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jfailing
Trad climber
Lone Pine
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Topic Author's Original Post - Mar 13, 2012 - 12:56pm PT
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I've looked around on this site, and the internet, and I can't seem to find an exact diagnosis on what I'm experiencing. I know I should see a doc or physical therapist, but figured I'd see if anyone else has had this problem:
Ever since a drunken arm wrestling match I had in college, I've had problems with my left elbow, especially when climbing. The pain is dull but persistent, and only starts after exerting a certain amount of force on it.
It's not "tennis elbow," as the pain is on the inside of the elbow, where the bicep meets the inner elbow. Curling motions or pullups seem to inflame the pain. Obviously this translates to climbing pretty easily.
If I warm up a lot and refrain from bouldering or climbing anything extremely steep, I don't have any problems with it. Pushing down is no problem. If anything, belaying up a second inflames it more than climbing on it. However, since it first started, there have been periods when I've been climbing strong (having lost weight too and been in general good shape), and have had no problems bouldering or climbing steep routes. Is it possible that I just need to be in better shape, or build up the muscles around the tendon?
Does anyone have experience with this problem?
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Hoots
climber
Toyota Tacoma
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Mar 13, 2012 - 01:12pm PT
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Sounds like golfer's elbow- medial epichondylitis (sp?). I got it last year from excessive rope wrangling and sport climbing. Took awhile for the inflammation and pain to subside, and now almost a year later, can climb pretty hard when I take proper preventative care.
-Rest is HUGE, these tendons take a very long time to respond to rest, weeks to months in most cases.
-Warm up slowly before climbing using a cut-up pool noodle about shoulder width in length and with straight arms stretch both forward and backwards at the wrist, using the opposite hand as resistance. I use this thing for about 15 minutes before even putting on my shoes.
-Use anti-inflammatories (I have found prescription Diclofenac gel (brand name Voltaren Emulgel) to be highly effective)
-Ice for after the really tweaky climbs.
 For me, it is crimpy sport climbs that do it- hand and finger jams seem to put less direct stress on the inside tendon. Your mileage may vary.
Good luck, it was a long road but there it does get better.
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Tahoe climber
climber
Davis these days
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Mar 13, 2012 - 01:50pm PT
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Also interested in this topic.
I have similar symptoms, but they're less elbow and more bicep.
Sort of a bicep-tendonosis issue that I can reproduce by doing a dumbbell curl.
I can make the pain disappear by firmly placing pressure on the tendon, just below the bicep, with my other hand while doing the curl.
Climbing wise, it flairs up during steep bouldering, but is mostly fine during vertical stuff. (Cue changeover to sport for the season.)
I know I should get a legit diagnosis, and also have some ideas on how to fix - rest, ibu, ice, self massage (maybe), but would like to hear more for sure - particularly exercises that would fix the imbalance that began the injury (chronic, not acute)
Thanks,
TC
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gonzo chemist
climber
Fort Collins, CO
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Mar 13, 2012 - 01:53pm PT
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If it is in fact Medial Epicondylitis (as the above post hypothesizes), then rest alone will NOT cure it. Temporary rest will help allow the symptoms to subside. But certain exercises are critical to helping it fully "heal," and preventing it from flaring up again. I gone through tendonitis issues. When I developed Lateral Epicondylitis, I read every article from every f'in publication I could get my hands on (including peer reviewed articles from respected academic journals); Conversed with tons of long time climbers about the issue; read blog posts from experienced professional climbers. In the end, it required a small period of rest, and then a VERY dedicated regimen of exercises (delineated in prior ST threads by Bachar and Ksolem). But I ultimately never had to stop climbing. And now I never have tennis elbow or golfer's elbow problems.
HOWEVER, I don't think that what you've described is golfer's elbow. I'm a little unclear as to the the EXACT location of your pain (from your above stated description). But I have also strained the connection of my bicep into the "crotch" of my elbow joint. I did it a couple years ago on the climb 'Morongo Man' in Joshua Tree. I wasn't warmed up enough, and the climb is very overhanging. After the strain occurred, several weeks were required to let the persistent pain subside. And ever since then, I have to be diligent about warming up properly, and stretching my bicep properly. I don't have problems if I do that.
I hope that this in some small way helps. These are just my (very limited) experiences. I'm not a physical therapist or anything.
One last thing....ever since giving up alcohol a couple of months ago, I feel WAY better. And this absolutely includes my joints. My workout recovery time has been significantly reduced, as well.
-Nick
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Forest
Trad climber
Denver, CO
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Mar 13, 2012 - 01:58pm PT
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I hit this. Took six solid months of rest (that means no climbing) with consistent ice massage (used frozen dixie cups) and strengthening exercises like these: http://www.hughston.com/hha/a.seven.htm
Yes, I know that says for tennis elbow, but it generally applies for both.
I went to a hand and elbow doc to get these recommendations, FWIW.
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Mark Hudon
Trad climber
Hood River, OR
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Mar 13, 2012 - 02:13pm PT
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I second Forest's recommendation. That's what did it for me.
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MarkWestman
Trad climber
Talkeetna, Alaska
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Mar 13, 2012 - 02:17pm PT
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I've had medial ep in both my elbows. The program lined up here (follow link atop the main page to the PDF) got rid of it entirely in one elbow and has nearly cured the other:
http://www.drjuliansaunders.com/resources/feature_articles/dodgy_elbows/
For the now cured elbow I previously tried taking 2 months off climbing, ice, acupuncture, massage- all to no avail. 5-6 months of consistent application of the above program made it go away after having it for 18 months. The other elbow flared up last fall and I've been keeping it at bay with these exercises, but consistency (as prescribed above in the link) is key- exercises twice a day, 5-6 days a week. I've been able to climb and do everything during the whole process. Ice is good too.
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le_bruce
climber
Oakland, CA
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Mar 13, 2012 - 02:25pm PT
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I went through something similar, a very frustrating condition or injury. Never understood what it was.
One early morning in Hidden Valley CG two physical therapists camped one site over saw me massaging my left bicep where it meets the inside elbow (never experienced pain in the right), probably with a grimace on my face. They came over, asked me a series of questions just out of the goodness of their hearts, and recommended what Forest describes above, in combination with frequent stretching. It's unlikely I ever would have gone to a professional.
Five years later I've followed their advice and never again felt that pain.
Truly one of the best gifts I've been given by total strangers. Now Forest has given it to you - hope you experience the same results I have.
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jfailing
Trad climber
Lone Pine
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Topic Author's Reply - Mar 13, 2012 - 02:32pm PT
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Strangely enough, there is a shortage of readily available pictures on the internet of the inside of one's elbow... This was the best pic I could find immediately.
When the pain starts up, it feels almost as if it's in the connection from the tendon to the muscle at about the halfway mark of the bicep (maybe an inch or two closer to the elbow) - less so than at the actual tendon connecting to the middle of the elbow.
After climbing a few weeks ago (trying to get through Skinny Dip... ha!), it started to flare up. A few days ago I did a few pullups and about a minute afterwards the pain was back.
Again, I feel like curling a dumbell would probably bring on the pain instantly. I can even feel it almost straining if I'm holding a medium sized book or folder in my left arm while it's bent...
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Steve L
Gym climber
SUR
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Mar 13, 2012 - 02:37pm PT
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Yup, I know what you're talking about. Particularly the part about belaying up a second. It was never an issue when using a skinny rope with an atc guide, but when I switched to a fatter rope…boom - pain at the base of the bicep. I just use a grigri with the fat rope now. I do get the pain from gym climbing/bouldering from time to time as well. As with most tendon pain, it never goes away completely, you just have to learn how to manage it and prevent flare ups. The way I keep the pain at bay is by being religious about thorough warm-ups, stretching after climbing, ice at the first sign of pain, antagonist exercises, and sufficient recovery. For this particular area, I've found tricep pull downs with a flat bar helpful. I'll also do the dumbell exercises detailed in the "dodgy elbows" article as a preventative measure, and plenty of pushing/pressing exercises that aren't climbing specific. Quality rest and recovery are hugely important. Don't underestimate the importance of diet either. Much of the tendon pain I had in my knees and elbows improved when I eliminated foods thought to have inflammatory properties.
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MarkWestman
Trad climber
Talkeetna, Alaska
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Mar 13, 2012 - 03:08pm PT
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Hard to tell if what you have is the same, if the pain is more in your bicep...the hallmark pain of medial epicondylitis is (among other things) pain from direct palpation of the condyle, the round prominent bone node on the medial side of the elbow; and mine hurts mainly on the forearm side of it where the flexor and pronator tendons (which are the problem tissue) attach.
The strange part of this affliction is that climbing itself is rarely when it hurt the most (except hard, overhanging bouldering). When I notice it most is menial, everyday tasks like moving bulky, heavy objects that require a 'bear hug' grip, shoveling, washing my face or hair, or grabbing a wet load of laundry out of the washer. It ends up making you 'guard' your elbow before every motion. Climbing just happens to aggravate it and then it hurts later.
It sounds like you may have a combo of that but with something additional involving the biceps tendon?
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ground_up
Trad climber
mt. hood /baja
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Mar 13, 2012 - 03:22pm PT
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I'm stuggling with a tweaked something in my left arm ...
mine is more top inside of fore arm running down toward
my wrist as opposed to toward bicep , did it on an overhanging
crack reaching way up for a thumbs down jam ...that was last
Sept. I don't remember ever getting a tendon tweak before..
I am not giving up beer or scotch ..... I can live with the pain
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jfailing
Trad climber
Lone Pine
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Topic Author's Reply - Mar 13, 2012 - 03:36pm PT
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The strange part of this affliction is that climbing itself is rarely when it hurt the most (except hard, overhanging bouldering). When I notice it most is menial, everyday tasks like moving bulky, heavy objects that require a 'bear hug' grip, shoveling, washing my face or hair, or grabbing a wet load of laundry out of the washer. It ends up making you 'guard' your elbow before every motion. Climbing just happens to aggravate it and then it hurts later.
Exactly! Even holding a bag of groceries against my side while opening the trunk makes me feel it.
I guess I should just bring an ice-pack to work.
What about those inertia gyroscope balls? I feel like those might be a good way of working some of the exercises in the above-mentioned links. Apparently frying pans work too.
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MarkWestman
Trad climber
Talkeetna, Alaska
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Mar 13, 2012 - 03:49pm PT
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I use a 30 lb dumbbell for the flexor tendon, and a large cast iron skillet for the pronator...works perfectly. The Saunders program stresses that you should adjust the angle of your elbow to cause maximum irritation of the tendon during the exercise. Apparently the science is that the tendon actually needs to be stressed in greater proportion to the muscles, allowing the to 'catch up' to the muscles, which have gotten too strong for the tendon to handle. The eccentric loading only loads the muscle at about 40% capacity, but for the tendon it is still 100%. again, though, it takes dedication and consistency to the exercises. I found it interesting that anti-inflammatory's are contraindicated as the problem when it becomes chronic is not inflammation, it is deterioration (tendonOSIS)...
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Cancer Boy
Trad climber
Freedonia
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Mar 13, 2012 - 07:36pm PT
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I have struggled with both golfers elbow and an affliction that sounds very much like yours. Golfers is pain right at the inner/medial point on your elbow. Feels like a bruise until it gets so bad it burns. This is the point at which your forearm flexor tendons attach. RICE for that.
The biceps/elbow thing is a different injury. If you grip a hammer or a fry-pan, with the weight hanging from the meaty side of your hand, bend your elbow about 45 degrees, and try to rotate the weight upwards (supination), you will feel discomfort deep inside your elbow, near the base of the biceps. This is because the biceps are actually brought into play to effect forearm rotation.
I was forced to climb at 85% (in the gym) for over a year. Rotation exercises (like the fry-pan, above) did me no good, though I thought I saw positive results for a while. Bicep curls made it worse. Overhanging bouldering was the worst.
I am now back to 100%, so take heart. What did I do? Stopped bouldering in the gym entirely. Climbed easy only once or twice a week. Did not stop climbing, but was VERY careful not to reinjure myself. Light sessions only for two months. It takes a long time to heal (but I am in my late forties). Stop your session immdeiately if you feel a twinge, and rest for three days. I am bouldering hard (for me) again, but I stay away from the really steep stuff. It isn't worth it. Good luck!
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zBrown
Ice climber
Chula Vista, CA
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Mar 13, 2012 - 08:24pm PT
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Found this:
Individuals having biceps tendinopathy usually experience pain in the front of the shoulder which gets worse at night. Pain may improve along with raising, pushing, or repeated over head reaching.
You did not mention any shoulder pain and it says "usually". So there's no conclusive statement to be made on tendinopathy. The bursa in the elbow is located on the outside below where your circle is, so it doesn't sound like bursitis either
You remind me of myself. I walked around on a sore knee for many months without seeing a doctor. I even convinced an endocrinologist that I had bursitis (pes anserine to be exact). I sorta convinced the orthopedist when I finally went to him too, but he said let's do an MRI just to make sure. Turns out I did have the bursitis, but also a complex tear of my medial meniscus.
It's nice that there a bunch of friendly people you can draw on for advice, but sometimes I think you just have to give in and go see the doc.
Edit: One last thought. Turmeric is a very good spice to add to your diet. It has strong anti-inflammatory properties. I used to take glucosamine/chondroiten regularly, but an MD acquantance quit because he had seen no studies of it's long-term effects. I switched off it and we eat alot of turmeric now and it's seems to be beneficial.
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skitch
Trad climber
pdx
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Mar 13, 2012 - 11:48pm PT
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I have had the same problem as you, pain where the bicep connects to the tendon right above the bend of my elbow. I have also had golfers elbow, it is very different, and for me is caused from my forearm getting pumped/tight.
I have a book called "one move too many" it's a book about climbing injuries, it calls this type of elbow pain ' climbers elbow' and claims that it is only seen in climbers. I get it if I campus, do really strenuous boulder problems (like the hulk in the happies!) , or if I get on a bmx bike, bunny hopping is a powerful movement! The book says that rest is crucial, of course, and strengthening the biceps. I think it has something to do with the bicep getting stronger than the tendons, so doing curls with weights that you can easily do 12 or 16 times and going really slow as you lower might help. The book also suggests doing reverse curls. I haven't been very diligent with these exercises, but I have been doing a lot of leg lifts where I'll lock off halfway and do as many leg lifts as I can do, I think this has helped my climbing more than any other training I've ever done. My core strength is much better helping me keep my feet on reducing my campusing, and it helps my lock off strength.
I hope this helps a little bit, I know how hard it is to actually take any time off, but if you can then you should.
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Bruce Morris
Social climber
Belmont, California
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Mar 14, 2012 - 12:16am PT
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Probably a pain memory programmed into your central nervous system and triggered each time you repeat a similar activity as the one that caused the original injury. Have to reprogram the pain pathways. One way is to lay off it and do something completely opposite. Think someone outlined that course of action above. There may not even be any tendonalgia or inflamation to speak of. Mix it up. Break the programmed pain cycle. Never had anything like that myself, but of course I never injured my bicep. Pain memories can be insidious and reenact under stress too.
Ask a real expert: Call for Ron Gomez!
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Nick
climber
portland, Oregon
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Mar 14, 2012 - 12:28am PT
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I had very similar symptoms for a few years, icing and eating vitamin I helped alleviate the pain, but it came right back after climbing or doing certain tasks. So, I started doing push-ups every day and pronator exercises every other day. After a few months my elbows felt better and have been pain free for several years now. YMMV
Your getting old Josiah!
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zBrown
Ice climber
Chula Vista, CA
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Mar 14, 2012 - 12:36am PT
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I was going to ask if it was both arms, but you already answered. Can you just climb one-handed? (hahahaha). Seriously, since it dates back a ways and is in one arm only - I'd get it checked out.
I had a pain in my shoulder many years ago and went to my wife's friend's husband an O.D., totally holistically oriented. He worked on me but he said
"sometimes these things respond best to cortisone". So I had him inject me. This is the only time in my life I had cortisone, but it worked.
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