Elbow pain is one of the most common and debilitating injuries climbers get. It stops a lot of people from climbing every season. This is also called medial epicondylitis, or golfer's elbow. It is a pain that comes from the inside of the elbow and sometimes goes up to your wrist as you climb. This type of tendonitis means the tendons that connect muscles to the elbow are inflamed and swollen.
Causes of climbing elbow injuries
It's usually only our toes and hands that touch the wall when we climb. When you wear tight shoes, your toes have the luxury of being wrapped in sticky rubber shoes that make sure your foot stays in place. On the other hand, the fingers have only the skin, muscles, and connective tissue in your hand to keep your upper body stable. In climbers, elbow injuries are prevalent because many of the forces help climbers control their hands and fingers come out of their elbow.
1. There are a lot of elbow injuries in climbers who get hurt because they overwork. When you climb, your muscles and connective tissue are regularly put under a lot of stress. To get stronger, make your tendons more durable, and become a better climber, it's essential to work your arms out regularly. We might face issues if we don't give our tissues enough time to change between sessions. Climbing back-to-back (or more) days a lot and for a long time is not the best way to build strength. Additionally, such practices would cause chronic injuries.
2. It's a standard part of bouldering for people to fall on their hands. "FOOSH" is the word for that. People often try to stop a fall with their arms when they don't expect to fall, but this isn't always the case. When you fall from a high place, the forces on your arm can be very high, which can cause damage to your joints or ligaments when you land on your hand.
3. When you climb, you can move in many different ways. In the case of strength deficits, imbalances, or poor form or technique, it can put too much stress on tissues that can't handle it.
Common climbing elbow injuries
So often, when we talk to other climbers, they will tell us about their elbow pain that comes and goes but always flares up at least once a year. They often find that when they take a break from climbing and training, their pain might get better, but it will still get worse when they start climbing again. It's not a given that climbing will cause elbow pain, even if it looks like a long-term and hard-to-treat injury.
Some of the most common causes of elbow pain in people who climb are:
1. Tennis elbow
Tennis Elbow or lateral epicondylitis is caused due to inflammation of the forearm muscles. It is a common injury in sports such as tennis, rock climbing, badminton, etc. due to overuse of the forearm muscle.
Physiotherapy helps in reducing the inflammation in the irritated muscles & tendons and prevents recurrence by increasing the muscle strength.
2. Golfer's Elbow
Golfer’s elbow or medial epicondylitis, is caused due to overuse or general wear & tear of the muscles used for grasping & wrist flexion. Activities that require repetitive gripping motions such as throwing, rock climbing, racquet sports, etc. can cause Golfers Elbow.
Physiotherapy can help with reducing the pain & inflammation and increasing the blood flow and strength of the tendon.
3. Cubital Tunnel Syndrome
Cubital tunnel syndrome is a peripheral nerve compression syndrome caused due to irritation or injury of the ulnar nerve in the cubital tunnel at the elbow. Physiotherapy can help with reducing the swelling and irritation of the nerve. Exercises will help in improving range-of-motion, muscle strengthening, nerve stretching & ergonomic training.
4. Sprain of the collateral ligaments
A sprain of the collateral ligaments at your elbow can cause your arm to bend in or out. In the case of repeated falls on your hands or similar actions, the connective tissue that keeps your elbow in place can be damaged.
This can cause your elbow to be unstable.
Exercises to reduce climbing elbow pain
The treatment for medial epicondylitis is very different from the treatment for cubital tunnel syndrome, even though they both look and feel the same. Keep in mind that these exercises are given with a specific diagnosis, so the plan of care is based on that. We don't think it's worth going through more than a 2/10 pain with these exercises. Please note that these are not "level 1" exercises, so there is plenty of room to scale up or down as you need to do.
1. Practice slow, heavy wrist curls. Current research shows that "time under tension" is more important for tendon health. Doing heavy, slow concentric exercises is a good alternative that tends to be less painful and allows you to do fewer repetitions, which means you can do work in less time.
2. When the ulnar nerve is squeezed or irritated as it passes through your elbow, it can cause pain in your inner elbow. This procedure allows the nerve to move through its sheath, known as "flossing." This allows the nerve to stretch and move more freely as the nerve moves through its sheath. These should not be done in case they hurt, numb, or tingle your body.
3. Most people overwork their elbows or fall into bad form because they're weak. There is a good reason why Ys and Ts are so popular. They are great exercises for your middle and lower trapezius when done correctly. Unfortunately, many people make the mistake of using too much weight for their Ys. It's important to scale the exercises accordingly, so you don't harm yourself. For this exercise, we often use an exercise band placed on a wall as an alternative.
When should you see a physiotherapist for elbow pain?
Getting hurt while climbing doesn't mean you can't do it for the rest of the year. It can be hard to figure out what is going on and whether it is essential to rest, strengthen and load the tissue, focus on mobility, or get more medical help. This is why it can be hard to know what to do. To get a thorough diagnosis, make a recovery plan that fits your needs, and get back on with climbing as soon as possible.
Our physiotherapists can create a personalised treatment plan which will fix the root cause of your elbow pain.