Golfer's Elbow (Yes I did the forum search first)

I cured myself with some simple changes and specific weight training.

#1 Change: NO CLIMBING ON LITTLE TINEY CRIMP EDGES IN THE GYM.

If your Middle finger/knuckle sticks up when you grab on, don't do it.

The workout that worked for me is a "Modified Frenchie"

Do a Arm Blaster workout, Triceps, Biceps, and your forearms, work them till failure.

Then, basically, you lie on your back, on a bench. Pick a light Bar, I use one with no weights on it. Hold your hands close together with the back of your hands on your forehead. Push the bar UP- IN TILL - your forearms are parallel to the floor - NOT ANY FURTHER - Keep your upper arm perpendicular to the floor. This is repeated over and over 20 times/set. The weight should be low so you never get pumped. While you are doing these, if you have blasted the big muscles, all the small muscles will get working and your elbows should feel warm.

I only bore folks with this advise because it worked for me.... That was 20 years ago, the advent of plastic and glue, I can still pull pretty hard with zero elbow pain. So try it.

Good luck

The R&I article that JohnJ80302 linked seems excellent, and from an authoritative & knowledgeable source (Dr. J). In the program at bottom Dr. J writes, "We are interested in an eccentric load (a.k.a. negative contraction) only." That matches a really interesting NYTimes article awhile back (link below). I asked my PT (he's a climber and great therapist) about it, and he said, indeed, the eccentric work is well-established/proven stuff for treating tendonitis. The rubber bar gizmo in the article surely isn't anything magical in itself, but just a way to elicit that sort of eccentric work.

well.blogs.nytimes.com/2009…

A good eccentric exercise is doing assisted wrist curls. Using a light weight dumbbell and assist your arm in the contraction(flexion) with your other hand. Then release and extend your fingers down and roll the dumbell out onto your fingertips without dropping the weight on your toes, then use your other hand to assist in another contraction.

Good form has you in a seated position with the back of your forearm on your leg. You want to isolate the forearm flexor and not use your bicep or shoulder.

BTW reverse wrist curls while a good exercise for climbers does nothing for medial Epicondylitis. It is a preventative exercise for tennis elbow ( i.e lateral Epicondylitis).

Do a search for Julian Saunders to get some good climbing specific advice for your condition.

Also I agree with the above that you will not fully rehabilitate golfers elbow without PT or moderate climbing. You should stay off your wall though until it no longer hurts when you are climbing. It is going to hurt after climbing for a while.

I had golfers elbow a while ago, because of climbing. I found through research that one of the best things you can do for golfers elbow it to wear a golf elbow brace . This alleviates pain by redistributing stress on the elbow as well as adding compression to draw blood to the area which decreases pain.

I have had tendonitis on the tendons for both my brachioradialis muscles (first my right, then I was putting most of my weight on my left to avoid my right arm, and that ended up injuring my left). Terms like golfer's elbow could actually be caused by injuries in any of several tendons, including the brachioradialis. A good doctor or physical therapist will be able to figure out exactly which tendon is the problem.

At the worst times I was unable to brush my teeth because my elbow would hurt so bad. It has been about 3 years and there is still some pain, but only minimal now and only when my arms are at certain positions. I had to stop bouldering when the problem was at its peak, but I never stopped rock climbing at all. I had two physical therapists, one was good and the other was very good. They gave me exercises and stretches to do which I did every single day; I think I've blown off the exercises 5 times, tops, in the past 3 years. The deep tissue massages from the therapists seemed to help a lot also.

So I guess I'm going against what other people say. I had fairly severe golfer's elbow, but I didn't stop climbing. I only scaled it back (by cutting out bouldering). Maybe if I had completely stopped climbing for a year or so it would have healed faster, but I didn't want to stop completely. During treatment, I saw my therapist weekly and did exercises/stretches every day. I'm hoping that within the year I'll be pain-free...but I'll keep doing those stretches and exercises, tendonitis really sucks and left me in a lot of pain for a long time.

Bill Shubert wrote:I have had tendonitis ... I had fairly severe golfer's elbow...

Tendonitis isn't golfers elbow, it's tennis elbow. Golfers elbow is Tendonosis and as has been mentioned, reverse wrist curls are the cure. I've never had tendonitis, so I can't comment there.

kennoyce wrote: Tendonitis isn't golfers elbow, it's tennis elbow. Golfers elbow is Tendonosis and as has been mentioned, reverse wrist curls are the cure. I've never had tendonitis, so I can't comment there.

From national library of medicine: "Tendinitis is inflammation, irritation, and swelling of a tendon, which is the fibrous structure that joins muscle to bone. In many cases, tendinosis (tendon degeneration) is also present." They usually go together. Although you are right, when I looked up golfer's elbow, I see that the tendon involved is not part of the brachioradialis. So I had a different elbow+tendon issue.

Golfers Elbow is medically known as Medial Epicondylitis and involves the wrist and finger flexor muscles and pronator teres.

Tennis Elbow is Lateral Epicondylitis and involves the wrist and finger extensors and brachioradialis.

Both can be inflammatory = Tendonitis
Or they can be non-inflammatory and in the chronic stage = Tendonosis

Here's a more permanent link to the Rock and Ice article by Dr. Julian Sanders. Thanks to Dr. Sanders for making this article available on his website:

drjuliansaunders.com/resour…

Bill Shubert, I am confused, you say you had this for three years and never stopped climbing, but your profile says you started climbing in 2012.

My experience, having had mild tendonitis (golfer's elbow) at least twice before, and fairly prolonged tennis elbow for about 10 months pretty recently, is that not climbing isn't a long term fix for the problem. Every time I start climbing again it comes back immediately with no real reduction in severity.

What seems to work is dialing down my intensity (for me, no bouldering - stick to moderate difficulty routes), warm up slowly and thoroughly, and with this most recent bout - I started stretching, eccentric contractions, massage, and use of a compression sleeve for the aggravated arm.

Stretches and eccentric contractions similar to what is shown here: stretches and contractions except I didn't do the lifting part, just slowly lowering. Three sets of ten of each, usually morning and evening, a day or two on, a day off. Especially did them the days I climbed.

I bought one of these: armaid It wasn't as obviously helpful as the stretching and eccentric contractions but probably did help some especially when I first started using it.

Compression sleeve: sleeve was helpful in minimizing further aggravation during any strenuous exercise involving my arm.

kennoyce wrote: Tendonitis isn't golfers elbow, it's tennis elbow. Golfers elbow is Tendonosis and as has been mentioned, reverse wrist curls are the cure. I've never had tendonitis, so I can't comment there.

Golfer's elbow and tennis elbow refer to, respectively, the inner and outer parts of the elbow joing. golfer's elbow tennis elbow

They're basically the same kind of injury, just different locations.

Charles Vernon wrote:Bill Shubert, I am confused, you say you had this for three years and never stopped climbing, but your profile says you started climbing in 2012.

I started bouldering in fall 2011. Started climbing in January 2012. My tendonitis came from weightlifting, I got it in late 2010, started going to a physical therapist (which is when it started getting better) about when I started bouldering. So maybe 2½ years of tendonitis, not 3, sure, and I have been climbing/bouldering for just under 2 years of that.

I guess people on this site are sticklers for accuracy.

Jeff G. wrote:Golfers Elbow is medically known as Medial Epicondylitis and involves the wrist and finger flexor muscles and pronator teres. Tennis Elbow is Lateral Epicondylitis and involves the wrist and finger extensors and brachioradialis. Both can be inflammatory = Tendonitis Or they can be non-inflammatory and in the chronic stage = Tendonosis

Correct.

FYI, you can climb through these injuries, and it is almost always possible to eliminate the stmptoms with proper excercise. Ponation and supination excercise and wrist curla work wonders.

Jake Jones wrote: This is incorrect based on what therapists and doctors have told me. Tendonitis is the initial inflamation or tissue damage to a tendon. There is almost always inflammation, but not always tissue damage in the form of a tear or rupture of the tendon. It can occur anywhere. Medially or laterally in the elbow, the shoulder, the knee, virtually anywhere that there is a joint. Tendinosis is a recurring degenerative condition where the tendon heals, or partially heals from damage (tear or rupture) that occurred, but repaired tissue scarred and hardened, making the tendon "tighter" which lessens range of motion, which usually causes more tearing and damage either at the same site as the previous damage, or a new site. This is why true recovery times and rehabilitation methods are so much more involved for tendinosis vs. tendonitis- because it takes a lot of time in efforts to increase blood flow to the affected area, ensure that it has truly healed 100% all while trying to maintain or regain flexibility and range of motion so that that the injury doesn't recur and worsen.

Interesting, I thought I had read somewhere (a R&I article possibly?) that climbers generally get tendonitis in the outside of the elbow (tennis elbow), and tendonosis in the inside of the elbow (golfers elbow). I know that at least personally, I get tendonosis on the inside of the elbow if I don't do reverse wrist curls.

As far as I know, the terms tendonitis and tendonosis are not black and white and universally accepted in their medical definitions. I believe some professionals have advocated the two usages to indicate different presenting stages of a chronic injury but I am not sure there are literal insurance coding differences or if it influences a doc's treatment...because treatment isn't based on semantics per se.

Whatever Jake said...I really believe is not completely accurate. My god, you could ask 5 doctors or therapists about this and get 5 variable answers. So whatever.

Bill Shubert wrote:I guess people on this site are sticklers for accuracy.

Forevar and evar! We accept nothing but the utmost in omnipotent perfection on this piece of gold!!!!!

Bill Shubert wrote: I started bouldering in fall 2011. Started climbing in January 2012. My tendonitis came from weightlifting, I got it in late 2010, started going to a physical therapist (which is when it started getting better) about when I started bouldering. So maybe 2½ years of tendonitis, not 3, sure, and I have been climbing/bouldering for just under 2 years of that. I guess people on this site are sticklers for accuracy.

Hope I didn't come across as a dick. I have had a nagging case of tendinosis for over a year and a half, so I read everything I can about the condition and particularly find it interesting when people have had successful experiences climbing through it. It's helpful for me to know that (1) you basically just started climbing; (2) climbing isn't what caused the injury and (3) you climb moderate routes. NO OFFENSE!

There are so many variations to this condition, and so many theories about how to treat it, that hearing about someone's experiences has become pretty meaningless for me without a lot of context.

Warm-up a lot, slowly.
Take fishoil a couple times a day.
Do opposition exercises like curls, pushups, dips, etc.

Charles Vernon wrote: Hope I didn't come across as a dick. I have had a nagging case of tendinosis for over a year and a half, so I read everything I can about the condition and particularly find it interesting when people have had successful experiences climbing through it. It's helpful for me to know that (1) you basically just started climbing; (2) climbing isn't what caused the injury and (3) you climb moderate routes. NO OFFENSE! There are so many variations to this condition, and so many theories about how to treat it, that hearing about someone's experiences has become pretty meaningless for me without a lot of context.

It's OK. I was mostly puzzled by why you even cared enough to compare my post with my profile.

And you're right, I was a new climber, doing moderate climbs. And as I said, I had to stop bouldering; the months I bouldered, my tendonitis got progressively worse, but once I switched to moderate top roping, it could heal. At this point I'm able to boulder again, and it doesn't seem to bother my tendons, but I never boulder more than once a week just to be safe.

I still do think that I serve as an example that at least in some cases, you can continue climbing with tendon issues. But you may need to stick with less strenuous climbing, and you definitely should have a good physical therapist.

I hope David Hodges is getting good info here.

Tendonitis and tendinosis are different and should be diagnosed and treated differently. They are highly misdiagnosed. Mr. Jones and Jeff G. are on the right track as far as what the literature says but whether practitioners properly diagnose and treat the issue correctly is another story all together. There are a lot of stupid PT's and Docs.

Many treatment plans for tendon issues center on controlling inflammation. The problem is there is no inflammation in -inosis. Realistically, there are only a few differences in treatment. Expect a longer healing time with tendinosis (months compared to weeks), skip NSAIDS (you'd be better off taking Vit C and E. Some in NSAIDs have been shown to impair tendon repair and there is no inflammation to control), you should be doing some sort of strengthening exercises instead of a solid 6 months of rest, and you should consider changing your habits when you get back into whatever caused the issue (warm-up routine,, # of days you climb, that sort of stuff.)