Climbing with Tennis Elbow

So, I've had fairly clear signs of lateral epicondylitis for about 3 months now, ever since my last trip to the Red (goddamned 5.10 wall at Roadside climbing nothing but pockets all day did it). When the pain was acute after the trip, I took about 2 weeks off until the pain was fully gone and then slowly incorporated moderate climbing back in combined with PT exercises (dumbbell, hammer, gyro ball). I've pretty much been there ever since.

When climbing, I am 100% pain free, but I'll usually feel moderate-uncomfortable pain and soreness 1-2 days after climbing, depending on the intensity of the climbing. Tweaky rope climbing and bouldering will usually make it worse, juggy climbing can sometimes actually make it better. PT exercises will usually diminish or eliminate the pain on rest days, but I can't quite seem to kick it completely, and I'm getting frustrated because it is difficult to improve when your training volume and intensity have to be so low.

I realize that the obvious response will be "see a dr," and I may have to do that if it comes down to topical/injected cortisone, but I'm trying to figure out how to kick the chronic pain and ramp my training back up without ceasing climbing completely. Things have been really stressful in my life lately, and exercise has always been my personal coping mechanism, climbing being the best form. To be honest, I don't think I could emotionally handle not climbing right now, although I recognize that continuing to climb has probably slowed my recovery.

So, for those of you who have suffered from lateral epicondylitis...
1) Is it possible to be rid of it while continuing to climb moderately?
2) How long did it take for full recovery?
3) Did it require cortisone, or did you try this? What were the results?

I've had it and managed recovery while continuing to climb. I was in the construction trades and didn't realize my work was aggravating the tendonitis. Once I clued on that I wore an elbow brace all the time...24/7 Even especially sleeping.
I backed off the grades and did more slabs. Vitamin C for inflammation..maybe some other supplements and ibuprofen plus deep massage to break up the scar tissue. Traumeel homeopathic ointment on the spot and cover with plastic wrap for a few hours.
I never climbed without the brace. One which worked best for me had a small pillow inside it for point pressure. Has a strap. Takes 2x times longer to heal this way. Didn't use cortisone injection but that can jump start the healing if you don't go out and overuse it cause it feels OK.

I have chronic lateral epi. and sometimes quite severe. I have found that if I don't climb at all it is just as bad. If I climb too hard it gets worse. There is a fine line of use that helps keep the pain at a minimum but does not make it worse.

As for how long it takes to get better...I'm going on a couple years. One elbow gets better and then the other one acts up. Repeat. It's really never gotten completely better.

Never tried cortisone, but definitely considering it.

Ted I don't have any advice on your three questions other than 1., yes it is possible I think, IANAD. But the thing that really helped me get over it was doing this exercise (the one with the hammer) ALL the time. Like, at work I'd be sitting there doing it with an inverted water bottle or something. I'm guessing you already know about it but I doubt you are doing many hundreds of reps a day like I was. I also found backstroke swimming* to be really effective, if you have access to a pool. *Backstroke only, the other common strokes replicate climbing movements.
youtu.be/XK9tqcQnykE?t=89

First question is how old are you?
Ever swing a hammer for a living?
I was in construction, swung the 32oz for years, got to the point i could not grab and turn a door handle, swing a hammer, etc. 1 cortisone shot took care of it for 20 years, until i started climbing.
5+ years into climbing, and i live with constant elbow pain; epicondylitis. Both tennis and golfers. This has been diagnosed by multiple docs. Pain runs from shoulder to 2nd knuckle of middle 3 fingers.
Funny thing is, climbing hard alleviates the pain temporarily.
What i have done for this is threefold;
1) Cortisone shot in my index 2nd knuckle. Worked wonders. ( I had taken a hard fall onto a great ring lock, 10% flexion in finger improved to 75%). This also concurrently helped my elbow for some months, not sure why.
2) Cortisone shot to the elbow. Having done research i spoke with my doctor ( i am very lucky to have a GP who is a sports med specialist; works with Olympic team) who is on the side of the benefits of cortisone shots. DO your research. YMMV.
3) I have multiple physical issues, knees, hip, elbow shoulder, hands. Use and abuse. Multiple doctors, physicians, surgeons have all had the exact same advice:
"Use it or loose it. Keep doing what you are doing, deal with the pain, don't push too hard, make sure you get plenty of rest".
I am 60yo next month, been climbing going on 6 years. Hope to find a 13 i can project this season. (Not good at thuggery!)
SO the long and the short of this missive is:
a) See a doctor to really know what is what.
b) Keep doing what you're doing, it don't get any better. (Again, YMMV and age dependent).

I had it in varying degrees for years and years. It only went away for good when, as a byproduct of old age, I started climbing less difficult pitches.

But there is more and better information available now than I had. For an excellent climb-specific account, see drjuliansaunders.com/dodgy-…

This just hit me out of the blue, too, so thanks for this post. What's bizarre is I have barely had time for climbing lately, and the tennis elbow flared up on a hike (taking lenses out their holders). Weird. Now it's really bad.

Should I try those exercises while it's still sore, or should I wait?

I used to get lateral epicondylitis pretty bad and pretty frequently (off and on for years). A couple years ago, I tore my labrum (climbing) and had to have surgery followed by physical therapy. When I was in physical therapy, I also talked with the physical therapist about the problems I had suffered from previously with the lateral epicondylitis. She said that a lot of people develop pain in the lateral elbows but it's actually due to shoulder weakness/laxity. Since I've gotten back into climbing over the past year, I've been training as hard at climbing as I ever did before, but have also been blasting my shoulders in the regular gym with weights. With the additional shoulder training, I haven't had any issues with the epicondylitis. I do the weight training for overall strength, but also add in shoulder stability exercises like internal and (especially) external rotation using the cables. It probably wouldn't hurt to add some triceps and chest exercises in as well to help balance the muscle groups.

Cool, that's reassuring. I've heard that about the shoulders before on one of the thousands of tennis elbow vids I've watched, good to know it worked for you. I'll try it!

Also, Andy I've been doing the hammer exercise, but not excessively. Maybe I should try doing it more.

Muscrat wrote:First question is how old are you? Ever swing a hammer for a living? I was in construction, swung the 32oz for years, got to the point i could not grab and turn a door handle, swing a hammer, etc. 1 cortisone shot took care of it for 20 years, until i started climbing. 5+ years into climbing, and i live with constant elbow pain; epicondylitis. Both tennis and golfers. This has been diagnosed by multiple docs. Pain runs from shoulder to 2nd knuckle of middle 3 fingers. Funny thing is, climbing hard alleviates the pain temporarily. What i have done for this is threefold; 1) Cortisone shot in my index 2nd knuckle. Worked wonders. ( I had taken a hard fall onto a great ring lock, 10% flexion in finger improved to 75%). This also concurrently helped my elbow for some months, not sure why. 2) Cortisone shot to the elbow. Having done research i spoke with my doctor ( i am very lucky to have a GP who is a sports med specialist; works with Olympic team) who is on the side of the benefits of cortisone shots. DO your research. YMMV. 3) I have multiple physical issues, knees, hip, elbow shoulder, hands. Use and abuse. Multiple doctors, physicians, surgeons have all had the exact same advice: "Use it or loose it. Keep doing what you are doing, deal with the pain, don't push too hard, make sure you get plenty of rest". I am 60yo next month, been climbing going on 6 years. Hope to find a 13 i can project this season. (Not got at thuggery!) SO the long and the short of this missive is: a) See a doctor to really know what is what. b) Keep doing what you're doing, it don't get any better. (Again, YMMV and age dependent).

teece303 wrote:This just hit me out of the blue, too, so thanks for this post. What's bizarre is I have barely had time for climbing lately, and the tennis elbow flared up on a hike (taking lenses out their holders). Weird. Now it's really bad. Should I try those exercises while it's still sore, or should I wait?

What worked for me was Trigger Point therapy. This was what got rid of the pain after I tried the exercises from dodgy elbows and rest.

theinspiredclimber.com/2014…

I started with the foam roller, and then moved to finger massage of the forearm (medial epicondylitis) and upper arm (lateral epicondylitis). If it hurts like hell, you are doing it right! Find the most painful area, and massage as hard as you can tolerate. Over several massage sessions (over a few days), the pain subsided. Now, if I feel some pain returning, I nip it in the bud right away, but I haven't really had any problems after getting rid of the pain the first time.

Good luck!

Have you listened to the training beta podcasts? The one below was a really good one about injuries. Maybe it will help.

Training Beta Podcast #026

recent scientific study finding reported in NYTimes is that people who performed special exercises for Tennis elbow had long-term outcomes and speed-of-healing only slightly better than people who just carefully returned to normal use.
. (but both of those groups did better than the ones who got surgery).

Conclusion of the article was that you'll save time by just being patient and waiting for your body to take care of healing the Tennis elbow.

Ken

Here's the reference for the original study reported in the NYT, for those interested.

bmcmusculoskeletdisord.biom…

Here's a description of the physio methods

A cooperating physiotherapist treated patients twice weekly for six weeks with deep transverse friction massage at the tendon origin for 15 minutes, Mills manipulation [21, 22] once each treatment session, and soft tissue treatment with stretching of the radial wrist extensors. The patients received oral and written instructions for home exercises daily for six weeks with eccentric exercise (three times 30 repetitions) and isolated stretching of radial wrist extensors (three times daily for 40 seconds). The eccentric exercise was done within tolerable pain level during the exercise by using a 500 ml bottle filled with increasing volume of water or sand as patients improved.

Other forms of physiotherapy may be more effective, but I don't have any expertise or much interest in the specifics. No doubt that will change with my next attack of climbers elbow!

I do recall thinking that those elbow bands I wore, that put pressure on the epicondyle, seemed to help, but maybe it was all placebo.

Well, the placebo effect is funny when it comes to pain management. If you feel better, does it matter?

I have had tremendous success in using Flexbar / Tyler Twist exercises to control then eliminate lateral epicondylitis. For the first time in many years of recurrence I am now on top of it and experiencing no pain. rgolds link to Julian Saunders' web page on the subject is gold - he helped me understand it, then I refined the suggested exercises using the flexbar (just google Tyler Twist).

A friend who I put on to this also had great success - but it did not work at all for my wife's case....

Good luck, it is a royal pita.

Flexbar did wonders for me too.

Muscrat wrote:First question is how old are you? Ever swing a hammer for a living? I was in construction, swung the 32oz for years, got to the point i could not grab and turn a door handle, swing a hammer, etc. 1 cortisone shot took care of it for 20 years, until i started climbing. 5+ years into climbing, and i live with constant elbow pain; epicondylitis. Both tennis and golfers. This has been diagnosed by multiple docs. Pain runs from shoulder to 2nd knuckle of middle 3 fingers. Funny thing is, climbing hard alleviates the pain temporarily. What i have done for this is threefold; 1) Cortisone shot in my index 2nd knuckle. Worked wonders. ( I had taken a hard fall onto a great ring lock, 10% flexion in finger improved to 75%). This also concurrently helped my elbow for some months, not sure why. 2) Cortisone shot to the elbow. Having done research i spoke with my doctor ( i am very lucky to have a GP who is a sports med specialist; works with Olympic team) who is on the side of the benefits of cortisone shots. DO your research. YMMV. 3) I have multiple physical issues, knees, hip, elbow shoulder, hands. Use and abuse. Multiple doctors, physicians, surgeons have all had the exact same advice: "Use it or loose it. Keep doing what you are doing, deal with the pain, don't push too hard, make sure you get plenty of rest". I am 60yo next month, been climbing going on 6 years. Hope to find a 13 i can project this season. (Not good at thuggery!) SO the long and the short of this missive is: a) See a doctor to really know what is what. b) Keep doing what you're doing, it don't get any better. (Again, YMMV and age dependent).