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Post by Charlie S on Apr 21, 2018 18:52:42 GMT -7
Pain started near the tail end of my hangboard season. I was pushing up against my limit pretty consistently. I was also deadlifting and doing other freeweights exercises on my off days.
Moral of the story, heavy hangboarding and heavy deadlifting don't mix. In the meanwhile, silly things like pinching, bringing a water bottle to my face, holding anything with an outstretched arm hurt across the brachioradialis muscle (across the top of the forearm and over the elbow).
Anybody have an success addressing this? Seems like info for healing is pretty limited. Going for a week off, started icing tonight. Reverse pronation doesn't actually trigger anything. Wrist curls not much either. Hoping it'll go away quickly so I don't lose those hangboard gainz!
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Post by scojo on Apr 21, 2018 22:19:19 GMT -7
Do you use an over/under grip for your deadlift? If so, I'm wondering if the supinated grip could have contributed to the injury.
(Sorry I don't have anything useful to say about rehab)
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Post by Chris W on Apr 22, 2018 3:03:45 GMT -7
Try eccentrically loading the muscle using the same protocol Dr. J uses in the Dodgy Elbows article for rock and ice. You'll have to fiddle around with the weights to find what works. Possibly eccentric hammer curls or eccentric supination. A lot of those overuse injuries and tendonopathies can be treated using those protocols.
I had a biceps tendinosis I successfully treated recently using the same eccentric loading protocol.
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Post by climbnkev on Apr 22, 2018 9:18:08 GMT -7
Hammer drills work. Unfortunately in my experience bracioradialis strain is often tied to lateral epicondylitis. The pinch is your enemy for a while.
Climbers have no reason to be using anything but the hook grip (double overhand)while deadlifting. If you are pushing past 2x BW you have lost the path. I also think it’s foolish to lift heavy on your rest days. I wasted an entire year trying this, with good results for my lifting but crappy effect to my climbing. Combine your HB and lifting on the same days so you have actual rest days. Would you do a day of weighted pull ups the day before or after you had a heavy hangboard day? Deadlifts are pulls off the ground, and use more muscular engagement. In my experience if you are doing them more than twice a week you are going to be overloading your pull muscles. I take a week to recover from a DL session when pushing past 85% max. Unless your DL really sucks, IMO you should only train it at less than 80%, and only a couple times a month.
Buy a rollaide and a green twist bar. Grab your 5 lb sledge hammer from your barn and put all 3 next to your bed. 2-3 times a day start working eccentrics at loads just under pain threshold. Grab your broccoli rubberband and put it in you car. Start with the band up at your second nuckle and work your way down. Unless you have no self control (like me) you should be able to beat it in a couple weeks. If you pretend it isn’t a problem and keep on training like usual you could easily stretch it to a 6+ mo recovery window. I can give you more specifics if you can’t find them online. As you are in Salt Lake I would go see Ester Smith with Grassroots PT. Good luck.
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Post by RobF on Apr 22, 2018 10:20:31 GMT -7
Some good tips above. A couple of years ago I had a deadlift technique session with Andy Bolton. He recommended 95%+ of lifts to be double overhand only going to alternate grip for maxes. Lots of technical factors relating to the deadlift that can lead to a neural cause of elbow pains. Ensure a neutral spine throughout engaging glutes and particularly no rounding of lower back or hinging of your neck. Make sure your weight is centralised through your foot / you should be able to wiggle your toes. Basically stick to weights that can be lifted with correct form not the max you can scrape up. I like deadlifts as a global warm up then move onto fingerboard stuff then weighted pull-ups after if doing them. Rest days are for rest unless I go for a cycle or jog or crag prospecting. 1-3x per week with a quality over quantity approach works ok.
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Post by RobF on Apr 22, 2018 10:50:12 GMT -7
Couple afterthoughts whilst resting in-between sets- impromptu deadlift session inspired by this thread :-)
Being able to differentiate between your own personal signs of neural fatigue and fatigue caused by glycogen depletion is very useful when programming (low volume high intensity) deadlifts in and around other things.
Try adding in some very light overhead squats. This will help identify any mobility issues that may need working on for an effective / safe deadlift.
Oh and don't forget principle of specificity of training- hope you're doing your deadlifting in your rock boots.
Right- back to the sesh...
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Post by Charlie S on Apr 22, 2018 14:56:29 GMT -7
Thanks for the pointers. Side note: double overhand caused lateral epycondlitis in both arms. Alternating with an alternate grip helped that. I started the deadlifting for two reasons. 1, HGH, and 2, my long-term trad project has a ridiculous squat off of small feet and I didn't have the lower chain strength to get out of that position. But the point is taken that even though it was fun, a 345lb max deadlift was probably more than sufficient for what I need out of those muscles. And though it's easy to point to that, I've also had to relearn hangboard form these past two seasons (I was "cheating" before and now have to control swing after the liftoff). I found this thread and have implemented some of those other exercises: www.mountainproject.com/forum/topic/112432693/pain-in-crease-of-arm-between-bicep-and-forearm-closest-to-forearmAlso doing massage and ice. Got an Indian Creek trip planned soon, so, hopefully it's better by then or I'll be spending a lot of time taking pictures!
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mcd
New Member
Posts: 30
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Post by mcd on Apr 28, 2018 10:25:47 GMT -7
I have had a very similar problem for several years. After several months of eccentrics hammer drills, reverse wrist curls and eccentric biceps curls( with thumbs up) I have finally started to make progress. brachioradialis flexes the elbow and can cause both pronation and supination of the forearm so you should target all of those motions with eccentrics. Check out what Ester Smi has to say about reps and set(low reps, but frequently throughout the day).In my case it was also related to lateral epicondylitis hence the reverse wrist curls. I also had to work a lot on thoracic mobility and engagement in my shoulders and lats. My athletic therapist explained that when strength and mobility in your shoulders is impaired you start to create force and mobility further down e kinetic chain (wrist and elbows) and these weaker muscles will eventually break down.
Hope that helps. Good luck.
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Post by Charlie S on Jul 31, 2018 18:20:09 GMT -7
Well here we are, 3 months later. Wanted to share an update and maybe that will help someone else in the future.
First note: back-to-back days of Moonboarding, then deadlifting is STUPID!
Following up on the previous story: the Indian Creek trips went really well. So well, that I decided to spend some time in the Forearm Farm and assess the healing. It hurt right off the bat. I figured if it was tendinosis, it would go away after the tendons were warmed up. After 15 minutes, the pain was excruciating and I ended the session. That is the hole I've been digging my way out of since May.
I saw a PT and an orthopedist. PT diagnosed it as an overuse of the extensor longus, gave some good exercises but an overly optimistic recovery window. After seemingly no progress after 10 weeks, I went to an orthopedist. He diagnosed the same muscle but said I had probably torn it at the muscle/tendon interface. He said he's seen that injury before, that I was on the right plan with recovery, but to expect 4 months.
Early on, the Armaid caused more damage than it helped. After 2 months, I began using it again in conjunction with the hammer drills.
I am finally making progress. I'm about 85% there. Cracks are fine. Gastons or anything that puts the wrist pronation past horizontal will still irritate it.
One of the most important lessons in this process is that when you start to feel an injury, don't climb through it. Address it. 1-2 weeks off is chump change compared to 4 months. I will have missed 2 training cycles by the end of it (I'm taking this season off too just to make sure I heal right). The good news is that I haven't lost much. Last weekend I onsighted a 5.11c. A few days before I made it to the top of a 5.12c but it wasn't pretty. The fitness will return; the base is there.
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Post by krisha on May 12, 2020 4:31:23 GMT -7
First post. Hopefully not last. I got the same issue it seems. Particularly when looking at the link from mountainproject that Charlie posted, my pain is located in the same place. First my climbing history. I climb since over 30 years, but that doesn't really mean a lot, since I sometimes had big brakes of it, due to life choices and circumstances. 8 years ago I RP'd up to 13a, but then pretty much stopped (just occasionally climbing moderates in between). About 6 months ago I finally found my proper psyche for harder (sport)routes again and it's increased ever since. Now the goal is 13b (makes more sense. 8a here in europe ). Even though I had bad experiences with training (i'm kind of injury prone), I looked for some more recent training protocols and loved the RCTM. So here I am. At the moment I onsight 12a regularly, RP 12b and 12c after around 3 to 5 go's. I guess my technique game is strong, my tendons are not. 2 weeks into my strength routine on the Beginner HB workout (taking it very conservative for now, since 39 is not considered mega young and my fingers like to tweak), I thought it was smart to do some ARC'ing the day after on an outdoor 11a. Too much it was. Next day my brachioradialis felt inflamed and in pain. After two days the pain receded a little and a lingering dull pain resided in my elbow. I thought it could be Lateral epicondylitis, also saw an orthopedist who gave me the painful dry needle treatment and I started rehab. Pain went away, I continued my HB'ing, pain came back. Ok, maybe I should have waited longer. The issue is, the pain is not really located where it should be with Lateral Epicondylitis, it really is more on the Brachioradialis. So my question is to Charlie how that all went down? Anyone else experienced this? FYI the picture attached isnt my arm, I was just too lazy to take a picture myself and took it from the mp forum. But in the red circle is where the dull pain lingers with light pain (like a sore muscle) going towards my wrist. PS: I had the symptoms maybe 10 years ago as well, so I just went crack climbing for half a year and it disappeared. But thats unfortunately not an option now.
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Post by Charlie S on May 12, 2020 6:11:23 GMT -7
My tactic was: Hammer drills early on then Armaid + hammer drills then just Armaid
You need to determine whether it's simply the tendon, or if the muscle is involved. In my case, the two had gone their separate ways and I had to simply rest to allow healing. Also, you need to determine if it really is the brachioradialis (what I thought it was), or if it's the extensor (what it really was). The former is right under the skin. The latter is DEEP. To massage it, you often have to "push" the brachioradialis out of the way.
If it's just the tendon (which is sounds like), you may want to check out Dr. Tyler Nelson's (@c4hp) elbow rehab stuff. Although it largely addresses medial and lateral pain.
Finally, there's one more stretch that I found helped early on. You have to hold it for more than 10 seconds before you feel something. I'll see if I can find it and post it.
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Post by Charlie S on May 12, 2020 6:16:59 GMT -7
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Post by krisha on May 12, 2020 7:11:28 GMT -7
Awesome, thank you.
I tried at first heavy load eccentric drills, but everything tells me that at least its too early to go there, even though i don't experience pain from it. It just feels like a very slippery slope. Hammer drills 'feel' to me more the way forward for now. I also did try Nelson's rehab approach... But the problem is also that I can't really pinpoint the pain. So with his program I don't ever really know where I am at, but I still continue with some of his strengthening exercises.
When I saw my orthopedist (5.14 climber before he got SLAP'd out of the game), he didn't think it was lateral ep(and so on), but something muscular or fascial. He found triggers in my elbow with the dry needles that released the tension a lot, but maybe I shouldn't have gone HB'ing the same day (yesyes. facepalm.).
Thanks! I'll try that stretch and be more patient.
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