Helpful Article for Elbow Tendinosis

I've benefited so much from MP forums on injury recovery and prevention I thought I might try and give a little back. I've been struggling through medial epicondylitis (golfer's elbow) in my left elbow and lateral tendonitis (tennis elbow) in both arms. From what I've come to understand about elbow tendon injuries, there are two distinct conditions that are often confused for the same condition. Tendonitis is an inflammation of a tendon from overuse or an acute trauma, whereas, tendonosis is a degredation of tendon tissues from stresses that produced accumulated damage without proper recovery/repair. This article on the NCIB website has some really good information for those of us suffering from tendonosis injuries (medial and lateral). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658379/ 

Of particular note,

"Mechanical loading of tendon tissue is anabolic by upregulating collagen gene expression and increasing synthesis of collagen proteins peaking 24 hours after exercise and remaining elevated for up to 70 to 80 hours. However, exercise also degrades collagen proteins. This results in a net loss of collagen 24 to 36 hours after training, followed by a net gain in collagen. Thus, a restitution time interval between exercise bouts is critical for the tissue to adapt and avoid a net catabolic situation. The tissue’s adaptive factors are linked to tenocytes, extracellular matrix, and nerve receptors."

Total rest is necessary in the beginning of recovery. However, all good rehab programs require a gradual reintroduction of exercise. The above makes a good case for avoiding climbing two days in a row during rehab. Probably even a good idea for us newbies who are still building strength in our tendons to avoid strenuous climbing or hangboarding back-to-back days.

The article also advocates eccentric exercises (multiple sets, 10-15 reps) and the principle that "proximal stability is needed to promote distal mobility." In other words, just because you hurt your elbow doesn't mean that's where the problem started. Shoulder and scapular exercises are recommended in the article to keep your kinetic chain intact and functioning properly. They have a list of recommended exercises that I have found to be super helpful.

Cheers,

Devin

My solution to evil-satanic tennis elbow is very simple. Part 1, stretch forearms everyday. Part 2, intense tricep workouts. 

Doing 10 pushups a couple time a week IS NOT ENOUGH. You need to blast those babies just as hard as you do your biceps during climbing. My personal fav tricep workout I call the big nasty: it involves a tricep pull down machine: start with 40 reps at 20 pounds, then without rest lower the weight to 15 pounds and do 30 reps, then 20 reps at 10 pounds, and 10 reps at 5 pounds. Form is the most important factor. 

Rest is good in the beginning if the pain is acute, but it will not solve the issue. Advil won't help. You need to proactively strengthen other parts of you arms.