric action as this is partly the cause of the issue. You can also orient your body/arm position to find the sweet spot. I personally find that having my arm straight out (resting on bench) and rotating to be the best. But others have found 90 degrees or 135 degrees to be ideal. Just play around or do a mix of them. Now about weight..... -->  If your inflammation/pain is low(ish) to not much (prevention/strength) aim for a weight that is submaximal but near.. maybe 80-90%.. but make sure you do your warm-up sets appropriately to get everything activated and ready. Aim for 3-4 sets x 8-12 reps per arm. Add weight over time to get the strength/tendon development. I do this.. and other things 2-3x per week. I have very very rarely had any elbow issues and this workout is one that I attribute that good fortune to. Other workouts that I find very helpful for this same symptom are;

- Weighted neutral grip eccentric pull-ups ( Pull up slow..... go down even slower.... add weight that gets you around 6 reps. Peg boards work perfect for this, as do rings with  the added benefit of stabilizer muscle development.
- Hammer curls with dumbbells (don't cradle the upper part of the weight.. grip shit out of the handle)
- Reverse bicep curls (using an EZ bar --> the slight supinated hand orientation helps ease wrist tension. again... slow on the eccentric motion.
- Lastly.. pushing in general, I find that seated neutral grip shoulder press is another great work out for this.

Just be mindful of getting fixated on doing these things to much. Overuse syndrome issues are always our worst nemesis with this sport.

Hopefully this post is helpful for you and any others suffering from this awful problem!

Heavy "eccentric only" wrist curls will both prevent, and help to rid you of medial epicondylosis.

Not heavy eccentric only.. A well rounded fitness regime is fundamentally crucial with many mechanical orientations addressed. I only presented some eccentric additions to what he/she/others may be concentrating on. Nonetheless., most research suggests that the eccentric load component has upwards of 40% more strength benefits than concentric actions.

Real simple.  Arm aid + Thereaband flexbar combo.  Routine maintenance with these should keep all of your pain at bay.

I definitely agree with Jake + Seb on the addition of massage and arm aid use!!!

- One useful stretch/nerve glide I think is helpful post workout or before bed (wont be loading your arms at all) --> On all 4's in table top position(yoga). Place the back of your hands on the floor, rather than palms (digits towards feet). Now.. rotate the eyes of your elbow so that they are facing forward. If your really tight. This will be hard. So make this action goal one. If you can  do it relatively easily, lean back a bit to add more extension. The final bit is the nerve glide part.... In table top, backs of hands flush against the floor, eyes of elbows forward.. try to make a fist while keeping your hands on the ground! (good luck)! This stretch/nerve glide is great and a great way to work on wrist mobility, elbow mobility and minimize nerve impingement from muscular/tendon hypertrophy!

Thanks everyone. Loads of helpful info. I have an armaid and will look into the theraband. Have been doing the tricep workouts as well as well as a general light lifting routine (something I've never done before in my life). 

One thing that's been a source of confusion in the process of researching preventative measures is the idea that, as Shane said, you should "Only load one side with the appropriate weight (should replicate the pain you feel, but not be excruciating." This is similar to the Dodgy Elbows protocol which states that "Fine-tuning the exercises is paramount. The angle of your wrist and elbow can dictate success or failure. If the exercises are not aggravating the condition (that is correct, you read “aggravating”) while you are doing them, change the angle of your elbow." But, if you don't have the pain (as I currently don't, thankfully), these exercises don't really seem tailored to prevention, but only to rehab. I'm wondering if some people simply do the reverse wrist curls, but without worrying about the angle & offset weight. I'd like to avoid doing things that aren't likely to have tangible benefit because, as Shane mentioned, "Just be mindful of getting fixated on doing these things to much. Overuse syndrome issues are always our worst nemesis with this sport." (As a side note, the Dodgy Elbows protocol didn't help my tendinosis years ago, and may even have made it worse, but I suspect I was doing it wrong. That was also before Dr Saunders refined his protocol.)

French curls.