Help! Elbow tendonitis (???)

[Guest]

I have a pain in the elbow area, happened after a gym session (what else?) a month ago and is not getting better.

If I straighten my right arm then twist it counterclockwise (as if turning a door knob with a straight arm) it hurts in the elbow area on the side close to the body. Same pain occurs if I push my hand against my face: the arm in L-shape, palm towards the face, push. Or arm straigh ahead and push down. In fact it hurts when I just bend my my arm as if trying to squeeze a pen in the inside if my elbow. The pain is worse after a gym session.

Tendonitis?

If anyone knows of exercises/care specific to this please (-please) let me know. Any reference to info is much appreciated!

Thank you, Rafael H.

[goatboy]

I'm no doctor, but I have suffered from tendinitis for about 7 years and have collected a fair amount of information about the topic.

The pain you're having sounds like "climber's elbow," also known as medial epicondylitis. All of these terms add up to tendinitis, which can be a potentially debilitating condition if ignored (which you are wisely not doing).

Different people respond in different ways to various treatments, but the one treatment that seems most likely to help is to REST it and to AVOID REINJURING it once it heals.

Tendinitis is the result of little micro-injuries to the tendon, which is, in the elbow's case, a very non-vascular area (very little blood flow to the area). This is why it is slow to heal, as blood flow promotes healing. Since the elbow gets very little blood flow, it can be slow to heal. All of these little micro-injuries can add up and create the inflammation and pain that you now feel.

I would recommend the following:

1) Applying heat and cold to the elbow (ie hot water bottle, ice pack) will stimulate blood flow as the capillaries in the area dilate and contract with the heat and the cold. This may promote healing.

2) Resting the elbow and NOT CLIMBING on it is essential to getting beyond the inflammation stage and into the healing stage.

3) Stretching and strengthening the muscles around the elbow seems like a good way to avoid future injury. I don't believe you can actually stretch the tendon itself, but you can warm up and stretch the muscles themselves so they absorb more of the dynamic force of climbing and impart less of that shock into the fragile tendon area.

4) My guess is that your biceps are much stronger than your triceps, which creates an imbalance in the way your arms exert force onto the elbow joint. Consider doing exercises which are aimed at specifically building up your triceps for a more balanced push-pull action.

5) Finally, beware of climbing gyms, or at least the OVERUSE of climbing gyms, which often compel climbers to utilize micro edges and holds which exert extreme force onto tendons. It was in a gym that I first hurt myself. Now, 7 years later, I still suffer from tendinitis and am going to have a sort of last-resort shot of cortizone today in my left elbow. I do NOT recommend cortizone as a first step, rather, as a last step, after you've tried lots of other treatments.

Let me know if this all makes sense or if you have any other opinions, treatments, or questions. Also, please correct me if I'm inaccurate in any of my information, I'm eager to learn more.

Good luck with your elbow, Rafael!

Steve Smith

[Guest]

Thank you, Steve. I'll start exercises and stretching today and will report on the progress.

Anybody or anything else?

[Courtenay]

Hi Steve, Rafael, Jason --

You've posted some really good information here. Thought I'd throw in my $.02.

The best cure for tendonitis (whether in the fingers, elbows, shoulders...) is definitely REST, though if you're like most climbers, not being able to climb for ANY length of time is probably way too long. Best to take it easy NOW instead of continuing to re-injure just as you think it's about healed, thus prolonging the healing process indefinitely. Rest for a good 2-3 weeks and see if it feels better, then rest another 2 weeks beyond that.

I'd also suggest focusing your time climbing outdoors as the weather permits (when you get back to it), rather than in the gym, as gym climbing just seems to lead to overuse -- unless you are primarily an indoor climber?

If you are just dying to climb, but don't want to do any pulling, you might hop on some slabs and focus on footwork, keeping arms at shoulder level or below (stemming, manteling, balancing, pushing rather than pulling) -- NO PULLING, I repeat -- but at least it will keep you sane as you try to recover. Good climbing instructors (who have been through the same thing) might be able to suggest other such drills that would aid in recovery.

There are elbow braces (like those for tennis elbow) that might assist you, though again using anything to mask symptoms or prolong your climbing to the point where you make it worse is inadvisable.

Finally, another suggestion that hasn't come up is electrical stimulation -- offered at PT offices, if you opt to go that route -- it works well for some, not so well for others.

When you do get back into climbing, ease into it gradually -- put 48 hours between climbing sessions (like you would strength) and try alternating harder climbing workouts with easier traversing/endurance workouts (what has your climbing routine been, by the way? how many times a week, for how long, and what level?)

Hope all of this is useful. Have you had a chance to check out any of the pre-season workout suggestions that CC.com has shared (through Body Results) that provide suggestions for maintaining body balance?

 

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Courtenay Schurman, CSCS

[Jason_Martin]

I too have had problems with my elbow. And everything Steve wrote is correct. The one thing I'd like to add to his prescription is ibeuprophin. This helps to relieve swelling.

When the pain in my elbow was at a peak, a doctor prescribed this to me with food. You should probably consult your physician before doing anything beyond this and what Steve wrote.

Good Luck.

Jason