Tendonitis/osis cross training and drinking.

For about the last 5 years, I've had intermittent bouts with tendonitis in the elbows. It was as it's worst when I spent a good amount of time at a bouldering gym. It was at it's best when I was climbing many different styles.

Upon return from Greenland, my elbows are the 2nd worst they've ever been. This was 100% caused by too much jugging.

My conventional prevention workout consists of many should presses and tricep (I'm sure there is a name for it) things with a 5lb medicine ball. The idea is that it keeps the elbow moving. In addition to this, I go through about 5 different stretches for the arms. Combined, and about 2-4 times a week, this works.

It's not working. I'm also throwing in about 50(20/30 sets) pushups 3 times a week because everyone swears by them. It seems to help but again it's not going away.

I try to get out on my road bike as much as possible, and swim in the ocean at least weekly. Both activities seem to really set my elbows off even more.

I curl my beers with my left arm, is this coincidence that the left is worse than right?

So for questions. Any magical exercises that I'm omitting? Is there something about the road bike that would further aggravate the elbows? How is swimming bothering me?

I blame all the old bland beer here. If we had 2 dozen more microbrews, I'm sure I'd be the pinnacle of health and sending.

hughston.com/hha/a.seven.htm
I have had a lot of trouble with tendonitis in both elbows and wrists. I find doing the exercises from the above link regularly (3x a day, 3 days a week) helps prevent tendonitis. Also, icing the elbows after any activity that aggravates them helps.

or switch to drinking beer through a straw ;)

I know it borders on blasphemy, but have you tried taking 10 days or so off of everything (even biking/swimming/push ups)? Tendinitis is just inflammation. Even with apposing muscle group exercises, if your tendons never have a chance to 'calm' down and heal they are going to keep hurting.

Biking kills my elbows every time too. I was having tendonitis for a while too and once I stopped biking regularly it helped...

A PT friend told me that there's no cure for tendonitis - it's an overuse injury. You just gotta let the tendons rest and recover. Thus, even doing the 'pre-hab' exercises like pushups doesn't *heal* the tendons (though, once healed they help it not get injured). That seems to have my elbows under control...I rested for most of the winter (climbed 1x per week and skied a lot) and did a lot of wrist curls/close grip pushups/etc etc. This summer I'm climbing inside ~2x/week and outside most every weekend injury free...

Maybe the hot weather is warming your beer to quickly and you can't apply the icy cold ones to the elbow fast enough?

I've been battling this for 5 yrs. At it's worse it felt like someone was setting my tendon on fire with a lighter and there was no way I could climb. I went and saw a doctor and PT about it and they sent me away with the same exercises that seem to pop up on every forum, magazine, and "How To Prevent" publication. My friend swore by Prolo-Therapy, but I'm not too psyched about injecting sugar water into my tendons.

My PT just said, "Don't stop climbing. Just climb what doesn't aggravate it." Because as soon as you take 3 months off and start climbing again you'll go at it too hardcore and blow it out even worse than before. I just found that laying off it for several months (this was at it's absolute worse) and using an ice bath instead of ice (read a book, watch tv with your elbow in a big bowl of ice water) worked the best. I would test it about once a week on a hang board and see how it felt by doing one, or two pullups to see where it was. Once it felt OK on the hangboard I stayed off it for 2 more weeks and then started going back to the gym. The trick was to really dumb it down with my climbing. Which meant climbing up vertical 5.5's all night. The next week start doing 5.6's and SLOWLY escalating back to previous fitness.

All these exercises that you read about are preventive in my opinion and not what you should do once your tendonitis has gotten out of control. Massage just aggravates the tendons so I stayed away from that as well. And steep bouldering will bring it back faster than anything else will.

Mine consistently flairs up as soon as I start bouldering too much at the gym, and is additionally aggravated by a desk job and overall overuse.

What I've learned is to STOP and rest when it gets aggravated, but I usually seem to wait till it hurts too much. Massage, proper stretching and icing seem in ADVANCE seem to help keep it at bay.

I'm doing pushups/ reverse wrist curls to try to help alleviate the pain, but preventative proactive treatments seems to be the plan instead of reactive. Also watch those non-climbing activities such as using the computer etc. that make matters worse.

I just picked up the cho-pat tennis elbow band, so we'll see if that helps the tendon to heal.

Oh and I use icy cold can or bottles of beer as "icing".

Overall this ALWAYS comes from the damn gym. Going in and climbing too much without proper stretching.

johnL wrote:Is there something about the road bike that would further aggravate the elbows?

The same thing happens to me from biking. A road biker friend of mine told me that my bike fit might be making me extend my arms too far so that when I start to get tired at the end of the ride and tense up my arms more, hitting bumps could be aggravating my elbow. You might want to try to readjust/check the fit of your bike and make sure the handlebars are at the right position for you.

Maybe rather than beer you need to switch to margaritas (with extra rocks) or some sort of frozen island-y drink...should keep cold longer than beer.

I used to get tendonitis really bad in the elbows. I mean so bad I remember once sitting in camp half an hour after bouldering and shaking from the pain.

During that time I was playing a little tennis and it was so painful I broke a racket serving because I couldn't hold onto the racket and it flew out of my hand straight into the ground.

I stopped climbing in the gym, stopped doing pull-ups/frenchies, stopped playing tennis or doing anything that hurt my tendonitis. In fact, I pretty much stopped working out altogether other than bouldering outdoors every 2-3 days and playing rugby. I also started taking glucosamine.

I'm completely pain free a year later and climbing a couple grades harder. I think it was pretty much just overtraining - trying to get strong too quick. I find that I get much stronger more quickly when I climb for a long time one day, then rest for 3 days before climbing again. Alternating between pumpy sessions and fingery sessions seems good too. Working on my technique and static climbing probably helps too.

Best of luck to everyone out there suffering the horrible elbow pain.

Caughtinside - gotta agree with you about the warmup too... I started doing a 30 minute traverse warmup before each session and a stretch afterward... could certainly be one of the reasons the tendonitis is gone, and as an added bonus my endurance is up.

Tendonitis on the outside (lateral epicondylitis or tennis elbow) and inside (medial epiconylitis or golfers elbow) are notoriously hard to treat. Lots of web info available.
This device has helped me. I got it when it was on sale. At least read the free download.
us.tenease.com/
Tendonitis (Medial or lateral) is not an inflamation issue but icing does seem to help. Will Gadd has had luck with the "twisty thing". It is the TheraBand FlexBar from the company that makes the rubber bands for PT work. Has only been of marginal help to me so far.
thera-band.com/store/index.…
For medial epiconylitis, make sure you do the reverse Tyler twist exercise.
blog.thera-bandacademy.com/…

Twisty thing:

blog.thera-bandacademy.com/…

It worked for me.

Skip the purchase of the twisty and just use a rolled up towel to twist in your hands. PhysTherapy uses it often and saves money on expensive devices that way. Fat thick full size or beach towel works nice.

I had the debated cortisone shots. I think they helped but there is risk, although my doc thinks they are ok up to 2.

But, I consider finding a good PT the thing that finally got rid of it. Two things I would pass on, she examined strength of the shoulders and said that my favored side shoulder should have been stronger than my other and gave me a lot of shoulder exercises. Something about compensating for the weaker shoulder by using the elbow causing the problem (not climbing induced, AFAIK)

The other is one of the exercise was a hammer twist - with arm supported on leg, rotate hammer in and out repeatedly. I think it may be similar to that twist in loading the elbow.

But each is different and a good PT will give your hands/elbow/arms/shoulder a good going over and give exercise for YOU.

John,

I do pronation and supination exercises with a hammer or something similar. A wall hammer works but I find that something a bit longer is better because it gives you options on intensity depending on where you hold the... the thing that you are holding.

I usually take about a two foot long stick and wrap a bunch of webbing around the end with a steel biner or a rock or something.

I have lateral epicondylitis (tennis elbow) which I THINK is more common to climbers. It seems that supination exercises help this more than pronation, but I do both and This website recommends both.

I do 3 sets of 20 reps, both arms, both pronation and supination. It takes about half an hour but I can drink beer w/ the other hand so it's a good after climb activity.

Push-ups are good too but I find that while they make my elbow feel better for the moment, the don't really do a good job of preventing future pain.

Good news is that you can't do any damage to your tendons... they might hurt worse after you climb but tendonitis is no reason to stop climbing. The exercises MIGHT help... they rid me of pain all together when I actually do them for more than a week at a time. Other than that your elbows will hurt until the day you die.

I could also send you some thera-band if you want to do those kind of exercises. They are excellent for prevention of shoulder problems (rotator cuff) but also help with golf and tennis elbow.

Hope you're enjoying the island life. I've recently left my island... wondering if I'll make it in the real world.

Ryan Williams wrote:John, I do pronation and supination exercises with a hammer or something similar. A wall hammer works but I find that something a bit longer is better because it gives you options on intensity depending on where you hold the... the thing that you are holding. I usually take about a two foot long stick and wrap a bunch of webbing around the end with a steel biner or a rock or something. I have lateral epicondylitis (tennis elbow) which I THINK is more common to climbers. It seems that supination exercises help this more than pronation, but I do both and This website recommends both. I do 3 sets of 20 reps, both arms, both pronation and supination. It takes about half an hour but I can drink beer w/ the other hand so it's a good after climb activity. Push-ups are good too but I find that while they make my elbow feel better for the moment, the don't really do a good job of preventing future pain. Good news is that you can't do any damage to your tendons... they might hurt worse after you climb but tendonitis is no reason to stop climbing. The exercises MIGHT help... they rid me of pain all together when I actually do them for more than a week at a time.

Agreed, I had tendonosis for 2 years as a result of to much ice climbing and pullups. All the rest in the world didn't cure it but those subination/pronation exercises did. The only time I have noticed it since is when I stopped doing those exercises for a month. As long as I do them once I week I can pretty much do what I want...

In no way am I an expert, but I would definitely say to look into the fact that the pain is being indirectly caused by an imbalance in your other muscles. It was hurting one of my elbows to swim and I developed impingment in my shoulder - all due to weak central back muscles - strong lats, but weak rhomboids.... After PT and relearning to initiate my swimming stroke from my back muscles, it was all better...

And obviously you're not drinking enough - you're still feeling pain

the fact that road biking aggravates the problem has me puzzled. i raced competitively for several years and have never heard of anyone who had elbow problems. that leads me to wonder about a couple things.

first, have you had someone do a bike fit for you? with proper fit, your arms actually do very little to support you on a road bike with most of the support coming from your core. the guy who fit me for my bikes once told me that the ideal fit would allow you to remove your hands from the bars while remaining in the same position.

considering you're a strong climber, you almost definitely have a stronger core than most cyclists. so, if you're putting a lot of weight on your arms, you should consider getting a bike fit.

and, what kind of bar/stem set up do you have? vibration can irritate tendonitis tremendously. getting a carbon stem and bar set up will greatly reduce the vibration coming through your handlebars. a less costly solution is to double wrap your bars or use bar tape that has some for of padding, a gel insert or other dampener.

finally, rest is important. i'd recommend getting a beer helmet so that you can imbibe while allowing your elbows to rest.

If the tendonitis is on the bony lump on the inside of the elbow as is typical with climbers, I believe the flexor digitorium profundus muscle doesn't attach to the medial epicondyle, so my untested theory is that using pure open hand grip on finger tip holds with the wrist in a neutral position may not aggrevate the issue as much as hard crimping. The flexor digitorium superficialis and wrist flexor muscles do attach to the medial epicondyle though I believe. As for rehab, eccentric exercises of the affected tendons have been shown to be effective treatment in some studies. So for medial epicondylitis you might try eccentric wrist curls. I had triceps tendonitis for about 2 years and didn't get over it till I did lots of eccentric tricep exercises.

The cure: invent a drink called "flexor digitorium profundus" - heavy on ice, maybe a few Ibuprofen crushed up in it, climbing chalk around the rim of the glass...I'm thinking tequila being the main ingredient.

This may take extensive experimentation on your part though...

Sleep with your elbows straight.

Ironically, drinking may be the most important part of this solution. Your actual choice of drink isn't all that important - it's that you drink enough of it to keep yourself from bending your elbows in your sleep.