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Upper elbow pain updates

Original Post
David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

Hello,
My issue started early on when I was just starting off climbing. Probably a month or two back I starting having issues with tendinitis in the inside of my arm/elbow. It would be the equivalent to "golfers elbow" but in my upper arm instead of my forearm. Iv taken off climbing for around 4 weeks now but am still having issues with the inside of my elbow being sensitive and even achy throughout the day. Usually caused by sitting at a desk or if I'm on my phone with my elbow bent for a while it will flare up.
Anyone have this issue or know of anything I can do? Iv been to my chiropractor and he's done multiple laser treatments on it but it has yet to be healthy enough to climb and I fear going back would cause a tear or it would reset my issues.

Kevin Neville · · Oconomowoc, WI · Joined Jun 2013 · Points: 15

If it's been a month or two, it sounds more like tendonosis than tendonitis. I'd recommend seeing a PT. Ask climbers in your area if they can recommend someone who understands climbing overuse injuries in particular.

grog m · · Saltlakecity · Joined Aug 2012 · Points: 70

Elbow tendinitis is a curse that I wouldnt wish on my worst enemy. Its not enough to cripple you, but it prevents hard sending.

Rest will not fix it. I repeat rest will not fix it. Ice dipping and specific exercises were the only things that worked for me. There are many exercises online through climbing forums. Do them every day. Sacrifice 6-8 weeks now, instead of 1+ year later.

I highly recommend going to physical therapy if you want fast results, ~6 weeks. Otherwise your climbing will be hindered for 1+ year. Learn from my mistakes.

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

I guess I'll have to go see someone more than just my chiropractor for it, has definitely gotten better but it's becomes rather centralized to a point and it's been going on for a while now. Even just hitting or bending my elbow will start to irritate it eventually...

grog m · · Saltlakecity · Joined Aug 2012 · Points: 70

Yep, been there with very similar symptoms. You have to actively fix it

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

Any recommendations for exercises? Only things I can find are for tennis/golf elbow and mines clearly not either

grog m · · Saltlakecity · Joined Aug 2012 · Points: 70

For exercises go to physical therapy.

Ice dipping:
1. Fill a sink or very large bowl with water and ice/ice packs
2. Dip affected elbow (wrist and forearm is okay) for 10 seconds, 10 seconds only!!
3. Repeat every 5 minutes for 1 hour
4. I usually did this while watching TV or reading.

goingUp · · over here · Joined Apr 2013 · Points: 30

so the pain is proximal to your elbow rather than distal? what makes it worse? palm down flexing your wrist against resistance? or moving the elbow? or does it hurt like hell when you throw say a baseball - (possible fracture to the medial epicondyle - little leagers elbow)? and what were you doing when it started (it began slowly,,,, and got worse, one day it just began etc...)
do you ever notice tingling or numbness in your forearm on hand? - (nerve involvement, and can help to specify which nerve, or muscle is compressing it..)
or is it more of a pain in the 'crotch' of your elbow... call it the anterior aspect (the insertion point of the biceps tendon - a very common tendonits/osis in climbers)
or is there pain on resisted pronation of the forearm (does it hurt worse to turn your hand from palm up, to down against resistance)-pronator teres.

basically, unless you have a stress fracture on the medial epicondyle of your humerus (you need more rest....) the Tx for all these is the same...
Take a dixe cup, fill it with water, freeze it, and use the block to massage the painful muscle/tendon. REST.
NSAIDS (Ibuprofen or alleve).

for now you need RICENS....Rest, Ice, compression (they make bands and straps for this look up tennis elbow braces but the clinical evidence of their efficacy is debatable... some people swear by them), Massage and elevation... and NSAIDS... and Stretch.
Once this begins to get better, exercise (lightly) bu flexing the elbow at 90 degrees, hold a light weight in your hand (or use a band for resistance), and rotate your hand from palm up to down slowly and controlled...
the key is to STRETCH the muscles of your forearm (unless you have a fracture...). basically muscles get tight, tight muscles pull on tendons, that hurts, and strains/scars the tendons and their insertion points into bones and that becomes inflamed.....

if these non invasive interventions dont work for 8-12 months, you can consider a steroid injection or scar tissue debridement... but try this stuff for a few months.

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

Saw an othopitic surgeon was and it was diagnosed as neuritis of my ulnar nerve. Completely makes sense due to the symptoms that I have. On an Advil regiment with rest and ice as much as possible. Thanks to both of you for helping out and commenting. Hopefully I can kick this and get back to climbing asap!!!

grog m · · Saltlakecity · Joined Aug 2012 · Points: 70

Will you please follow up in a few weeks or so?

DR · · Unknown Hometown · Joined May 2014 · Points: 922

When you come back to climbing try climbing one day on one day off, and avoid climbing back to back days. Start with 2-3 days a week and ease back into climbing.

What you need to do, and what all climbers should be doing is preventive exercises to avoid having the issue again and again and again.Rest helps now but if you don't change anything about your routine it will just come back.

People call these preventive exercises antagonist exercises or prehab exercises, but basically you need to work on balancing the muscle structure in your arms to offer support to the tendons. If you do PT this is essentially what they will have you do.

I like to do reverse wrist curls,dips,push ups etc. Focus on pushing muscles to balance all of the pulling you are doing with climbing. As a climber most of what we do is wrist turned down, pulling based exercise and you start to become imbalanced. Muscle balance is important to avoid injury.

Check out these articles and websites:
theclimbingdoctor.com/produ…
climbhealthy.com/prevent-cl…
nicros.com/training/trainin…
mojagear.com/journal/2014/0…
theinspiredclimber.com/2014…

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

Update:
After being on an Advil regiment, icing every few hours when I'm able to, and doing Ulnar Glide stretches to keep the nerve mobile. Still haven't attempted any finger hangs or pull ups. Will still have random achiness just above my inner elbow joint along my nerve. Still able to work out daily but will assess if it is worth stopping everything upper body to give it full time off.
Current recommendation (as of last Wednesday) is continue what I'm doing and come back in a month is pain still continues. Hoping for less and less aching episodes and eventually an ease back into climbing

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

Update 2:

Slow but sure recovery...
I believe I am 6-7 weeks out of climbing and have felt a gradual improvement in my nerve. I have switched off of upper body weight training completely in order to try to finish off the last bit of inflammation that I am having in my nerve.
I am well past the depressed mindset of being unable to climb and have just moved into doing everything I can to get back without rushing any part of the process. Hoping to be climbing within the next two weeks but as of now it's still just a waiting game.

grog m · · Saltlakecity · Joined Aug 2012 · Points: 70

Thanks for the update. Not climbing is depressing but you can do some other stuff that you would normally put off - dating, cardio, etc

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

Mini Update 2.1:

So a new gym opened and I ended up going in and climbing 3 routes
5.7= on a slab (no overhang)
5.8= no overhang
5.8= slight overhang at the top

No pain during climbing but was very aware of straining my right arm.

Next day:
Nerve isnt much better or worse, there really isnt much pain at all anymore just an "off" feeling. I will continue to leave out upper body workouts for another week and probably continue to skip climbing for another week or so. Promising but still not ready to come back 100%

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

Update 3:

Finally.. FINALLY not having constant pain in my armpit down to my elbow. I am now off of the daily Advil regiment and have just now started to introduce some light upper body lifting into my weekly routine. Was at the climbing gym yesterday and still decided to hold off on climbing until I am 100%. I am hoping to be fulling back to an upper body routine in the weight room in the next week or two and will be hopefully back climbing within 3-4 weeks.

Its been a very slow and painful recovery process that, I realize now, could have been prevented through multiple red flags that were being waved before I had to call it quits... Trust me (now out for over 2 1/2 months of climbing) when your body tell you to stop... DONT PUSH THOUGH IT... It's not worth it..

I will continue to update until I am finally back on the wall full time.

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180

Update 4:
Pain has continues even with almost all elbow use being eliminated.... Getting an EMG test tomorrow with the intent to confirm that I will need Ulner Nerve Transposition surgery sometime in the future..... Not exactly where I was hoping this injury would take me and I'm not too encouraged about it

grog m · · Saltlakecity · Joined Aug 2012 · Points: 70

Hang in there man and keep believing. This is how climbing goes for people who stick with it long enough - intermittent periods of injury. You might have to step back from it for a while and entertain other hobbies...for now. But I promise you will be back

Joe Keyser · · Scottsdale, AZ · Joined Jan 2001 · Points: 1,047

SinRopa said:

"PRP (platelet rich plasma) therapy. Miracle cure for me. YMMV..."

How long did you have the tendon issues before trying the PRP?

I have had some tendon issues on the inside elbow for over a year, and am thinking of trying it. Doesn't stop me climbing but makes it hurts some. That is not a problem in itself unless it fails, which I'd rather it doesn't.

David Pagel · · Milwaukee · Joined Mar 2016 · Points: 180
Joe Keyser wrote:SinRopa said: "PRP (platelet rich plasma) therapy. Miracle cure for me. YMMV..." How long did you have the tendon issues before trying the PRP? I have had some tendon issues on the inside elbow for over a year, and am thinking of trying it. Doesn't stop me climbing but makes it hurts some. That is not a problem in itself unless it fails, which I'd rather it doesn't.
It's a nerve issue, not a tendon issue
Joe Keyser · · Scottsdale, AZ · Joined Jan 2001 · Points: 1,047

Hope that gets better. I read that nerve issues in the neck can also lead to elbow nerve and/or tendon problems. Might check that out with a chiropracter? There is a lot of information out there and nothing very consistent. So I really don't know anything other than the fact that elbow issues are usually stubborn. I had a issue in the outside of my elbow for 5 months and it suddenly vanished.

For my current inner elbow problem, I have had two cortisone shots in 1.5 years, and tried prolo. I heard the comment from the guy that had success with PRP and was hoping to know more about that situation. I hate to chase cures that might do nothing but waste time.

I can also say that I cut a tendon in half on my hand once and had it sewn back together. Was in a cast all winter ice climbing with one hand, probably 15 years ago. Really improved my footwork..

Guideline #1: Don't be a jerk.

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