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cowpoke
climber
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Aug 31, 2009 - 08:43pm PT
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These data look promising.
One thing I've never quite figured out, however, is *when* I should be doing these or, for that matter, other recommended prevention/intervention methods (e.g., see bachar's suggestions in http://www.supertopo.com/climbing/thread.html?topic_id=893462&tn=0 for supination/pronation exercises). Should I be doing this stuff on the same days I climb or rest days?
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klk
Trad climber
cali
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Aug 31, 2009 - 08:47pm PT
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although they tested it on lateral epicondylitis, not medial.
it's not clear to me why this exercise would work better than other supination/pronation exercises that've been part of the standard therapy for years. hard to imagine that pronation with this particular type of resistance is magically better than the same exercise against, say, a theraband. or one of those deals that ksolem built in his garage.
they didn't do a 3rd group using other supination/pronation exercises-- the control did nothing at all.
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Jaybro
Social climber
Wolf City, Wyoming
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Aug 31, 2009 - 09:16pm PT
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4 yrs into recovery from Medial E, time and common sense, in my case.
Hope this works for people!
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bubble boy
Big Wall climber
T100
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Aug 31, 2009 - 09:51pm PT
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this was my miracle cure.
http://www.thestick.com/
had tendonitis for 3 years. couldn't climb anything vertical at all. tried everything from months off to western PT to accupuncture. nothing worked but the stick. best 40 bucks i ever spent!!!!!!
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Forest
Trad climber
Tucson, AZ
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Aug 31, 2009 - 10:16pm PT
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nothing was working for me until:
1) I stopped climbing. entirely. for like 6 months - 1 year (a few lapses in there, so 6 months is probably more accurate). Find something else you can get psyched about during that time.
2) especially don't climb anything vertical to overhung
3) did these stretches and exercises: http://www.hughston.com/hha/a.seven.htm
I still make an effort to do the stretches before I climb. So far, so good.
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bubble boy
Big Wall climber
topanga, CA
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Feb 16, 2010 - 07:31pm PT
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BUMP. So many people out there with this issue, and so many have have been able to deal with it. I'm still using "the stick" and it's still working.....
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426
climber
Buzzard Point, TN
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Feb 16, 2010 - 07:40pm PT
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ASTYM is another treatment that works well, like I've said for years...
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gonzo chemist
climber
a crucible
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Feb 16, 2010 - 08:07pm PT
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I guess I'll throw my two cents in here, b/c I just recently recovered from some Lateral Epi. My tendonitis came from two things: gym climbing and tennis. I alternated the two activites during weeknights. It destroyed my right arm. So after about 3-4 weeks of resting it and icing every night, and NO improvment on the pain, I sought other methods. I read up on cortisone shots. Not interested! So I looked into physical therapy type remedies.
I bought a Theraband flexbar for about $12 on Amazon.com and proceeded to do a specific exercise that loads the muscles of the forearm eccentrically (there's some vids of this online somewhere). Basically, what's happening is you flex your outer forearm muscles (by twisting the bar) and then extend your arms (see the video). This loads the muscles and connective tissues in an unusual way, b/c the muscles are flexed but you're now extending them WITHOUT relaxing them. Physical therapists are finding this method of strengthening muscles and tendons, and alleviating connective tissue inflammation, to be very effective.
The second thing I did was supination and pronation excercises. I actually only did these about 2 nights per week.
The third thing was reverse wrist curls (basically grab a 5 lbs weight and lay your arm out on a table in front of you with the hand/weight hanging off the edge--palm side down--and just curl the weight back up. I did TONS of 'em.
lastly, whenever the elbow seemed to be bothering me, I stretched the outer/upper forearm using a specific stretch
http://www.youtube.com/watch?v=UMbo4O6D0y8
Anyway, I did these EVERY-F*#KING-DAY. I brought the flexbar and 5-lb weight into work and did these exercises whenever I had downtime. Within 8 weeks, I had NO more pain. I didn't even stop gym climbing during the whole process, and in fact, my grip strength/endurance only became stronger and stronger. Funny thing is, I thought for sure I would have to stop climbing for like 6 months or longer. My elbow was KILLING me. I thought, "that's it, my climbing is shot this whole winter."
So that's it. I just did a LOT of some very specific exercises. If you want a 'miracle cure,' this one was mine; but you do have to put in some consistent effort.
-Nick
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tenesmus
Trad climber
slc
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Feb 16, 2010 - 09:44pm PT
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Thanks for this link. I'm a PT (not in orthopedics) and hadn't heard. I wonder if it works for Flexor tendonitis too? That's what a lot of people get from the gym.
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Alexey
Trad climber
San Jose, CA
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Feb 18, 2010 - 09:29pm PT
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useful climbers info
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blahblah
Gym climber
Boulder
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So I've got tennis elbow brought on by too much gym climbing. First noticed it about 5 weeks ago. It has got slightly better, but not much and I'm discouraged by the apparently slow rate of healing. I'd characterize it as a "moderately severe" case, kind of hard to say, but I'm not in extreme pain or anything close to it. Doing certain "household chores" causes minor pain and there's a feeling of weakness when grasping or pinching objects.
My question:
Does anyone plagued by this malady have an opinion as to whether easy gym climbing at this stage is a bad idea, good idea, or doesn't matter one way or the other?
I've read the above posts and there's helpful stuff, but if anyone else has words of wisdom, I'd love to hear them.
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mike bodine
climber
bishop, ca
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hey thanks for the words - i've had epicondylitis for years, lossed my job over it - then I quit climbing - anywho Im gonna give this a try - the pros tell me Im too young for the knife, but too old to start a new profession
thanks again
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rgold
Trad climber
Poughkeepsie, NY
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I've battled medial epicondylitis for many years; pretty much have it under control, although I don't think you ever really get over this once you've got it if you climb actively.
I've found eccentric forearm exercises to be quite effective. I think the fancy new twisty sticks are primarily gimmicks, although they have the significant advantage of portability if you are on the road and don't want to travel with a bunch of dumbells. For climbers, I wonder whether they supply enough resistance.
All you need to do eccentric forearm work with a dumbell is to train one arm at a time and use the free arm to return the dumbell to the starting position for the eccentric motion (it does seem a little strange doing this at first).
Massage and alternate hot-cold soaks are also good, as is a neoprene elbow sleeve to keep the area warm and a little compressed when you're in the gym.
There is no good answer to whether or not one can continue climbing (in the gym or outside) with these injuries. The key is the pain level---anything more than a dull ache is too much. It takes a lot of discipline to stop when the pain gets a little sharp, but the consequences of pushing on rarely make it seem even remotely worthwhile afterward.
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blahblah
Gym climber
Boulder
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rgold--thanks for sharing your experience (my problem is lateral epi rather than medial; not sure how much of a difference that makes, but lots of climbers suffer from each so comments are useful regardless).
This may be as hard to answer as climbing with epicondylitis symptoms, but what about doing forearm exercises with some pain (or at least feeling of symptoms, even if it is below the pain threshold)? Should you wait until the arm is basically healed before doing reverse curls?
Mike bodine--sounds like you have it a lot worse than me; I'm "lucky" enough to be a guy who works in an office so this is just a bummer b/c going to gym is my major hobby (and climbing outside a little too, I guess). Good luck.
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rgold
Trad climber
Poughkeepsie, NY
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Blah, my experience is that you can do the eccentric exercises as part of the treatment, meaning while you have the injury, if doing them does not go beyond the "dull ache" phase I mentioned before. (Of course, no pain is the best.) After many bouts of this, I think I have a pretty good idea personally of just what is ok in terms of rehab and what is going to just exacerbate the injury, but it may be that everyone has to learn about their own thresholds (the hard way, unfortunately) for themselves. Hard as it is for most climbing personalities, "when in doubt, do less" is usually the best approach.
I should also mention that I have not had good luck with complete rest; the injury can feel fine but comes roaring back as soon as you go back to climbing. One does need some rest at first to let the thing calm down, but then I've found that exercising below the pain threshold, no matter how absurdly light the exercise is, seems much better than complete rest.
I think the best way to come back is to have a hangboard mounted so that you can grasp medium-sized holds when standing on the floor. By adopting progressively overhanging but foot-supported positions, you can very slowly and with great precision increase realistic climbing loads to your hands. It is hard to overstate how boring this is, but being able to very gradually increase stresses in an always-controlled way is, at least in my experience, very helpful.
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gonzo chemist
climber
a crucible
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blahblah,
It was my personal experience that doing reverse curls actually aided the healing process. Doing nothing but resting really didn't help me at all. The pain didn't actually subside until I started with reverse curls and eccentric exercises. I don't have as much experience dealing with this as rgold or some of these other guys, so I'd say that their opinion probably carries a little more weight...
-Nick
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blahblah
Gym climber
Boulder
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Mar 12, 2010 - 02:30pm PT
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I got a Theraband flexbar and have been doing the "Tyler Twist," and the tennis elbow is feeling much better. Have also been doing reverse curls and using Metolius GripSaver (no longer marketed, but same thing is available under a different name). I also got a GripStik (works like the old dowel tied to a string attached to a weight). What can I say, I seem to like exercise gadgets.
It's hard to say which if any exercises are helping. (Been about six weeks since the TE flared up, so healing could just be the result of time off.) But the Tyler Twist definitely gives a different feel that seems beneficial. Like it's stretching the tendons that need to be stretched. I think it's the same exercise as the negative (eccentric) part of a reverse wrist curl, which I think (as klk noted) has been recommend for a long time.
I'm still not back to hard (for me) climbing so I can't declare victory yet, and I can still feel the tennis elbow when doing things like squeezing (anything) hard. Just throwing this out for others having the same issues.
Thanks again to those of you (Nick, rgold) who posted with your own experiences.
If Bubble Boy reads this: can you say more about your use of "TheStick"? I looked at the website, and it seems like a massage tool mostly for use on legs. Did you just roll it up and down your forearm? Is it easy to do that by yourself? Am I missing something?
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Jay Wood
Trad climber
Fairfax, CA
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Mar 18, 2010 - 12:21pm PT
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On the strength of bubbleboy's recommendation I got (one of the many models of) 'the stick'.
Had it about a week.
Promising, so far. Portable, not annoying to use
Far from the worst $40 spent
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Rock Monkey
Mountain climber
Thousand Oaks, California
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Aug 11, 2014 - 07:13am PT
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I think using free weights for eccentric exercises (forearm pronation and wrist flexion) actually works better than one of the rubber bars. Taking something with cissus also helps with recovery and prevention. I've used Elbow Revive and Super Cissus in the past. Elbow Revive seemed to get me back in action faster, but both did the trick. Other than that, fish oil really helps with reducing inflammation.
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Patrick Sawyer
climber
Originally California now Ireland
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Aug 19, 2014 - 02:03pm PT
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All you need to do eccentric forearm work with a dumbell is to train one arm at a time and use the free arm to return the dumbell to the starting position for the eccentric motion (it does seem a little strange doing this at first).
Rgold, I'm not sure I follow you about using the free arm to return the dumbbell to the starting position. Could you elaborate? I must be stupid, but do you mean to use the free hand to assist the arm being worked?
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rgold
Trad climber
Poughkeepsie, NY
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Aug 19, 2014 - 02:36pm PT
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The point is eccentric exercise, which is to say lowering the weight under muscle tension, rather than raising the weight by contracting the forearm muscles. The muscle is getting longer, not shorter, in an eccentric exercise. So, if doing wrist curls, you start from the full contracted (most curled) position and lower the weight. Then you use the other hand to assist in bringing the weight back to the fully curled position, with the assistance so strong that the curling hand expends virtually no perceptible effort. For example,
[Click to View YouTube Video]
The method works just as well for lateral epicondylitis, except you do eccentric reverse wrist curls (palm facing down) rather than eccentric wrist curls as above
A related technique is the Hammer of Thoretta (a lame attempt at humor, with apologies for any perceived misogyny)
[Click to View YouTube Video]
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Jaybro
Social climber
Wolf City, Wyoming
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Aug 19, 2014 - 05:43pm PT
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A climber whose opinion I trust, Henry Lester, speaks highly of The armaid https://www.armaid.com/store/. . I met him in the seventies and he still trains like a fiend and climbs hard. I'm looking into it!
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Patrick Sawyer
climber
Originally California now Ireland
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Aug 20, 2014 - 08:17am PT
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Thanks Rgold, gotcha. I'll try it.
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rgold
Trad climber
Poughkeepsie, NY
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Aug 20, 2014 - 09:18am PT
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Jammer, just for a counterpoint, I did exactly the same stretches and got no benefit from them at all. Which is not to say folks shouldn't try them; obviously different things work best for different people.
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Jawon
climber
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Aug 20, 2014 - 09:48am PT
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Absolutely no science behind this (that I can point to), but it must've come from somewhere, I didn't make this up...
I had/have tennis elbow and doing basic exercises that worked the entire arm/shoulder area seemed to have helped me. I worked my biceps, triceps, lats, chest... throw in some easy wrist curls, wrist rotation exercises, you get the point. I found it easier to do these common exercises than the ones focused only on the elbow, I'm just too lazy to do PT-type exercises on my own!
I think the idea is that my muscles were imbalanced from the climbing. In fact, now after each climbing session, doing some of these other exercises seems to really relieve the pressure on the elbow immediately.
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rgold
Trad climber
Poughkeepsie, NY
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Aug 20, 2014 - 10:40am PT
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Jammer, I don't really know anything about the physiology involved. Some discussion, in lay terms, of possible physiological mechanisms is in http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971639/ . Whether the proposed "tendon structure remodeling" can occur when the muscle is stretched, but not with resistance, is not addressed.
There is, however, a lot of clinical evidence out there for the effectiveness of eccentric rehab training, especially for achilles and patella tendons.
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jgill
Boulder climber
Colorado
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Aug 20, 2014 - 06:45pm PT
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What worked for me in 1970 when I first developed climber's elbow, and after trying a number of procedures, was to locate a trigger point on the inside of the forearm, then do deep and painful massage with the thumb. Rest a few days, repeat. After a while the sharp pain resolves to a dull ache, then eventually it's gone. For what it's worth.
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BruceAnderson
Social climber
Los Angeles currently St. Antonin, France
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Aug 20, 2014 - 10:28pm PT
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The reverse eccentric wrist curls shown above are really effective. 3-4 sets of 15 reps, as much weight as you can handle (there should be a little discomfort) , 4-5 times a week did wonders for my elbow last year. I do em now 2-3 a week as preventative maintenance and voila, no problems.
I'll also add that I've thrown in doing handstands into my normal strength training routine and these seem very good for stretching the extensors and building their strength isometrically.
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PortlandRob
climber
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Feb 12, 2018 - 09:32am PT
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Does anyone know where you can buy Elbow Revive or what happened to it? It seems to have vanished from the market. The website doesn't seem to be active and I don't see any other sellers.
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