Elbow Tendinitis- Searching for the Magic Bullet

Elbow tendinitis. Like I said, it totally wasn’t worth it. Sitting around Bishop and not climbing on some of my favorite boulders in the country is lame, but if there’s a silver lining to this whole elbow thing, it’s the fact that I’ve learned quite a bit about what to do if the demon gets you. The last post (linked above) admonishes those who might be tempted to ignore the pain and/or live with it. This one sums up what I’ve learned so far.

Jen does some massage on the affected forearm.

I should mention that I got in this mess by ignoring about 2 years’ worth of elbow inflammation. If you are just getting started with your “itis,” you’re in luck. A little bit of care will see you through. But if you’re a chronic patient like myself, you might need to throw the whole kit at the problem.

Strength gains happen much, much faster in muscle than in connective tissue, so idea behind most of the following advice is to isolate tendons, relax muscles when they aren’t being used, and increasing vascularity in the joints.

As a disclaimer, I’m NOT a doctor and you should probably seek real medical treatment. The purpose of this article is to show you what happens when your injuries get the best of you, and what might be done about it. Also, if anyone reading this has any expertise, please leave a comment.

If you’re getting the first signs of medial epicondylitis

You’ll probably want to read this article by Dr. Julian Saunders. It’s the best one I’ve seen on the topic, and he also injects Aussie wit into the prose. (clicking the link will download a PDF) (Thanks Michal!)

The biggest single thing is rest. I can’t stress this enough. Listen to your body. It needs rest. Avoid things that hurt it. Mix in some days of easy sport climbing or something; don’t just boulder hard all the time. REST!

I would emphasize stretching everything above and below the elbow joint. Triceps, biceps, and all sides of the forearm. The theory here is that tense muscles lead to knots and trigger points, and they just sort of constantly pull and tug at things. After a while, this pisses off your connective tissues. Also pay attention to the Brachioradialis stretch in the above-linked article. If you can do your best to relax, or “neutralize” everything above and below the affected joint, you’ll be helping yourself a lot.

Another great way to neutralize your arms is with massage. My friend Mike Papciak is a very skilled bodyworker, helping to get people such as Ethan Pringle back on track. He strongly recommends using a lacrosse ball, and pinning it between your arm and a wall, then just leaning into it with body weight to really dig into the pressure points. Put the ball behind your back to target the flexors. Or get your guy/gal gym crush to help iron out your sexy beefcake arms. Explain that it’s for your health, and all should be fine.

It should go without saying, but since climbing is all pulling, it will lead to muscle imbalance if you do not incorporate antagonistic muscle work. Pushups. Shoulder stabilization. And for our purposes, forearm extensors. For this, I’d recommend the rice bucket, which you can make yourself for $10 or so. Fill a 5-gallon bucket halfway to the top with some rice, and then do this.

It Wasn’t Worth It

Good news: my broken heel is no longer broken. I’ve been walking now for about three weeks, hiking and biking for two, and I ought to be back to powerful lowballs and sport climbing now. I should have cranked out a storm of vengeful conquest on Saigon Direct.

But I can’t. I have another injury, and it’s my fault.

This is what I deserve.

This whole road trip has been a façade for me, a thin patina of improvement protecting a fragile, rotten, slowly deteriorating core. Even before the trip, I maintained an uneasy truce with that infamous and ubiquitous demon from the first circle of climbing hell, medial epicondoylitis (or climber’s elbow or golfer’s elbow or “why does it hurt when I do deep lockoffs?”). I paid lip service to antagonistic exercises, to an icing ritual, to stretching, to rest, but it never got so bad that I couldn’t just climb through it, try a little harder, and feel hardcore for wearing my throbbing badge of overtraining like so much finger tape.

I come to you now bearing the gift of wisdom hindsight. Had I dealt with my tendinitis aggressively long ago, or maybe just not tried to climb at my limit 3-5 days a week, I would likely not be in the situation I am in now. With the first niggles following a few too many lockoffs, I should have banished the demon once and for all. I should have developed the good habit of doing those boring exercises in the last 10 minutes of the session, rather than using that time to dyno and bullshit with my friends. But I didn’t, and then we went bouldering across the USA for a year.

We tried hard to adhere to a day on/day off rest cycle, but frankly, it’s very hard to rest when you’re so psyched to get to a new playground; you’ve been reading the guidebook for the last week; the weather’s perfect and might change. And after trashing ourselves, it’s hard to get back to camp and cook and clean and try to stay warm, and still have energy left for stretches and eccentric loading exercises.

Over the course of the past 12 months, a distinctively crunchy noise has developed in my right elbow, and it’s not pretty. It sounds a bit like  I would imagine a rock tumbler to sound. It’s crepitus, the term also given to the noise that broken bones make when they rub their fragments against each other. Pleasant, no?

Still, there was little pain, and I was managing to climb harder and harder things. I thought, “maybe it’s just part of my anatomy now, and it’s fine to keep trying hard.” I pitted this pittance of wishful thinking against the constant fact that my right arm was sore, weaker than my left despite my right-handedness, and perpetually tight.

I was forced to take the rest I needed when I broke my heel, and I thought that 6 weeks of inactivity would help. It didn’t. I went to see Dr. Karch, the orthopedist who has put many of my friends back together after their various gravity-induced injuries. I explained that I had a demon that I wanted to banish. The nature of the beast is first-world: it only prevented me from recreationally grabbing small geological irregularities and pulling them to my chest, but it didn’t prevent me from typing or cleaning the dishes or picking up the child I don’t have and bouncing him on my knee. My injury does not prevent me from living, only from schralping the glacial erratic gnar.

In other words, this is the problem of the spoiled person. I get that. And if you’re smart, you’ll take my advice and make sure this doesn’t become a problem for you.

I am now in the health purgatory known as physical therapy, sort of a halfway house for unfortunate and/or hubristic athletes, as well as predictably injured people in repetitive motion situations. My therapist is Jen. She scrapes my tendons, which also makes a gross noise, in order to break up scar tissue. She uses ultra-sound. She gives me homework, like 30-second stretches 4 times per day and eccentric dumbbell exercises which are tremendously boring and feel useless. I don’t hold any of it against her. I need this.

For once I am trusting the process, I am being diligent, and I am going to vanquish my foe. And I’m here, now, in this crappy non-climbing non-training non-grabbing-things-with-my-right-hand situation to tell you that it wasn’t worth it. Do I remember those tired burns at the end of the session that I did instead of calling it a day and stretching and cooling down properly? Hell no. And I don’t feel cool for being able to say that I tried so hard that I very slowly injured myself over the course of 24 months. But I will always remember the start of 2013, the year that began on crutches and transitioned into elbow convalescence. And I will always remember that putting all the micro-trauma and chronic soreness on the body’s credit card is not worth the interest.

In the next post, I’ll detail all the things I do (which, if you don’t already, you might consider doing yourself). As a preview: PT takes me about an hour each day. The good part is that all exercises can be performed with whiskey in hand.

Daniel Woods on Lucid Dreaming

Unexpected messages pop up sometimes. It could be an old Facebook friend, a spam phone call, a LinkedIn invite. This time it was Beau Kahler, our friend from Fort Collins whom we also climbed with in Joe’s Valley. He knows photos, and is now trying to know video. He hit me up on the ‘Book on Monday, asking if we had any extra Organic pads.

The skinny: He and Daniel Woods schmobbed out to Bishop from Boulder in a 15 hour push with the singular goal of climbing (Daniel) and filming (Beau) the second ascent of Paul Robinson’s Lucid Dreaming (V15/8C). They had three days. I offered my help on camera #2.

We met up at the boulders on Tuesday morning. We snapped some photos and got some video of Daniel trying the standstart, Rastaman Vibration (V12). He quickly did the crux jump move, and we moved into position to film the attempts from the start.

Beau Kahler, showing he knows video too. Check out http://www.beaukahler.com/

Daniel had more trouble that expected with the sit-start moves and transitioning into the stand. The crux consists of the first four moves: a hard pull into a sharp, tiny undercling with the right hand, coming in to match on top with the left, standing up tall on the undercling to reach up to the infamous glassy left-handed micro-pinch, and finally the hard move from the pinch to the crimp that defines Rastaman.

One of the worst holds I’ve ever seen a person use.

After watching several attempts, it was clear that grabbing the tiny, sharp, toothy undercling from below meant that he was holding it in the wrong position to be able to stand up to the micro-pinch. Still, he made great progress and nearly stuck the crimp from the sit start.

The next day, Wednesday, was cold, windy, and miserable. We tried to escape the wind by sitting in a cave, but soon retreated to our friend R Tyler Gross’ van for warmth. He’s a very talented photographer from Santa Barbara, and he’s shooting stills of the Lucid project. We shot the shit and enjoyed ourselves, but the wind was gusting around 50 MPH, so we called it.

Thursday was much better. The temps were perfect and the wind was from 0-10 MPH with a touch of humidity. Daniel said that the holds, particularly the crux pinch, are so glassy that they require a bit of moisture to feel any tackiness, ergo the humidity was a good thing.

After a thorough warm-up DWoods started trying the problem from the sit. He was having trouble getting through the opening sequence to feeling solid on the move to the pinch, and after dozens of tries he cut a hole in his left index finger. After a couple of attempts with tape on the wound, he resorted to nixing the index finger entirely and began giving attempts using only two fingers on the sharp undercling. As someone who has bouldered a fair amount, I have to point out that watching someone crush a tiny undercling with only two fingers was a sight to behold.

One of the sharpest holds I’ve ever seen a human being use.

Told you it was sharp. Those are Daniel’s fingers for scale.

Still, the problem eluded Daniel, and after over 50 tries, he threw in the towel for the day. That left Friday, the day that he and Beau were scheduled to leave.

Sadly, the storm that had been threatening Bishop for the past couple of days finally unleashed some snow this morning, and the boulder was soaked by 8AM. Beau and Daniel packed into the car and headed back to Boulder.

Daniel can definitely do the climb. Every go seemed like it would be “the one,” but the climb requires such precision for several consecutive moves that it could’ve been the next go, or it could’ve taken a hundred more tries. Add to that the pressure of a short trip and changeable weather, and you’ve got a tough order indeed. So for now, Lucid remains unrepeated. I imagine he’ll be back to try again though!