|
angry
Apr 6, 2007, 3:58 AM
Post #1 of 28
(8107 views)
Shortcut
Registered: Jul 22, 2003
Posts: 8405
|
I don't have tendonitus right now. I will very soon. I can feel it coming on. It's tight but for now it's great. Within two weeks it's going to hit me. If it does, that will be three seasons in a row it's blasted me right when it warms up. Every time it's worse and worse. If I get it by may, that will mean I've spent more time this year with it that without it. I'm wondering about the dynaflex ball. Think it would help the elbow tendonitus? I don't care about improving hand strength or endurance or grip. I climb a lot, then a little more, so specific workouts are not an issue. What I want though, is to be injury free long enough to continue riding the improvement curve upward. They are not super cheap but I'd happily pay for one if I thought it would help my elbows stay in their current untendinitused state. Thoughts?
|
|
|
|
|
dripdry
Apr 6, 2007, 4:17 AM
Post #2 of 28
(8094 views)
Shortcut
Registered: Jul 26, 2005
Posts: 196
|
Actually, I was having a tiny bit of tendonitis (not sure if it's your kind) back in the fall. The dynaflex actually seemed to aggravate it. On the other hand, I was using it while the inflammation was still on (maybe not such a good idea). I haven't tried using it since it got better.
|
|
|
|
|
ryanpfleger
Apr 6, 2007, 4:29 AM
Post #3 of 28
(8092 views)
Shortcut
Registered: May 12, 2003
Posts: 243
|
I had chronic elbow tendinitis (medial epicondylitis) for 3 years. I had and used the Dynaflex, the Metolius Grip Saver, Glucosamine, DMSO, reverse curls, whatever, you name it. Nothing helped. In retrospect if I would have laid off the campus board, taken a few more rest days, and also done all those things I listed before, I would be climbing a lot harder right now.
|
|
|
|
|
fluxus
Apr 6, 2007, 4:48 PM
Post #4 of 28
(8062 views)
Shortcut
Registered: Apr 3, 2003
Posts: 947
|
When it comes to injury treatment and prevention making random guesses is a terrible idea. Don't bother with a toy like the dynaflex ball. Do the following: 1) define the type and severity of tendonitus that you have. 2) define the specific activities, hold types, movement types, that are the primary causes. 3) Make the necessary changes to your climbing / other activities, so as to reduce the stress on the tendon(s) in question, without totally stopping physical activity. 4) Start a rigorus program of stretching, and icing. Do not underestimate the importance of #4, very few climbers do a good job of stretching the muscles of the forearm (the flexors and extensors of the wrist and fingers). Its my sense that a good deal of chronic pain that climber's have in the elbow. (specifically at the medial and laterial epicondyle) would go away (or be reduced at least) if they would stretch correctly every day.
|
|
|
|
|
jh_angel
Apr 6, 2007, 5:17 PM
Post #5 of 28
(8050 views)
Shortcut
Registered: Oct 12, 2004
Posts: 232
|
I had a case of full blown lateral epicondylitis this winter. They only way to make tendoitis better is to first STOP CLIMBING. I wasn't happy about it, but it worked. The first week do I did very little and iced the area every morning and night. The second week more of the same except I started to use the dyna-flex a little because I heard it would help. Remember only use it a little this early and always ice after use. Increase use gradually over the 3rd and 4th weeks. Week 5 I started climbing easy stuff and in under 2 weeks was as strong if not stronger than before. If you've got medial epicondylitis than the time table might not fit. Any way you go you're going to have to stop climbing some time, better to do it on your terms.
|
|
|
|
|
nnowinowski
Apr 6, 2007, 6:06 PM
Post #6 of 28
(8038 views)
Shortcut
Registered: Sep 5, 2003
Posts: 84
|
if you can feel it coming on change your climbing pattern 1. stretch the crap out of your flexor muscles all through your arm esp. your forearm 2. ice and (ice and heat is even better) 3. change your routine for a few weeks to more mileage and less intensity (cracks vs bouldering) 4. Arnica Gel 5. oppositional weight lifting rows, tricep presses, ect.
|
|
|
|
|
fluxus
Apr 6, 2007, 8:09 PM
Post #7 of 28
(8025 views)
Shortcut
Registered: Apr 3, 2003
Posts: 947
|
jh_angel wrote: They only way to make tendoitis better is to first STOP CLIMBING. This is not always the case. It depends on how bad it is, and how good the climber is about changing their climbing habits. In mild cases it is possible to climb through it.
|
|
|
|
|
sidepull
Apr 6, 2007, 8:57 PM
Post #8 of 28
(8011 views)
Shortcut
Registered: Sep 11, 2001
Posts: 2335
|
I'd agree with Dripdry - I don't think a dynaflex is going to prevent tendonitus. Flux - I was surprised you didn't suggest strengthening antagonistic muscles. I know you're far better versed in kinesiology than me, but everyone I've ever known that has developed tendonitus from climbing has been able to reduce it with rest AND by doing pushups, dips, or other similar exercises. Am I wrong that this is helpful - in other words, is this an incorrect anecdotal correlation?
|
|
|
|
|
fluxus
Apr 7, 2007, 7:36 PM
Post #9 of 28
(7966 views)
Shortcut
Registered: Apr 3, 2003
Posts: 947
|
Side, There is some confusion in the climbing world concerning the definition of what an antagonist actually is. Climbers tend to believe in the incorrect notion that the relation between antagonist and agonist muscles is fixed, for example that the tricep IS the antagonist of the bicep, or that it is in climbing. This is incorrect, it depends upon the joint action under consideration. For example, the becep is the antagonist of the tricep in movement of simple elbow extension, the tricep is the antagonist of the bicep in actions of simple elbow flexion. In climbing there are many moves that include both flexion and extension of the elbow, there are many examples where both the biceps and triceps are prime movers. So we have to consider the complexity of climbing moves before we go into simple formulas such as advocating wrist curls and dips etc. I know that their are many climbing books that advocate exactly that sort of thing but those authors were thinking in very limited terms and not considering actual climbing movements when they made those recommendations. So When I hear climbers advocating for strengthening the antagonist muscles my first though is that they are over simplfying things, my second thought is that they are (often) advocating the strengthening of muscles that are already strengthened through climbing (such as the tricep or extensor digitorum communis). All that being said, having balance in strength, flexibility, and active range of motion in all directions around a joint is something we should strive for, and it should be an aid in injury prevention, but I am skeptical of the conventional wisdom in the climbing world concerning the cause and treatment of problems such as medial epicondylitis. That doesn't really answer your question about an anecdotal correlation, but its very difficult to show what activity played what role (if any) in the healing process with anecdotal accounts. Its also difficult to see how strengthening one muscle plays a direct role in healing a different muscle (and / or its tendons). If you have medial epicondylitis you treat it by applying thearpy to the medial epicondyle and the flexors of the wrist and fingers.
|
|
|
|
|
srwings
Apr 8, 2007, 12:05 AM
Post #10 of 28
(7947 views)
Shortcut
Registered: Jun 27, 2004
Posts: 247
|
I don't know if the Dynaflex ball is indicated for your situation but in my situation it contributed to an overuse injury to my forearms. I'd climb then on my off days I'd use the Dynaflex on my 45 minute drive to work. Big mistake. It took a lot of ma$$age therapy to get my forearms to loosen up.
|
|
|
|
|
edl
Apr 8, 2007, 4:06 PM
Post #11 of 28
(7913 views)
Shortcut
Registered: Feb 26, 2004
Posts: 134
|
Another excercise that I, as well as several of my freinds, have had success with reducing tendonitis is the following: Take a hammer, hatchett, or other similarly "balanced" utensile and, grabbing the bottom (opposite the head) of the handle, hold it with your arm perpendicular to your body with the head of the hammer pointed straight up. Keeping the utensile held at ninety degrees, rotate the utensile back and forth slowly, all the while keeping your arm perendicular to your body. This also helps work your rotator cuff a little. The idea is to strenghten all the little muscles that help hold the joint together so you get less inflamation in the joint from your major muscles pulling things around. Keep in mind that I am of course no professional. Anyone had any experience of their own with this? Thoughts?
|
|
|
|
|
wideguy
Apr 8, 2007, 11:07 PM
Post #12 of 28
(7879 views)
Shortcut
Registered: Jan 9, 2003
Posts: 15045
|
edl wrote: Another excercise that I, as well as several of my freinds, have had success with reducing tendonitis is the following: Take a hammer, hatchett, or other similarly "balanced" utensile and, grabbing the bottom (opposite the head) of the handle, hold it with your arm perpendicular to your body with the head of the hammer pointed straight up. Keeping the utensile held at ninety degrees, rotate the utensile back and forth slowly, all the while keeping your arm perendicular to your body. This also helps work your rotator cuff a little. The idea is to strenghten all the little muscles that help hold the joint together so you get less inflamation in the joint from your major muscles pulling things around. Keep in mind that I am of course no professional. Anyone had any experience of t heir own with this? Thoughts? This is one of the many exercises that my PT put me through for my tendonitis. There are lost more exercises you can find online. Massage the joint at least three times a day, Ice massage (Frozen dixie cup full of water, peel the cup back and massage 15 minutes) will all help. and , according to my PT, absolutely STOP whatever activity is causing it. you want fasted healing? bite the bullet, not "modified climbing", not "Taking it easy"... STOP. Lose a couple weeks, learn about and practice the massage and stretching that is commonly used to treat this and you'll not only heal faster but you'll have the tools you need to keep it at bay all season. Of course, first visit a doctor, make sure you don't have a tear or something more severe but if it turns out to be just tendonitis, this is what you'll be hearing.
|
|
|
|
|
fluxus
Apr 9, 2007, 2:51 AM
Post #13 of 28
(7858 views)
Shortcut
Registered: Apr 3, 2003
Posts: 947
|
edl wrote: The idea is to strenghten all the little muscles that help hold the joint together so you get less inflamation in the joint from your major muscles pulling things around. This is exactly the kind of lack of understanding I was getting at in my earlier post. Now I know the poster was trying to be helpful and he admitted to not being very knowledgable so what follows is not a put down of him I'm just going to provide some information. First, muscles do not hold joints together. This very important function is served by ligaments. The function of muscles is to move bones and joints. Second, the joint in question in the exercise he described is the radioulnar joint which is responsible for supination and pronation of the forearm. Third, the muscles involved in supination and pronation of the forearm described in the exercise are the Pronator Teres, Brachioradialis, and the supinator. So there are not lots of little muscles involved in the movement of the radioulnar joint there are only three. and the idea that exercising these specific muscles would somehow reduce inflamation caused by stress placed on the elbow by the elbow flexors and extensors is not plasuable. first because we are really talking about two different joints and second because we are talking about different muscles that perform different jobs. Next, the question remains what relationship is there between these muscles and the types of elbow problems that climbers have? This is a difficult question to answer but its worth noting that the the supinator has its origion on the lateral epicondyle of the humerus. This is a common place for climbers to feel tenderness and it is also the origin of the Extensor digitorum and Extensor carpi ulnaris so its not a suprise that we climbers get some inflamation there espicaly if we don't stretch. But why would this exercise help reduce tendonitis? What kind of tendonitis? There is no such thing as generic elbow tendonitis, it occurrs at or near the origins or insertion of specific muscles, commonly around the medial epicondyle. But this exercise would not be of any benefit that I can see for classic medial epicondylitis. My point is that when thinking about injuries and their treatment you must always know the specifics: what muscles, what joints, what range of motion? This is the ONLY way to come up with a treatment plan that will work. This is also another reason why its not necessary to always stop climbing to get over tendon problems, by altering the type of climbing or the steepness, etc., its very possible to keep climbing without doing any further harm . . .but again to do that you need to know the specifics!
|
|
|
|
|
edl
Apr 9, 2007, 5:39 AM
Post #14 of 28
(7842 views)
Shortcut
Registered: Feb 26, 2004
Posts: 134
|
fluxus wrote: edl wrote: The idea is to strenghten all the little muscles that help hold the joint together so you get less inflamation in the joint from your major muscles pulling things around. This is exactly the kind of lack of understanding I was getting at in my earlier post. Now I know the poster was trying to be helpful and he admitted to not being very knowledgable so what follows is not a put down of him I'm just going to provide some information. First, muscles do not hold joints together. This very important function is served by ligaments. The function of muscles is to move bones and joints. Second, the joint in question in the exercise he described is the radioulnar joint which is responsible for supination and pronation of the forearm. Third, the muscles involved in supination and pronation of the forearm described in the exercise are the Pronator Teres, Brachioradialis, and the supinator. So there are not lots of little muscles involved in the movement of the radioulnar joint there are only three. and the idea that exercising these specific muscles would somehow reduce inflamation caused by stress placed on the elbow by the elbow flexors and extensors is not plasuable. first because we are really talking about two different joints and second because we are talking about different muscles that perform different jobs. Next, the question remains what relationship is there between these muscles and the types of elbow problems that climbers have? This is a difficult question to answer but its worth noting that the the supinator has its origion on the lateral epicondyle of the humerus. This is a common place for climbers to feel tenderness and it is also the origin of the Extensor digitorum and Extensor carpi ulnaris so its not a suprise that we climbers get some inflamation there espicaly if we don't stretch. But why would this exercise help reduce tendonitis? What kind of tendonitis? There is no such thing as generic elbow tendonitis, it occurrs at or near the origins or insertion of specific muscles, commonly around the medial epicondyle. But this exercise would not be of any benefit that I can see for classic medial epicondylitis. My point is that when thinking about injuries and their treatment you must always know the specifics: what muscles, what joints, what range of motion? This is the ONLY way to come up with a treatment plan that will work. This is also another reason why its not necessary to always stop climbing to get over tendon problems, by altering the type of climbing or the steepness, etc., its very possible to keep climbing without doing any further harm . . .but again to do that you need to know the specifics! All I can say is that I was told that it was a good exercise to do, and it worked for me, it worked for some of my freinds, and apparently someone here had a personal trainer recommend that as an excercise to do specifically to reduce elbow tendonitis (which kind was not stipulated) and it worked for him too. Not trying to challenge your obviously vast knowledge on the subject, just trying to be helpful. How about yourself, any excercises that you would recommend, or would you just recommend that Angry go see a PT or use his own vast knowledge to medicate himself? edited to add: Wideguy also did a bunch of other stuff in conjunction with the aforementioned excercise, and the combination worked for him.
(This post was edited by edl on Apr 9, 2007, 5:52 AM)
|
|
|
|
|
dasgib
Apr 9, 2007, 7:33 PM
Post #15 of 28
(7797 views)
Shortcut
Registered: Apr 13, 2006
Posts: 2
|
Seems to be sound advice. Do you have any suggestion for a stretching routine that might be useful for this specific injury?
|
|
|
|
|
michal104
Apr 9, 2007, 8:24 PM
Post #16 of 28
(7773 views)
Shortcut
Registered: Apr 9, 2007
Posts: 25
|
The above mentioned "hammer" pronation and suppination exercise can actually help with medial epicondylosis by strengthening the pronator teres attachment at the medial epicondyle. A good stretch is anything the mimics this position: if you're facing a wall, arms straight out, palms touching the wall with you fingers pointed down. Just do that often, especially after climbing. Also, be clear as to what you're treating. If you have an acute injury, just rest for a week or two and come back gradually....you should be fine. If this is a chronic injury, you're going to have to start an exercise regimen of heavy weight eccentric weights, stretching, contrast baths and some massage, followed by a very gradual return to climbing and careful attention when you make that return. Trust me....I've been through a lot with my elbow....a couple of weeks off is nothing. Take care of it now....climbing is for life, so losing a bit of fitness by taking a short break is absolutely meaningless.
|
|
|
|
|
angry
Apr 9, 2007, 9:46 PM
Post #17 of 28
(7754 views)
Shortcut
Registered: Jul 22, 2003
Posts: 8405
|
First off guys, thanks. Also, it needs to be noted that as of today, I don't have elbow or any other tendonitus. That I know of anyway. The whole post stemmed from the fact I'm getting stronger as spring is getting springier, and if the last two years are an indication of this year, I will get tendonitus really soon. I thought the dynaflex might help as their website claims that it will. I could of course start a website and claim that swallowing golf balls helps prevent rectal cancer. Anyway, as to what I'm doing. I have started spending the cash and getting a full body massage every couple weeks. She spends particularly long on my arms. She can't work on me as much as I need though because frequently my arms are too scabbed or raw for massage. I have also started stretching. It's something that I more than know I should do, but something I don't do. I have awesome body flexibility but my arms are like banjo strings ready to break. I'm trying to cure that. I'm not going to change my climbing habits though. I'll bitch and moan about it here if I do end up with tendonitus again.
|
|
|
|
|
ryanpfleger
Apr 10, 2007, 2:04 AM
Post #18 of 28
(7704 views)
Shortcut
Registered: May 12, 2003
Posts: 243
|
In reply to: She can't work on me as much as I need though because frequently my arms are too scabbed or raw for massage. Quit climbing offwidths so you can get a proper massage. Goddard and Neumann's book specifically recommends cross-fiber friction for tendonitis. I imagine your massage thereapists is doing other than just giving you a general relaxation massage, but if not get some sports massage designed for your issues. I never had any luck trying to climb through tendonitis but if you don't have it yet (pain that is), but are just feeling some minor twinges, dialing back might help. Are you doing any campus training? Fingerboard? A lot of gym climbing or bouldering? Those are the things that trashed my elbows. Anecdotal evidence but maybe it will help.
|
|
|
|
|
fluxus
Apr 10, 2007, 3:04 AM
Post #19 of 28
(7689 views)
Shortcut
Registered: Apr 3, 2003
Posts: 947
|
michal104 wrote: The above mentioned "hammer" pronation and suppination exercise can actually help with medial epicondylosis by strengthening the pronator teres attachment at the medial epicondyle. The thing is the Pronator teres has its origion more on the epicondylar ridge than the surface of the medial epicondyle itself. I guess it just depend upon how much of the common flexor tendon it shares.
In reply to: A good stretch is anything the mimics this position: if you're facing a wall, arms straight out, palms touching the wall with you fingers pointed down. Just do that often, especially after climbing. Climbers who do not stretch that often will need to ease into it. If you already have tendonitis and go right into this stretch it will be painful and perhaps not helpful. I find that if one starts with 30 seconds or so with the fingers pointing up, thats a good way to start, then rotate the fingers into the downward position, if you can't hold it for 30 - 60 seconds without it hurting slide your hands down the wall a few inches, this decreases the degree of wrist extension and so is less of a stretch. But dasgib is correct that the stretch, as he described it, is the way to get the most complete stretch of the forearm flexors. As a side note, after years of chronic inflmation and pain of my medial epicondyle on both arms, I started stretching the flexors and extensors of the fingers every day, I increased the flexability and ARM of these muscles and the pain went away completely. I continue to do these stretches daily.
|
|
|
|
|
duckbuster_13
Apr 19, 2007, 5:03 PM
Post #20 of 28
(7555 views)
Shortcut
Registered: Nov 10, 2004
Posts: 154
|
Any way to tell the difference between tendonitis and bursitis in the elbow? About a year ago i went to my MD with complaints of elbow pain. After a few tests he said it was bursitis and to lay off it for a week or two and take 3 ibuprofen 3 times a day (9 total). This seemed like kind of a crappy solution and only kinda worked. I learned that taking an anti-inflammatory prior to climbing generally helped it and the pain only lasted a day or two after climbing, rather than all week... but I'm wary of taking anti-inflammatory/pain relievers before climbing. Sometimes feeling pain is a good thing and lets you know when to back off a bit to avoid injury. So my original question is the difference between bursitis and tendonitis in terms of type of pain etc... and also in difference of treatments/prevention. It's my understanding that bursitis is the inflammation of the fluid filled membrane in your joint... is there any danger of permanent damage if you just stick out the pain? Obviously there is with tendinitis. Any thoughts? Thanks.
|
|
|
|
|
michal104
Apr 19, 2007, 5:40 PM
Post #21 of 28
(7534 views)
Shortcut
Registered: Apr 9, 2007
Posts: 25
|
Can you describe the pain? Where exactly on the elbow is it? Is it on the medial epicondyle (small bony bump on the inside of the elbow) or elsewhere? Is it related to particular activities or a more constant pain? If you've had pain for a year I imagine it's not bursitis, which is an inflammatory condition, but a tendinosis, a degenerative condition. I would see a doctor or some other medical professional who knows what they are doing....did your doctor do any tests when he diagnosed you? I've seen many doctors who knew far less about elbows than I would expect/like them too.
|
|
|
|
|
duckbuster_13
Apr 19, 2007, 6:41 PM
Post #22 of 28
(7517 views)
Shortcut
Registered: Nov 10, 2004
Posts: 154
|
the pain is kind of an ache that radiates out from "inside" the joint. for instance, when my arm is fully extended... there is the little nodule that is typically the "point" of the elbow.. and then a little "dip" or gap.. and another smaller nodule on the inside of the arm. It comes from the gap and kind of in the middle of the whole joint. It radiates outward towards my tricep mostly. The pain starts sometimes acutely upon exertion... like if campusing or often times when i'm really stretched out reaching for a hold and have to pull down from that position. More often though, it's something that sets in after an hour or two of climbing and then continues as a dull pain for the next day or two. sometimes a week. I also notice it when maxing out on barbell curles or when close to it... but not so much when just doing 75% of max and high reps. Are there any treatments (aside from the therapeutic massage... ice and heat etc that treats the symptoms) that can help to actually "cure" tendonitis? For instance, specific PT regimen, pharmaceuticals, surgery... etc. ?? Thanks VERY much for the reply. It's greatly appreciated.
|
|
|
|
|
michal104
Apr 19, 2007, 7:46 PM
Post #23 of 28
(7491 views)
Shortcut
Registered: Apr 9, 2007
Posts: 25
|
It really sounds like you have medial tendinosis, perhaps with some inflammation after exertion to the ulnar nerve (which runs through the little "dip" between the two prominent points on the elbow). The pain you describe is much like what I had, though mine got worse at times than what you're describing. There are things you can do other than ice and heat. See the post above and my reply regarding the "hammer" exercises. Do those as well as reverse wrist curls. Good descriptions of these exercises are found on Eric Horst's training center site on nicros.com. The two exercises I'm about to describe are the two that helped my elbow the most. 1. Heavy weight (20-25#, though you may have to start at 15 and work up) wrist curles where you only do the eccentric part of the movement. Here's what it looks like: arm at 90 degrees, forearm down on a table, bench etc. With your palm facing up, place the weight in your hand. You want the wrist to be cocked all the way up. Then slowly lower the weight until your wrist is straight, pick the weight up with your other hand (or have a friend do it) and move back up to the starting position with the wrist cocked up. Do 3 sets of 10, 4 times per week. Stretch after and ice. 2. Place a bunch of rubber bands around your fingers and expand your fingers out against the resistance. Do this for a while, should feel pumpy, but on the extensors of your arm, not the flexors. Combine these two exercises with ice afterwards and some massage and stretching and you will get better. Hope that helps.
|
|
|
|
|
duckbuster_13
Apr 19, 2007, 8:04 PM
Post #24 of 28
(7483 views)
Shortcut
Registered: Nov 10, 2004
Posts: 154
|
VERY cool. One last question, ( it may be covered in the above post, which i'll read and then subsequently answer my own question in a second I'm sure) Should these exercises be done "while" i have the pain, or should i wait to recover fully before trying it? Thanks again. I'll let you know how it turns out after a month or so.
|
|
|
|
|
michal104
Apr 19, 2007, 9:12 PM
Post #25 of 28
(7455 views)
Shortcut
Registered: Apr 9, 2007
Posts: 25
|
Start doing them right away, even if you have pain. The worst thing to do for these injuries is just sit on them. That goes for the exercises, not for your climbing or other weightlifting. Don't stop those either, just don't crank near your limit or do tweaky or snappy moves. Keep it a little chill with the climbing and weights for the next few weeks while being religious with your elbow exercises, stretching and icing. Definitely post after a few weeks to update on your progress. Give it a couple of weeks and you should start feeling better, then keep right on doing your rehab until one day, magically, the pain will go away. Coolest thing ever. Then it's just maintenance, not overtraining, and stretching after you climb. |
|
|
|
|
|