Tennis Elbow success stories?

Working toward success-ish...!? Thirteen months out from the initial trigger (not tennis or climbing, specifically; bad pole strap adjustment and poor poling technique tele and xc skiing last xmas). I babyed it for the next 4-5 months rock and ice climbing, following generic recommendations for stretches and PT, but it got really bad when I tried to climb harder again after ski season and ramped up mountain biking. By June, it the most gentle touch hurt and burned if I tried to grip anything with my palm or thumb down. I stopped mountain biking entirely, and relegated myself to top rope climbing 5.8s, using the right hand for balance.
My chiropractor started treating me with a combination of the graston technique and dry needling that got me to the point that I could touch the outside of my elbow again without jumping out of my skin after 6 weeks or so. I iced and took ibuprofen (too) frequently, which helped with the pain (until I came close to an ulcer), but don't think that inflammation was really ever an issue.
My massage therapist turned me onto an amazing homeopathic massage gel called Lasting Touch that was immensely helpful for relieving the pain topically.
Also ALWAYS wearing a wrist brace to sleep is a huge help!
I started formal PT in September when I wasn't improving on my own and focused on rebuilding shoulder and back strength so I could stabilize my arm better in preparation for returning to mobility. Nerve flossing exercises, pec stretches, and very lightweight eccentric strength training seem to be the things that helped me break through finally after another solid 8 weeks.
I saw an otho specialist to make sure there wasn't anything more going on that was impeding healing. He said sometimes it just takes 12-18 months to resolve on its own. He couldn't guarantee surgery would help, so referred me to a colleague seeing positive results in platelet replacement therapy (PRT). Oddly, the most helpful thing he said was that I couldn't do more damage or make the condition worse; only the symptoms, if I pushed through the pain to increase my "activity" levels. I essentially felt like he gave me permission to return to all of the lame everyday "activities" that I had been avoiding because I didn't think they were worth reinjuring myself or causing a setback (e.g. picking up a 10+ oz coffee/beer, squeezing the tube of conditioner, putting more than one dish away at a time).
PT has continued to improve the situation. I feel like I'm in line for success, but not there yet. I have bumped up to TR 5.9s and a few 5.10s now and then at the gym. Managed to ice climb with a workaround (hooking with my right tool, and only swinging with my left). I've adjusted the brakes and gears on my mountain bike so I can squeeze them with several full fingers, not just the first knuckle on one, and I ride on the bike path, not trails so I don't have to push or pull on the bars. I adjusted my ski poles so my thumb stays pointed up and am mindful of maintaining an upright posture with shoulder set in the socket, and have managed to xc and ski uphill successfully/ditch the poles when I tele down.
Without PT, I think I would've continued making modifications and coming up with workarounds that were more harmful than helpful in the long run.
I met with the PRT specialist last week for more info. He says he has a 60-70% success rate with one treatment ($550), another 15-20% after two treatments, the rest are out of luck. Trouble is the 6-week recovery period where they don't want you lifting or stressing that arm much at all. If I don't continue to improve, I'll reconsider it... after ski and ice season. ;)
It's been an extremely slow and humbling go, but I'm hopeful now that I'm making more progress. Best of luck to a full and speedier recovery than me!             

I was off climbing for 6 months. I am pretty much all better now. I am a doctor so I get more frank discussions with other docs, and the hand surgeon pretty much told me time will heal and no actual intervention makes you heal faster. I had whole blood injected into the joint which made things worse. Other stuff I tried like acupuncture and stuff were useless. In the end I think time was what made it better along with PT. My hand therapist was my climbing partner so that was nice. I am sure you will get through this. It can be a really long journey though. Hand surgeon was quoting up to a year so I am glad it wasn’t that long for me. 

I had serious medial epicondylitis in 2015 from excessive hand jamming on steep terrain (I went from climbing outside once a week to five times). The motion of opening a door handle would trigger it. I was getting symptom relief from a massage therapist but it was an expensive bandaid.

Antagonist muscle training and the Armaid resolved it for me.

Thanks for the tips on the Wave Tool.  I had tennis elbow for 4 months from a three day session cleaning routes with a wire brush. No improvement until I used the wave tool to go to town on my pain points. Massage hadn't worked. Eccentrics alone hadn't helped.  But here's the combination that helped:

1) Graston/ASTYM with the wave tool. First swipe hurts like hell, but the fifteenth always seemed to barely hurt.  I mirrored the motions on my other elbow to ensure I wasn't doing too much bruising.

2) Tyler Twist with theradong green.

3) Hot/cold baths.  Run your elbow under the kitchen sink as hot as you can handle until you get used to the temp, then switch to cold water until you adjust.  5 or 6 iterations and stop on hot.  Really promotes blood flow to promote healing of the graston damage.

4) Climbing easy routes at the gym with a focus on endurance over cranking.

5) I cut out everything that might exacerbate the problem like my manual coffee grinder.  Optimized my typing posture and wrist support.  Took lots of breaks, etc.

Anyways, I'm like 80% better now and the pain is not interfering with any climbing.

I think this is a good read when dealing with elbow issues, http://drjuliansaunders.com/dodgy-elbows/  

grug g wrote:

Well? Update OP?

Sorry it's been a minute since I've posted.

Finally after about 9 months I'm just now *starting* to see some noticeable improvement.

I'm back to going to the climbing gym about once or twice a week, but I'm limiting myself to "easier" routes, and only 3-4 routes per visit. I put "easier" in quotes because they don't feel so easy anymore, hah!

The improvement:

• My forearm & elbow no longer just randomly hurt throughout the day. The static pain is gone. In order to cause pain I have to do specific movements (like pinching a laptop and lifting it - that's the worst!)
• After the light climbing gym workouts, my tendon no longer flares up! By the end of my climbing I feel a general soreness / weakness that usually precedes the tendon flare up, but that's as far as it has been going. For contrast, a few months ago, even doing just 2 easy routes would cause the tendon to get all pissed off. So ya, pretty big improvement

I have no idea what's helping it to start feeling better, but my perception tells me pushups have helped a lot. I do them every day, and use them to help warm up before climbing now.

The injury is definitely still very present, and I think if I did any routes that required pinches, or pulling on crimps, it'd probably piss my arm off really bad, but the improvement I've been having is quite encouraging.

Update:

Injury is still very present, but I think it's starting to fizzle out a bit. It's been almost 10 months since I realized it was really injured in a bad way.

I've been going to the climbing gym twice a week, and also playing basketball 2-3 times a week since the beginning of February. 

I've continued to do lots and lots of pushups, as well as the wrist flex exercises. I've also continued to do graston on myself every 2 weeks or so.

The pain I used to feel when pushing on the tendon in the elbow I haven't felt for quite awhile now. Even after trying hard in the gym, it does not appear!

I've been warming up before I climb religiously by doing tendon flexing exercises with my fingers, pushups, and hangs.

What does still hurt:

• Start of a climbing gym session: Certain moves trigger mild to moderate pain in my forearm / elbow - I try to avoid these, but sometimes the route demands it.
• Towards end of climbing gym session: Every move I make with the bad arm triggers at least mild pain in my forearm / elbow - This has been my cue to call it a day.
  • After this, my whole forearm and elbow have a general soreness/achiness to it, but the elbow tendon itself feels fine, even if I push on it.
  • While in this state, clenching my fist and rotating my elbow causes pain.
  • This state is now only lasting a few hours after a climbing session, whereas a few months ago it would last at least 24 hours.
• Picking up a laptop by pinching it, or picking up an object with any weight to it with my palm facing down, and then rotating elbow inward toward me will trigger pain
• If I keep my elbow bent, and keep my wrist straight, and then try to flex my wrist backwards while putting resistance against it, this triggers pain (However, if my arm is straight while doing this, there is no pain).

My motivation for keeping this thread updated is for future climbers that end up with this injury. Hopefully it can be helpful for these hypothetical future people, and give them some realistic expectations from a real-life example.

That's great Avram!
For me it was definitely the push ups - sounds weird but it really worked. 

Also - overhangs and shock loading the elbow would exacerbate the issue and it took a bit longer before that sort of climbing didn't irritate my elbow.  (FWIW)

Hey Avram,

If you are willing to put out a little bit of $ I would def recommend reaching out to camp 4 human performance.  I had serious elbow issues, which turned out to be distal bicep tendinosis.  Basically had pretty serious pain doing something like brushing my teeth.  This place, when you consider the normal cost of paying a PT per visit, is pretty minimal and they set me up with a workout plan (each segment could last a month or more) and focused heavily on doing isometric holds at certain elbow angles amongst other exercises (think modifying your pushup, so instead of doing full range of motion you might lower only down to 120 degrees or 90 degrees and then hold the position for 10 seconds and go back up, this works as well with pull up bar hangs (stepping off a box or something so you don't move the angle).  Took some time (as you noted with your ongoing 10 months of rehab), but I started seeing improvements after a couple of months and this issue is now basically resolved.  Worth the $ in my opinion.

Cheers!

There is some great advice in some of the above replies, but just a couple of things to note…..if you are getting repeated bouts then effectively you are training an imbalance and you need to understand the root cause…each root cause will potentially have different solutions.  It you find your solution you need to keep doing it more regularly than training ( not same day, think active rest).  For me I had a bad bout 3 months after breaking my back.  Muscle wastage in my shoulders led to over exertion of my triceps, which put a strain on my forearm tendon leading to the elbow injury…..my solution is simple but took a while to find, i do sets of narrow press-ups (elbows touching sides) the day after climbing to strengthen the triceps.  normal press-ups train different muscles….good luck…..

Ring dips. Ring dips. Ring dips. i cant preach this enough

pkeds wrote:

Ring dips. Ring dips. Ring dips. i cant preach this enough

Sounds way more complicated than just doing some pushups. Care to explain why ring dips are worth the effort?

+10 for pushups

grug g wrote:

Sounds way more complicated than just doing some pushups. Care to explain why ring dips are worth the effort?

Works th muscles around the elbow / forearm better which promotes faster recovery and better treatment.  

grug g wrote:

Sounds way more complicated than just doing some pushups. Care to explain why ring dips are worth the effort?

Way more stability work in elbows. Rings aren't static like the floor 

Quick update:

It's still improving slowly. In 2 weeks it'll be a full year since I realized I had a major issue. 

My affected arm feels tighter / stiffer than my good arm after getting pumped on a route, and just gets inflamed / irritated easier than the good arm. Certain moves like side pulls and pinches cause just a little bit of pain (Nothing too bad, just enough to remind me it's there...)

I'm up to about 60-70 pushups a day (I do a set of 40, rest, and then do them to exhaustion). Still doing wrist flex exercises, and have been doing a light daily hang-board routine for my fingers.

I'm starting to think that without surgery, this may never 100% go away, but I think that's okay. I'm already (after a year) to the point where it's more of a nuisance than something that is debilitating. As long as I keep seeing improvement, it continues to be manageable, and I feel I can continue to improve & challenge myself as a climber without relapsing the injury, I can be optimistic and content.

I watched this 10 minute youtube video last week and it changed everything I knew about tennis elbow. Seriously this explains all my problems from deadlifts, pull ups, and climbing. 

Its all about maintaining a neutral wrist position during exercises. After watching this video I paid attention to how I was cocking my wrists for various exercises and holy shit I was using poor wrist form. Almost no doubt in my mind that this could help you too. 

https://www.youtube.com/watch?v=XXjaCsUlrZs

Quick update. It took 14-15 months, and the pain is mostly gone now. Gets slightly flared up when climbing hard, or if I sleep on it wrong. But I'd say it's 90-95% better than it was at its worst. 

Daily pushups to exhaustion, and wrist extension exercises felt like the key to me. I still do them every day. I also warm up the tendons before I climb religiously, and always start on an easy route before I try something hard.

Thanks again everyone in this thread for your advice, and words of encouragement.

Someone mentioned this way back at the start of the thread, but be on the lookout for non-climbing related causes.  My medial epicondylitis went away as soon as I stopped bench pressing with a barbell and switched to dumbbell / machine where I could get my hands about 30 degrees off prone.

 I much prefer free weights normally but a lot of machines are set up with this grip position and they invariably keep my elbows in better shape than a straight bar so I have learned to live with it because dodgy elbows suck and >= body weight dumbbells are pretty unwieldy (for me at least).  

Just one more thing to try if you have a chronic issue with this.  

It sounds like you are getting there Avram, that’s awesome!  

In ten years of climbing what has primarily worked for me for medial/lateral is getting stronger. Even including things like pull-ups and pull up negatives (with bands if necessary) can be very helpful. And I agree with others, dips and ring dips are awesome but always warm up well and take 2-3 rest days if you are really sore/tired. 

Also down climbing routes has been very beneficial but only downclimb when you aren’t completely exhausted. 

Lastly, it sounds like your strength training is quite light and I wonder if you are getting any progressive overload on your triceps etc. Without that you won’t get stronger. 

Oh and ICE ICE BABY, you can ice 15 min of every hour if really sore/inflamed. I used to think ice was total bs but it works.