over active brachioradialis?

[mcd]

My Athletic therapist tells me that during all movements I generate force from the elbow, which is obviously not a very efficient way to do things. Due to weaknesses that I didn't realize I had (shoulders, lats, and bicep/brachialis) apparently I have been using the brachioradialis (wrist stabilizer and elbow flexor) for a lot more things than it was meant for. I have been suffering from dull pain in the lateral anterior portion of the elbow, worse with flexion for about a year. I have also been working pretty hard for the last few months at strengthening all the previously mentioned week areas, but it has not yet made a change for me. Crack climbing, especially hand and fist jamming bothers me a lot less or not at all, but there just isn't that much of it around where I live. Has anyone heard of anything similar to this?

[MarkAnderson]

I have not, but I must admit I guessed "Brachioradialis" was some newly discovered species of dinosaur

[mcd]

Right now it's more like a pair of small grumpy dinosaurs with toothaches.

[Chris W]

I haven't heard of that issue specifically, but I'm not surprised if it's bothering you. It's another "pull" muscle, which we love to abuse as climbers. It's great that you're doing work to strengthen weak areas, but have you tried to rehab the painful area specifically? Is your athletic therapist a physical therapist, or an athletic trainer? Most PT's these days are educated at the doctorate level, and a good PT can make all the difference in the world.

Also, in the grand scheme of things, several months is not a lot of time. Generally, if your rehab from something like that is effective, I would expect your symptoms to have improved in 6-12 weeks, though not necessarily resolve in that time. To put things into perspective, I developed an elbow tendinosis several years ago from hanging with bad form on my 35 wall and doing pullups with bad form. It took me about one week to realize what was going on (not one year) and I started to rehab it immediately. It took close to one year for it to stop bothering me (though it wasn't crippling and I was still climbing well on it). For the next two years I actively maintained my therapy exercises to prevent it from recurring.

[mcd]

I think part of the problem is that it is a pull muscle as well as a wrist stabilizer. This means  that Brachioradialis is doing double duty, its already turned on while gripping, so when the other pull muscles are not firing properly it is already "on" and compensates to makes the pull happen. I used to have a very good PT in my area, but he moved away to work with national team athletes and circus performers. I haven't had much luck since, most PTs where I live are really well versed in ski injuries, ACL rehab etc. but don't know much about the forearm anatomy. Most of them just want to call my problem Tennis elbow and start dry needling (is IMS a new obsession in physiotherapy?).

I have started working with an athletic therapist, not an athletic trainer. So far the sessions seam a lot like when I had a really good physio. We spend a lot of time working on functional strength, recruitment and movement patterns, which historically have been the cause of most of my injuries. I get a lot of work to take home with me instead of just manual therapy. I guess some more localized treatment could also be helpful. 

I have been able to climb, actually a fair bit, but this problem really inhibits my high end. I have actually had a fairly good season by increasing my "low end" capacity, ie grades that feel "easy" have been improving, but it leaves me wanting more and every time I try to turn up the intensity my elbows get a lot worse. This hasn't caused me to lose a season, but it is becoming a chronic problem that I need to deal with.