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burning elbow?
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By rogerbenton
Apr 24, 2012
Whoever this guy is, he's just plain irresponsible...
hey all-

hoping someone can help me out with this.

for a while now (5-6 months) i've been having progressively worse problem with my left elbow.
there's an acute burning/pain in the inside of the joint; try to bang the side of your hip with the inside of your elbow and that is the point i'm talking about.

it starts out as pain, but when it gets worse it get hot, like a really hot burning. it is very focused on a small area right in that part of the joint, where the ball of the humerus fits against the ulna.

pulling is fine, climbing, pullups, etc.
it's when pushing that it flares up.
I usually do sets of 50 pushups, 15-18 dips, but with this I can't do a single one.

i've let it rest for a few weeks, no climbing/exercise. that had zero effect.

i've tried extensive warmups, trying to really baby it into a usable state, no dice.

I can still climb but I'm worried about making things worse.

anyone have any ideas?

Thanks!

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By Brendan N. (grayhghost)
From Salt Lake City, Utah
Apr 24, 2012
You have Dodgy Elbows

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By Joe Huggins
From Grand Junction
Apr 24, 2012
mmmm....tree
Sounds like pretty standard tendonitis. Do you ice it every day? Do any oppositional training? Ibuprofen with lots of water? Be sure to get enough lipids? Massage with transverse friction? In my experience, all of these things will help. Lots of folks also use compression supports with good results.
EDIT
drjuliansaunders.com/resources...
Yeah, what he said.

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By Kiri Namtvedt
Apr 24, 2012
I had "burning elbow syndrome" on the outside point of the elbow joint for at least six months last year - it would come and go, but never quite go away. I had it diagnosed as thoracic outlet syndrome, and then as tendonitis. Sometimes climbing seemed to make it feel better, sometimes not.

What finally worked for me (and who knows, maybe it was just the healing effects of time) was chiropractic, believe it or not. I had my elbow and neck adjusted repeatedly. I also made an effort to keep my arm straight rather than curled up while sleeping, because that seemed to be a problem.

Probably anti-inflammatories and heat/ice would help.

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By rogerbenton
Apr 24, 2012
Whoever this guy is, he's just plain irresponsible...
brandon, joe-

dodgy elbow it is.
crimping and a sudden increase in training.

i never ice it.
i do do oppositional training and stretching.
ibuprofen, yes.
lots of water yes.
no idea what a lipid is.
how should i massage with transverse friction?
the sore spot is on the bone, and it's tender to the touch.

thanks for the help though, I'll be following whatever protocol Dr. Julian prescribes.

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By Jeremy Hand
Apr 24, 2012
slopey
Joe Huggins wrote:
Sounds like pretty standard tendonitis. Do you ice it every day? Do any oppositional training? Ibuprofen with lots of water? Be sure to get enough lipids? Massage with transverse friction? In my experience, all of these things will help. Lots of folks also use compression supports with good results. EDIT drjuliansaunders.com/resources... Yeah, what he said.



+1

This happened to me a couple years ago when I wasn't doing enough oppositional training. I did 35 push ups in the a.m. and p.m. for a couple weeks and was good to go.

Also, lock off training is a plus!

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By Scott McMahon
From Boulder, CO
Apr 24, 2012
Bocan
mountainproject.com/v/inside-o...

Came across this from earlier this year while researching for my own elbow.

So here's a question. Is it better to lay off all works outs as "rest" or keep on with the oppositional training. I've heard mixed reviews.

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By Scott McMahon
From Boulder, CO
Apr 24, 2012
Bocan
rogerbenton wrote:
the sore spot is on the bone, and it's tender to the touch.


So's mine...so much so I thought that maybe it was nerve damage.

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By Erik Pohlman
From Westminster, CO
Apr 24, 2012
Erik on Demise of Mr. Riffraff, near the top.  Pho...
I would like to suggest that you get an evaluation from a physical therapist. This sounds like a standard tendonosis, but could involve cervical (neck) issues or even neural compression or gliding problems. In my opinion, it would be best to see a professional to truly determine what the problem is. Self-diagnosis and treatment can work great sometimes, but if you are wrong then you are setting back your climbing by spending more time figuring it out.

I didn't see where you are from, but if it is along the Front Range in Colorado, I know plenty of good clinicians I could suggest.

Erik

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By rogerbenton
Apr 25, 2012
Whoever this guy is, he's just plain irresponsible...
Scott-
thanks for the link.

jeremy-
oppositional training is mostly out for me, that's when it hurts. pushups, dips, etc are what causes the burning.
maybe reverse wrist curls with light weight, and the old "rotate the sledge hammer" one, but definitely no pushing.

and to scott's point on tenderness, i was thinking it could be that i banged it bad somewhere along the line, got a "bone bruise".

it really does feel like what they call "golfer's elbow" or what the link earlier calls "dodgy elbow".

whatever it is, it's a pain in the ass and doesn't seem like it will go away any sort of quickly.

erik p-
i'll definitely get a referral to a specialist from my doc to be sure.
The problem for me with physical rest is that my job is physically demanding and there is no way to just not use my left arm.

but we'll see what the elbow DR. says.

thanks for the input so far.

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By Finn the Human
From The Land of Ooo
Apr 25, 2012
Mathematical!
I've had success with this little exercise:


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By Mike McKinnon
From Golden, CO
Apr 26, 2012
Bunny pancake
rogerbenton wrote:
brandon, joe- dodgy elbow it is. crimping and a sudden increase in training. i never ice it. i do do oppositional training and stretching. ibuprofen, yes. lots of water yes. no idea what a lipid is. how should i massage with transverse friction? the sore spot is on the bone, and it's tender to the touch. thanks for the help though, I'll be following whatever protocol Dr. Julian prescribes.


Ice is problaby the most important therapy for this type of injury. I had it so bad when I played lacrosse in college I could not dress myself. Now I am wiser, I ice after every hard session whether it hurts or not. Ice, heat, ice is a good protocol.

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By Scott McMahon
From Boulder, CO
Apr 26, 2012
Bocan
Mike McKinnon wrote:
Ice is problaby the most important therapy for this type of injury. I had it so bad when I played lacrosse in college I could not dress myself. Now I am wiser, I ice after every hard session whether it hurts or not. Ice, heat, ice is a good protocol.


Agreed!! This is the first time I've started icing and it's helping considerably! I sit in the chair and stretch first, then work the pronator with a hammer, stretch, then ice. It's feeling decent.

I always just didn't bother with using ice and I regret it now.

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By rogerbenton
May 2, 2012
Whoever this guy is, he's just plain irresponsible...
how long after use can the icing get pushed?
an hour?
more?

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By Joe Huggins
From Grand Junction
May 2, 2012
mmmm....tree
rogerbenton wrote:
how long after use can the icing get pushed? an hour? more?

I don't have any real data, but I would get a pronounced benefit even if I iced 3-5 hours after exercise.

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By Scott McMahon
From Boulder, CO
May 2, 2012
Bocan
rogerbenton wrote:
how long after use can the icing get pushed? an hour? more?


Well you figure if the problem is due to inflammation, ANY time is good to ice as it's always inflammed.

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By Joshua1979
From Colorado Springs, CO
May 6, 2012
It sounds like medial epicondylitis which is what I had. Here is what worked for me:

~Ice massage after every training session followed with an ice wrap (can freeze water in dixie cups for ice massage). Then after icing some self massage with fingers to stimulate blood flow.

~Immobilize at night while sleeping so as to keep straight (I would naturally sleep on my side with the affected arm at a 90 degree angle torqued under a pillow and would wake up with wicked pain). I wrapped a hand towel around it and then ace bandage while straight...seemed to work well for me but i'm sure there are trinkets you can buy for this sort of thing too.

~Do the exercises from the dodgy elbows link above religiously until pain subsides and then continue at a reduced volume for maintenance. Here is a video of one of the exercises that worked best for me sites.google.com/site/healgolf...

~stretching after a training session also seems to have therapeutic value for me. Flexors and extensors and also pronation and supination (cant find links for those so maybe someone else can add in).

I have learned that a little bit of prehab goes a long way in preventing elbow and shoulder pain from becoming and issue. Might be a good idea to throw some shoulder stabilizer and rotator cuff exercises in the mix to keep things healthy there too.

btw I am a fully authorized interwebs doctor so take this as FACT.

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By Joshua1979
From Colorado Springs, CO
May 6, 2012
forgot to add that rest did not help me with this either. I was able to continue climbing with this prog and now I am climbing harder than ever with no pain (at least climbing related pain that is...having knee probs from bjj but that is another post;).

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By Hmann2
Jun 6, 2012
the fridge leavenworth
remember RIP! Rest Ice Pushups! Do pushups to fail daily, and when it feels better dont stop! Do at least 30 pushups daily to avoid having the problem return and everytime after you climb Pushup to fail. I have tendinitis also and this is what works for me.

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By Charles Vernon
From Tucson, AZ
Jun 6, 2012
Question for Joshua 1979 or other person with a similar experience:

You seem pretty knowledgeable about your injury, and I was wondering if you know specifically whether you had tendonitis or tendonosis. I have the latter (medial--golfer's elbow) and have been resting and have begun rehab. But I am debating whether to continue climbing and wondering if it makes a difference whether one has tendonitis (inflamation) or tendonosis (actual damage). I would be interested to hear from others who have had tendonosis specficially. "Dodgy Elbows" seems great but doesn't really address whether you should stop climbing altogether.

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By Jake Jones
From Richmond, VA
Jun 6, 2012
Me and the offspring walking back to the car after...
There is actual damage in both tendonitis, and tendinosis. The major difference is that tendonitis is the initial injury- usually brought on by local trauma and/or overuse. Tendinosis is a recurring degenerative condition. Tendonitis can be anything from inflammation to a mild tear to a series of microtears- or all three. Tendinosis is most often a result of tendonitis, but not always. Tendinosis happens when microtears heal and form scar tissues. The scar tissue is not as flexible and elastic as the original tissue and the result is a slight reduction in range of motion. When the scar tissue is stretched past its range, then more microtears occur again- thus the recurring degenerative nature of the condition. This is why the pronation, strengthening and stretching exercises are so important. They strengthen the tendon and slowly improve the range of motion.

I had it really bad about a year ago- so bad that I could barely hold a toothbrush. That's how I learned all this. I have no doubt that if I had just kept "climbing through it", I would have done some serious permanent damage.

If you do in fact have tendinosis, I would stop climbing and start Dr. J's program right away. I followed it to the letter and it worked very well FWIW.

Edit: The guys above that mentioned massage as a part of therapy are dead on. It helped alot.

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By Joe Huggins
From Grand Junction
Jun 6, 2012
mmmm....tree
Jake Jones wrote:
There is actual damage in both tendonitis, and tendinosis. The major difference is that tendonitis is the initial injury- usually brought on by local trauma and/or overuse. Tendinosis is a recurring degenerative condition. Tendonitis can be anything from inflammation to a mild tear to a series of microtears- or all three. Tendinosis is most often a result of tendonitis, but not always. Tendinosis happens when microtears heal and form scar tissues. The scar tissue is not as flexible and elastic as the original tissue and the result is a slight reduction in range of motion. When the scar tissue is stretched past its range, then more microtears occur again- thus the recurring degenerative nature of the condition. This is why the pronation, strengthening and stretching exercises are so important. They strengthen the tendon and slowly improve the range of motion. I had it really bad about a year ago- so bad that I could barely hold a toothbrush. That's how I learned all this. I have no doubt that if I had just kept "climbing through it", I would have done some serious permanent damage. If you do in fact have tendinosis, I would stop climbing and start Dr. J's program right away. I followed it to the letter and it worked very well FWIW. Edit: The guys above that mentioned massage as a part of therapy are dead on. It helped alot.


Great synopsis! Thanks; I'll admit that the only times I've managed to stop climbing are times that I've lived away from a major climbing area-maybe a valid solution, but, I'd rather not...

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By Charles Vernon
From Tucson, AZ
Jun 6, 2012
Yeah, that was really helpful, thanks. The only thing that's weird for me is that although the pain and location perfectly fits the (medial) tendonosis description in dodgy elbows, it's just not actually very...painful. At all. None of this "I can't do daily mundane tasks without searing pain." The pain is there but very mild and not normally present. Which is why I am tempted to climb through it--albeit moderately and with the full rehab program.

[edit] Muttonface--I'm curious how long your recovery took from when you started doing the exercises (and yes, I realize everyone is different!).

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By 1Eric Rhicard
Jun 7, 2012
It is a good sized roof. Photo: Jimbo
Hey Charles, I had some issues with my elbow too. Seems to be getting better by climbing through it, but backing off on the numbers. Call me if you want to hear more.

EFR

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By Jake Jones
From Richmond, VA
Jun 7, 2012
Me and the offspring walking back to the car after...
No one wants to stop climbing when they just have what seems to be some mild to strong discomfort that only lasts a day or two after climbing. Some people just back off, and the lesser degree of doing stuff that doesn't demand extreme forces from tendons is enough to both limber the tendon up, and allow it to heal and strengthen.

Another variety is people that acknowledge the injury/condition and back off like 1Eric Rhicard, and incorporate the Dodgy Elbows or similar program as part of their regular regimen. I hesitate to outright recommend anything because I'm not a doctor, trainer, or a physical therapist, but experience leads me to believe that this is probably preferable to most climbers that start to notice the onset of symptoms, are reluctant to quit climbing for any amount of time, and do not have serious, debilitating pain that accompanies an extreme case.


For others that are too far gone, stopping climbing completely for a while to do some PT and rehab is the only way to manage it and hope to gain any kind of recovery. I was the latter.

I think what helped me most is diligence doing it. Every other day for twelve weeks I would do the pronation and strengthening exercises. I massaged and stretched every day, twice a day. A few key points in Dr. J's program are important. First, for the medial variety, don't pronate over vertical, and only produce resistance on the downward half of the motion- he explains this in his article. Second, after you've been doing the exercises for a couple weeks or so, position your arm so that you get the most agitation of the affected area WHILE you're doing the pronations. For me, this was holding my arm up so that my forearm was about 20 to 30 degrees difference from the floor, instead of parallel.

I started with just stretching for a week because it was too painful to try using weight for wrist curls and pronators. My case was extreme though- so use your judgement. Once I started exercises, I did three sets of 15 reps for each arm, each exercise. After the first week, I upped the amount of reps for each set to 20. The second week, I added another set. I kept the 4:20 regimen the entire time (no pun intended, although I don't discourage self-medicating), adding weight when I felt like I was getting too strong to offer much resistance.

I'm babbling now. If you read Dodgy Elbows, he's pretty clear on instructions, and you can vary it a little to suit your case specifically.

I took three months off- absolutely ZERO climbing. It sucked bad. I only had one small recurrence, and I picked the program back up for two weeks, and I haven't felt a thing since. That was a year and a half ago. To anyone with this malady, you have my sympathy. I hope you are able to heal well.

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By Charles Vernon
From Tucson, AZ
Jun 7, 2012
Thanks Mutton & EFR. I'll call you soon Eric.

As an unrelated note, Mutton, I must say I'm suprised you initially chose an alias with a name like Jake Jones. That's a heck of a name.

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