Hammering/demo work make my golfer's elbow worse?

I was climbing at my hardest level and feeling strong. I was also doing some demo work on the side. No jack hammering but lots of metal pry bar getting wacked with a hammer. It was a side job, and was never too crazy...I always wore gloves. I wonder if the metal on metal and pounding in general contributed to a raging case of golfer's elbow soon after?

Was climbing hard, about 3 days a week. Was not sleeping well, and did a lot of fasting at the time. Curious if you know more or have a similar experience. 

Highly likely. Tendons don't like a rapid change in loading. Not sleeping (definitely) and fasting (likely) won't have helped recovery and may have contributed. 

Also, if your profile is accurate, you're a dangerous age! Young enough to have a clear memory of what you could do when you were 21 but without the body to cash the cheques your brain is writing.

You'll probably have to cut right back on the climbing for the moment: significantly reduce but don't completely eliminate the load on your elbows. This probably means dropping your intensity (grade) and duration (frequently and length of session) sharply. Once things have settled, ie much less pain in every day life but not necessarily completely pain free, you can start building back up gradually.  This may take several months and will probably need a bit of experimentation as to what the correct load for you. A physical therapist who knows about climbing may be able to help with this process.

Anti-inflammatory medicines or injections can give temporary pain relief but don't treat the underlying pathology and may delay healing. Not recommended.

I had a severe bout of tendinnopathy at a younger age when I was training hard and then started a cleaning job. I did none of the above: ignored the problem initially then rested completely when it got worse. Had cortisone injections and gobbled NSAIDs. I stopped climbing and much else for eighteen months. None of this helped and I got quite depressed as a result: climbing was a big part of my identity.  It only go better when I very belatedly gradually started being more active again. 

Quit golfing, it's dumb.

Absolutely. I had a very similar experience and MOI. Climbing plus manual labor type stuff. Started when I was 41. Lots of PT/OT. Took me about two years to get over. 

Give it a few weeks rest. If you start back with activities and it comes roaring back you should absolutely see a medical pro.... or see one now if you are able.

See a Physicians Assistant, G.P., or Nurse Practitioner and take their advise. They most certainly will recommend PT/OT.

I was able to shake it, but still go through my OT exercises daily and am the guy at the crag with the Therabar. 

Absolutely. I have a job that requires heavy hammering and am always battling golfers elbow and biceps tendonitis. Climbing contributes, but the work is the main culprit. There are exercises you can do to help, but golfers elbow was originally called hammer arm

Hi Mikey!

I'm sorry to hear about your elbow pain, that is a really frustrating thing to deal with! I am a physical therapist and the mechanism you described is extremely common in people who develop either golfer's elbow (medial epicondylitis/epicondylalgia) or tennis elbow (lateral epicondylitis/epicondylalgia). The best thing to do as recommended earlier is to see a rehab professional like a PT or OT to assess if the source of your pain is the elbow itself or from the neck which can often be the case with elbow pain. Finding a physical therapist or occupational therapist who has knowledge of climbing would be a bonus. Generally, with tendon conditions the dose makes the poison meaning that excess loading/overuse will trigger the pain but the treatment is also loading. Tendons love language is loading so you will need to progressively load those tendons and muscles in order to reduce symptoms and get them to stay away for good. Keep this in mind with any rehab you pursue as it should be challenging and you will bump into symptoms along the way. 

This article is from The Climbing Doctor blog which is overseen by Dr. Jared Vagy, a physical therapist in southern California who specializes in climbing athletes. It is regarding tennis elbow/lateral epicondylitis but the concepts apply nicely to pain on the medial/inner side of the arm as well as seen with golfer's elbow. The main difference is which muscles/tendons are being affected, this is why the assistance of a rehab professional would be best. You can use the article for some ideas to get started on symptom management if they apply to you. 

Tennis Elbow Management for Climbers

I wish you the best in your recovery! I'd definitely get this taken care of sooner rather than later because it is a pain that tends to come back without intervention. Reach out with any questions you have!

Keith S wrote:

I was able to shake it, but still go through my OT exercises daily and am the guy at the crag with the Therabar. 

What do you do with the Therabar - warm up, or stretches between climbs, or after? I do this grab and twist thing, essentially lowering from a preacher curl, as I uncurl the afflicted side. I'm curious to know what you, reps and exercises, and when. Thanks

Dustin B wrote:

Quit golfing, it's dumb.

Obviously you're not a golfer

Mikey Seaman wrote:

What do you do with the Therabar - warm up, or stretches between climbs, or after? I do this grab and twist thing, essentially lowering from a preacher curl, as I uncurl the afflicted side. I'm curious to know what you, reps and exercises, and when. 

I just do the standard 'Tyler Twist' and 'Reverse Tyler Twist' as I deal with some cubital tunnel symptoms from time to time also. 

Before I do my warm up pitch I will do 1 set of 8 reps with each and try my best to take 10 seconds per rep. I will do my best to stick to doing this before and after a pitch. Not RIGHT before and after, but before I put my shoes on and tie in/ after I untie and take shoes off. 

I'll throw in a little cross tissue massage of the upper forearm here and there throughout my day at the crag also.

Edit:

Doing reverse wrist curls with a stick clip does the job also in a pinch. 

As a fourth generation carpenter I can tell you that steel on steel is a good way to wreck your elbows. I have been swinging a titanium Stilletto with a wood handle for the past 15yrs, it saves the elbows and wrists for sure!

I have a couple of compression sleeves to use when it flares up.

While it’s a bandaid fix, id recommend using that in the meantime since it’s part of your job. 

Yup, had a similar experience. I was stubborn and tried to push through the pain while half-assing rehab for 6 months before submitting and accepting I needed to stop climbing until I figured out what was going on. 

The protocol in the link shared by the Climbing Sig to the Climbing Doctor is super helpful and essentially what I followed. I didn't do those exact unloading exercises but I felt like I was making NO progress until I stopped all strengthening and focused on unloading. From what I remember, it took me about 2 months of stretching/massaging daily to eradicate the pain. A peanut lacrosse ball and a massage gun were massively helpful for me. 

Then it was all about progressive loading, and respecting the necessity of training antagonistic muscles, for 4-5 months before I was climbing 100% again (probably would have happened sooner if I went to a PT). It's been a year and I feel like I have full freedom with pushing myself day to day climbing and training. 

Key workouts for me:

Stage 1: Hammer twists, reverse wrist curls, shoulder band work (no moneys and T pulls), pushups 

Stage 2: added bench and dips - just continually trying to get stronger 

consider going in for treatments that help tendons to grow stronger

which include ultra sound shockwave and laser like at a chiro office or buy a used machine

Granite Grant wrote:

consider going in for treatments that help tendons to grow stronger

which include ultra sound shockwave and laser like at a chiro office or buy a used machine

Do you have more information to share about these? I've never heard of this

I just wanted to add that I battle with golfers elbow and hammering is part of my job. I recently started using power fingers again and doing antagonist training. My golfers elbow was gone in a couple days of doing a couple heavy sets.

Granite Grant wrote:

consider going in for treatments that help tendons to grow stronger

which include ultra sound shockwave and laser like at a chiro office or buy a used machine

I'll add that I had my acupuncturist hook electricity to the needles and I found it to be very beneficial. I went through a half dozen rounds of this over a few months and it helped my symptoms. 

Edit: acupuncture for the elbow(s) specifically. Electricity zapping above and below the elbow joint. Helped calm my pronator teres down quite a bit which really helped.

saign charlestein wrote:

I just wanted to add that I battle with golfers elbow and hammering is part of my job. I recently started using power fingers again and doing antagonist training. My golfers elbow was gone in a couple days of doing a couple heavy sets.

Thanks, can you get more specific about what you do? Not sure what you mean by power fingers? And what about reps, sets that sort of thing for antagonist training?

Mikey Seaman wrote:

Thanks, can you get more specific about what you do? Not sure what you mean by power fingers? And what about reps, sets that sort of thing for antagonist training?

power fingers

I just do 2-3 sets of 15-20 reps at a resistance that I struggle to complete 2-3 times a week. Seems to help if you cock your wrist up like you are doing a pushup while performing the reps.

I also find it's also a good way to warm up for climbing