Yet another dodgy elbow thread

You read the title.

Specifically, I've got the lateral version.

So yeah, I've had medial elbow tendonitis before, it bothered me but never stopped me. This is different. It built through the fall and is just killing me now. I think I've climbed 4 times or so since November. That includes the wall or anything else. If anything, I'd say that it's getting worse. If I pick something up with an extended hand and a pinch grip, it sends a burning sharp pain into my arm.

I can't hardly do little projects in my garage. I can't really hold onto a hammer or a drill. I manage at work but I do agitate it now and then. I've all but given up on starting to climb again. A compression sleeve helps for things like bike riding but it doesn't seem to help me to heal.

I expect the first comment to be "go see a doctor". Fine sure whatever, I can do that. I already know what will happen, he'll poke and prod it a few times and give me a cortisone shot. Cool, I'm sure it'll feel better for a while. Then he'll tell me to take it easy, even though I couldn't really be taking it easier. Next visit a few months down the road, all my symptoms will be back and he'll want an MRI. Bilateral elbow MRI sounds simple enough, I'm sure my shitty insurance will love it.

I know a bunch of people here have dealt with this same problem and not gone through the waste (money and time) of seeing a doc. There are multiple protocols online about it. So my question is for those who've helped themselves, what specifically did you do?

Any good doctor would not do what you just said, if they do, go see a different one. Find a doc to refer you to physical therapy (if you need a referral). There they will help you build strength around the tendon through antagonist, resistance, and negative rehab-level strength training.

Get the theraband flexbars and use them as prescribed by your PT.

Get the flex bar as stated above and gradually build up with that.  And use one of these Wave Tools to break down the unhealthy scar tissue and help with remodeling and laying down new , healthier tissue in the tendon.  Lots of videos on the website to learn how.  Or go see a Physical Therapist who does IASTM or ASTYM to learn how to use these Edge tools for Tendinopathy conditions.

https://wavetoolstherapy.com/

Don't get a cortisone shot for this.  Not a good option.  Could lead to tendon rupture and other unpleasant side effects.  

I found this website to be helpful. I use the wave tool and flexbar and it seems to help - wave tool 3x a week and flexbar 4x a week. I previously have not done any eccentric wrist exercise but I've been adding that in to see if it helps. Although the website below hints that eccentrics are the main way to feel better, static stretching seems to help me a lot. I sometimes can't really use the flexbar since my elbow just feels too stiff. I do 15 palm stretches with a bent elbow and a straight elbow for 10 seconds for each rep. I do these stretches daily while I walk my dog, but these stretches alone won't help.. I just found they are a good way to warm my elbow up so I can do a flexbar when my elbow is pissed off. 

http://stevenlow.org/overcoming-tendonitis/

I suffered with tendinosis since last November and now finally I'm almost 100% pain free.  I thought it was just tendonitis at first and never went to a doctor or P.T., but I knew after a month of it bothering me it was something else.  I tried acupuncture along with shockwave therapy with minimal results.  My elbow would feel good for a couple days to a week after the treatment but then the nagging pain returned.  I did borrow a TheraBand flex bar from a friend and I could tell that using it consistently did help, so I suggest getting one, but I think one of the best things that you could do to heal your elbow through rest and diet.  You should do some research into foods that supposedly help with tendon issues as there are many different foods that could help, but I did find myself drinking a lot of bone broth and one supplement that I feel did help was PhysiVāntage Super Charged Collegen.  https://trainingforclimbing.com/physivantage-supplements-climbers/  My wife was training for her first marathon and was also using the product and she could tell it helped her recover quicker from her long runs.  I hope some of this information helps and good luck with your elbow!  

Justin Compton wrote: I suffered with tendinosis since last November and now finally I'm almost 100% pain free.  I thought it was just tendonitis at first and never went to a doctor or P.T., but I knew after a month of it bothering me it was something else.  I tried acupuncture along with shockwave therapy with minimal results.  My elbow would feel good for a couple days to a week after the treatment but then the nagging pain returned.  I did borrow a TheraBand flex bar from a friend and I could tell that using it consistently did help, so I suggest getting one, but I think one of the best things that you could do to heal your elbow through rest and diet.  You should do some research into foods that supposedly help with tendon issues as there are many different foods that could help, but I did find myself drinking a lot of bone broth and one supplement that I feel did help was PhysiVāntage Super Charged Collegen.  https://trainingforclimbing.com/physivantage-supplements-climbers/  My wife was training for her first marathon and was also using the product and she could tell it helped her recover quicker from her long runs.  I hope some of this information helps and good luck with your elbow!  

Honestly - I lost a lot of respect for Eric Horst after he started this supplement stuff. I don't think there is strong evidence to support that the collagen does anything. I've taken some collagen protein shakes and am just suspicious that it could be that much of a game changer. Maybe if your diet was just naturally low in collagen I could see how maybe coupled with eccentrics the supplement could help. But at the end of the day I doubt it does anything and anecdotal evidence isn't sufficient. 

See reddit.com/r/climbharder/co…

for a discussion

A couple of years ago I had some persistent elbow pain from ARCing, maybe also from working at a computer too much. The Tyler twist with the flexbar helped me, though I no longer ARC because I am concerned the pain will come back (also ARCing was really, really boring and I'm not sure I got anything out of it).

I initially read it as Doggy elbow and was about to have a conversation about massage for retired elderly Crag dogs.  

Rest never made my ET better. Rest reduced inflammation when it was bad, but did not solve the issue. I had ET on and off for 3 years.

My ET was SOLVED through PT work. For me that meant really focusing on tricep workouts; bench, pushups, tri-extensions.

Climbing overdeveloped my biceps, lats, and forearm flexors. So I built up my triceps, pecs, and forearm extensors and haven't had ET in 2 years since I started workouts focused on building antagonistic muscles.

Pushups
Reverse wrist curls 15-20lbs
Pronators with 3lb sledge (one direction only)
Flex bar
Arm aid
Wave tools
PT
Hydrate
Eat well
Climb slab for a while

Lots of boring work unfortunately. 

Hey Alpine Toots (your version is better), sorry to hear about your epicondylosis. I've been suffering it myself for a few months now. Both left and right medial and most significantly left lateral. The extended arm pinch and lift/extend your forearm motion hurts like hell just as you describe. Funny thing is I'm pretty sure I injured my lateral by trying to strengthen my medials following the Dodgy Elbows advice from both those articles. One day after doing the exercises for the medial side, the lateral side started hurting so I backed off and took a break for a few days. Then when I tried doing them again the lateral hurt like hell and didn't stop hurting.

I've had all of the same BS from doctors, "if it hurts, don't do it." Yeah no shit, thanks for nothing. Finally, after about a month poopy pants attitude, my gf made me go see her physical therapist (she has been going for almost a year now for a torn meniscus in her knee). I brought the Dodgy Elbows articles in with me and the PT looked them over and asked me a lot about climbing and what about it makes my elbow hurt (he's not a climber, but was really open to hearing everything about it). Anyway, he started me on some exercises that I did reluctantly and with a huge gulp of skepticism, but after about a month of going three days a week I'm cautiously optimistic that it's starting to get better. He told me to keep climbing but go easy and use it as a gauge to determine if there is improvement. I go on the weekends and climb easy and report back to him and we go from there.

I think it's going to be a long process, but seems like it'll work. Going to the PT forces me to do the exercises that I might laze out of on my own. And finding the right PT will make a difference too (I'm fortunate to have a PPO health plan that allowed me to go to a PT without a Dr referral). To paraphrase the good Dr.'s Dodgy article comment we have to strengthen our way out of this predicament just as we likely strengthened our way into. At least that's been my general experience so far. Good luck.

KrisG wrote: Hey Alpine Toots (your version is better), sorry to hear about your epicondylosis. I've been suffering it myself for a few months now. Both left and right medial and most significantly left lateral. The extended arm pinch and lift/extend your forearm motion hurts like hell just as you describe. Funny thing is I'm pretty sure I injured my lateral by trying to strengthen my medials following the Dodgy Elbows advice from both those articles. One day after doing the exercises for the medial side, the lateral side started hurting so I backed off and took a break for a few days. Then when I tried doing them again the lateral hurt like hell and didn't stop hurting.

I've had all of the same BS from doctors, "if it hurts, don't do it." Yeah no shit, thanks for nothing. Finally, after about a month poopy pants attitude, my gf made me go see her physical therapist (she has been going for almost a year now for a torn meniscus in her knee). I brought the Dodgy Elbows articles in with me and the PT looked them over and asked me a lot about climbing and what about it makes my elbow hurt (he's not a climber, but was really open to hearing everything about it). Anyway, he started me on some exercises that I did reluctantly and with a huge gulp of skepticism, but after about a month of going three days a week I'm cautiously optimistic that it's starting to get better. He told me to keep climbing but go easy and use it as a gauge to determine if there is improvement. I go on the weekends and climb easy and report back to him and we go from there.

I think it's going to be a long process, but seems like it'll work. Going to the PT forces me to do the exercises that I might laze out of on my own. And finding the right PT will make a difference too (I'm fortunate to have a PPO health plan that allowed me to go to a PT without a Dr referral). To paraphrase the good Dr.'s Dodgy article comment we have to strengthen our way out of this predicament just as we likely strengthened our way into. At least that's been my general experience so far. Good luck.

Kris what exercises did your PT have you do? Thanks for your input. I think PT is really important here but I have been surprised by my interaction with some PTs that had similar sentiment as your Dr. 80% of the PTs I have been to were really interested in learning more about climbing and were open minded to me describing the specific things that seem to piss off my elbow, if they didn't already understand something about climbing. 

John L wrote:

Kris what exercises did your PT have you do? Thanks for your input. I think PT is really important here but I have been surprised by my interaction with some PTs that had similar sentiment as your Dr. 80% of the PTs I have been to were really interested in learning more about climbing and were open minded to me describing the specific things that seem to piss off my elbow, if they didn't already understand something about climbing. 

Hot pack on the elbow for about ten minutes first, then stretches: arm extended out with wrist bent down 30 seconds then up 30 seconds (using opposite hand to push/pull my hand into the stretch), 3 times each. The routine is a mixture of the following exercises:

Rubber band fingers extension: start with all fingers together and rubber band around the outside of all fingers, expand open then a slow (5 count) return back together. 3 sets of 10 (3x10) for 30 total extensions. The key to this one is the slow 5 count back together.

Ball squeezes: I don't know what kind of ball it is, but it's kind of like a cross between a racquetball ball and nerf ball. Anyway, hold the ball in the offending hand and touch each finger to your thumb squeezing through the ball with just each finger/thumb one at a time. Pinkie finger to index finger then back down to pinkie finger and back to index finger for 30 finger/thumb touches.

Resistance band: sit with offending arm braced on quad/knee and hand sticking out off your knee. With palm down, grasp the band between middle and ring finger and make a fist to hold the band, step on other end/middle of band with foot (on same side as forearm you're working) to provide resistance and extend your wrist/back of your hand upward then slowly lower back down for a 5 count. Do 3x10, and again the key is to lower slowly. Next flip your hand over and grasp the band the same way between middle and ring finger and do wrist flexors (no slow 5 count lowering here). Finally, do ulnar and radial extensions with the band. For Radial, brace your forearm on your leg while sitting like before. Grab the band with palm facing toward your opposite knee or inward, step on the other side of the band for resistance, and rotate up your forearm upward, then back to neutral position. Do 3x10. For Ulnar, hold the band with both fists palm down about 6" apart and arms extended out in front of your chest. Using your "good" hand to hold the band and provide resistance, bend your wrist outward such that you're working it in the last direction you haven't yet done (the Ulnar direction). Basically you're working all four wrist/forearm directions, extensor, flexor, and side to side in both Ulnar and Radial directions with these exercises. 3x10 for each.

Theraband Flexbar: Grasp the bar with both hands palms down, one on each end, extended out in front of your chest. Rotate the hand of the hurt forearm back and the other hand forward a little and slowly rotate the hurting side back to neutral starting position. 3x10.

Dumbbell rotation: Grab a lightweight dumbbell (3-5 lbs) and hold it on its very end (vertically upward) in your palm-up hand braced on your knee as before. Rotate your wrist (and forearm) downward until the dumbbell is vertically downward and return to starting position. 3x10.

Forearm extensions with dumbbell: Sitting with forearm braced on quad/knee and hand hanging out off the end of your knee. Hold a dumbbell in your hand palm down, wrist straight. Extend your wrist up then slowly lower back down (5 count). 3x10. I started with 5 lbs I think and worked up to 10lbs.

Dumbbell curls: Good 'ol bicep curls. I started with, no joke, 3lb weights and holy mother of Mary did I feel that by the end in my hurt forearm. Eventually I used 10lbs and they tried giving me 15 at one point but it hurt too much on my medial tendon (go figure...) so I stuck with 10s. Here you just take it easy and laugh to yourself that the elderly patients are curling more than your 5.12 pipe cleaners can handle. Do 2 sets of 10 each of regular curls, hammer curls and reverse curls. So 10 regular, then 10 hammer, then 10 reverse. Rest a sec. Then repeat.

Arm bicycle: It's a machine at the PT place. And it's exactly what it sounds like. 5 min or so, medium resistance.

Standing rows: Using machine, do 3 sets of 10 lat. rows.

Standing Lat pull-downs: Using machine, do 3 sets of 10 lat. pull downs.

These are all the exercises I can recall that they had me do. Again, I never did all of these in one session, but a subset like 10 of them. I did pretty much always do the first three I listed including all the resistance band ones, and after a few sessions pretty much always did the Flexbar and dumbbell stuff too. The PT really emphasized the slowly releasing or lowering or what-have-you on those particular exercises, and stretching too. You can't stretch too much basically (but you can over stretch...).

I absolutely suggest seeing a physical therapist, a good one will have you right as rain within a month or two. Research to see if you are able to go directly to a PT because in Colorado you are able to do so without a referral.

These are mostly good ideas here, however a good PT will develop a specific game plan tailored to your anatomy and issues.

I agree that seeing a general practitioner for these sorts of soft tissue injuries can feel rather pointless but you may need to see one for a referral. 

Armaid- mentioned above. Works pretty good 

Dolphin push ups.

i had severe tendinitis years ago, nothing seemed to help until i had PRP - i know it doesn't work for everyone but it was a miracle cure for me and i haven't had a relapse.

All that they said. I put off actually dealing with mine for long. Just took the winter off to deal with it. Really low intensity ( I would let go if climbing something that started to ask anything remotely hard) and only like twice a week. I dropped my training and instead went with general maintenance. core etc. Antagonist shits and armaid and flexibility and downclimb etc. I  don't know what worked. took a few months. much better now. forget about project - if you want it to heal I need to stop. I did like you for long and it sucks - I now realize you just need to bite the bullet.

I would add acupuncture and hot cold contrast. like ice water for 1-2 minutes then as hot as you can take it for similar time. finish with longer cold interval if you have been working out and need to fight inflammation or finish with cold to promote healing. And I do mean as hot cold as you can take. immersion in water is what you need ( much better thermal conductivity) you should feel like it did some work after 15 minutes or so of alternating those

like if it's that bad healing it should be your new project.