Date: 13th April 2012
This started off as the reply to an email but it’s now a post. NOTE: I’ve got zero training for this topic, go read my friend Dave Macleod’s excellent post here for the professional view (and everything else the guy writes, he’s a smart one). The below is just my experience with elbow issues.
Elbows: I’ve done every elbow rehab exercise ever over the years. For me these things work:
Initial Problem Stage, or “Yes, I’m going to admit I’m all messed up finally, and my elbows are a disaster. Shit.” How to stop the damage:
-ART massage. Not “sorta ART,” ART. Expensive, painful, works.
-Ice. Put it in little Dixie cups in the freezer, rip off strips of Dixie cup, apply. Brilliant. Twice a day. I don’t know for how long, I sit there until my elbow is cold and feels right.
-Don’t quit all activity involving your arms. This does not work for me, in fact I get worse. But do change whatever activity you’re doing. Swim, yoga, climb trees, whatever, but you’ve gotta keep your arms moving or everything gloms, especially when I’ve let it get really bad.
-Stretch. One fingers at time, full hand, but you’ve got to decrease the “walking around” load on the elbow. I don’t know why, but it is very important for me to heal.
Cure/Rebuild:
-Continue with the above as required to be pain-free and add the following:
-Do these: http://www.youtube.com/watch?v=bV-RjM_Y_hc Medial or lateral depending on injury. Looks silly, works.
-Also, and I hate to say this but it has worked for me, do bicep curls if it’s medial. Rotate the weight as you do the curl–light, very light to start, then over a period of weeks to months increase the weight until it’s actually hard. Doesn’t seem to much matter how you rotate the weight as you do the curl, but rotate it fully. If it starts hurting back it down until it doesn’t hurt. You may be doing these with a salt shaker to start, no lie.
-Go climbing, but at a grade that is far, far below your peak level. If you insight 5.12 then go climb some long 5.8s. I believe the easy load in the same manner that caused the injury is somehow good for setting things right. I don’t know why, but it seems to work well for me and others.
Maintenance
-If your elbows start to hurt stop what you’re doing and change your game. Immediately. If you’re climbing jugs in the gym then go crimp something, vice versa. If you keep doing what has led to the problem then you’ll be injured worse. I write that because I keep learning that lesson. Keep climbing, but change it up–most injuries are due to too much of the same thing over and over. If you’re bouldering put a rope on, etc.
-Do some of the above as required to keep pain at bay.
-Do different sports. Paddle, ski, etc. Take some time off for longer periods. The goal is to climb forever, not just this year or month…
-Don’t crank the load or intensity too quickly, or you will get hurt. If you’re feeling good then don’t jump on a V-Hard boulder problem/route.
-Avoid “tweaky” shit like pulling in a fat rope through an ATC for hours. Horrible. Get a Gi Gi or something if you’re a guide or do a lot of multi-pitching.
And when you forget all of the above and get injured accept this fact early, and rebuild carefully. The longer you delay the rebuild the longer you’ll have to rebuild.
If I can only remember my own advice I should stay off the therabar for another year or two…
Posted in: Blog
Good advice. As for the ART massage, there is a company called Armaid which sells a self massage device (Looks even more ridiculous than the theraband but it works.) I have found it quite effective. Won an editor’s choice award from climbing magazine.
Got to say that doing something about it early made a big difference to me. I got a bad dose of golfers on my right arm and didn’t do too much about it at first, other than reducing difficulty of moves for a week or so. It got worse and in the end took me a year to recover. It always seemed to be clearing so I gave in to the temptation to get back to where I’d left off. Big mistake. Recently, I developed tennis elbow on the left. I laid off climbing for three to four weeks as soon as I was sure that damage was done, gave it the stretches, icing and light weight training and I was clear in less than two months. If it hadn’t been for the previous lesson I’m pretty sure I wouldn’t have done enough and early enough. It was a whole lot easier and less stressful to just get serious about it as soon as I noticed a problem.
Will – when we discussed this a couple of years ago you were big on the Flexbars. Are you now thinking that they are maintainence only and not a rehab tool? Thats what a PT and chiropractor both thought/told me – wait until the pain is gone and start using the bar… And in the previous post, talking about the rings, don’t those hurt your elbow, even with the ability to rotate the wrists/arms? Did you ever try dry needling? I have had a little done as an experiment and it made it feel better in the short term but didn’t seem to help long-term (of course the short term release just led to going back to climbing hard so it may have a long-term help if I don’t self implode!) Good post, thanks for the help, hope to see you soon, maybe in the air…
Great Post Will! As someone who has suffered from elbow issues for six-seven years now, I totally back what you’re saying about massage. The one thing I want to bring up to anyone with elbow pain is Cubital Tunnel Syndrome. Sometimes occurring alone, or in-conjunction with tendonitis Cubital Tunnel is the pain that occurs directly in the elbow, and is the result of the Ulnar Nerve being stretched or compressed. I spent years being told I had tendonitis, and that I just needed to do more stretching and wrist curls before I finally saw a specialist. Other signs of Cubital Tunnel are that icing will cause more pain, as well as simply bending the elbow, or (if left untreated) numbness and tingling in the ring and pinky fingers.
(And as another aside, sleeping in wrist braces does wonders for the tendons!)
Cheerio and good luck with the elbows!
-Keese
Some interesting newish research on this: https://otc.tax.ny.gov/webapp/wcs/stores/servlet/StoreCatalogDisplay?catalogId=10001&storeId=10151&ddkey=https:SWANSiteminderLogon#
A lot of stuff (especially ice) seems to lack any support for chronic conditions. This study advocates an intensive eccentric exercise routine (something I’d never heard suggested).
Personally I’ve gotten good benefit from strength training at a greatly reduced intensity, and heat (blasting with shower massage head).
Also, totally agree with avoiding tweaking shit like pulling a rope through an ATC all day. I don’t know why, but stuff like this (or walking down the street with bags of groceries) can aggravate the bejeezus out of my elbow injuries, while training reasonably at the gym works magic.
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