I have a history of (undiagnosed and untreated) tendonitis in my elbows. My right one gets particularly cranky.
For the last week or so, in my right arm, I have constant dull pain in the distal bicep, irritation in the medial elbow, and I can’t fully extend my arm. It gets achy when in flexion. The most irritating part is trying to do push exercises. I can no longer get my right arm into the fully lengthened (i.e. the bottom of a press) position under load. In fact, I stop degrees short of 90, so not even close. My third and fourth fingers on that hand are starting to show a little bit of nerve symptoms, too: they’re tingly and sometimes a bit numb. I assume I have some ulnar nerve entrapment going on here.
Any suggestions? I’m not in debilitating pain, but I am uncomfortable most of the time. I’m very limited in the gym, although I was able to get through a bit of a pull workout yesterday. Pressing is much, much worse.
Hey mate - I think you’re on the right track with the ulnar nerve suspicion
Which side of the 3rd and 4th finger are your symptoms?
Regardless, my experience with elbows - neural or not - has been that they usually just need a proper deload for at least two weeks. I would drop pretty much any movement which requires elbow flexion (dynamic or static) to let that area chill. Pec deck, reverse fly, lateral raise, front raise etc. should all still be fine. Back squat would require a very wide grip, and front rack positions would also be out.
If you’re open to it, an ultrasound (you’d need your doctor to refer you for a specialist musculoskeletal sonologist) can track the ulnar and median nerve paths through the arm to search for sites of neural entrapment or changed neural vascularity, as well as image the tendons. If positive for neural pathology, injections may be beneficial for “quick win” symptom relief. An ultrasound would likely show chronic degeneration of the elbow tendons, but I wouldn’t recommend an injection for the tendon
The other consideration is neck stuff. Generally speaking issues with the cervical nerve roots / brachial plexus would increase your odds for more distal neural symptoms. Paying attention to the mobility, muscle tone and posture at the neck, shoulders and scaps is strongly recomended
This is likely just semantic, but the ulnar nerve covers both the palmar and dorsal side of the little (fifth) finger and the half of the ring (fourth) finger closest to the little finger. Though this is probably what you mean by the third and fourth fingers, excluding the thumb; anatomically these are usually called the fourth and fifth fingers.
If you actually mean the middle finger is involved, this is not the ulnar nerve. I doubt this the case, but point it out anyway to help with your diagnosis.
Even though neural pain referral isn’t always as neat as the textbooks suggest, considering @trainforpain’s neural symptoms are palm-sided I was going to say the same thing
The symptom distribution in the hand and bicep insertion seems more in line with median nerve, whilst the medial elbow symptoms and pain in flexion is more in line with ulnar nerve.
Given a combination of primary, simultaneous median + ulnar nerve would be remarkably rare, paying extra attention to the neck is warranted.
Depends how desperate you are for things to improve. In general, I would suggest waiting until week 3 minimum
I have had steady improvement in my presumed gluteus medius muscle strain. It’s still not back to normal, however, so I thought I would touch base.
It is rarely painful, and I have not needed anti-inflammatories. I can sleep on the left hip. I have gone easier on exercises involving it, with some specific physio along the lines of previous discussions. I can now jog on a treadmill at moderate speed. If I rack pull 700 or deadlift 400, or bridge 300, it would not hurt at the time.
But after these loads, it might certainly feel stiff the next day without being painful. Occasionally I limp if a workout a day or two before was ambitious. The leg has never felt like it was giving way or felt unstable; just I am self-conscious about limping since I falsely see myself as a younger man. But no difficulty with socks or shoes, and decent hip ROMs.
You stated active physio is work, not fun. I’ve read sources suggesting working out with mild to moderate pain has its role. I don’t find it frustrating that my workouts are a bit less - I get these things can take months to heal. But what do you tell clients about stiffness? I took five days off, and without exercising it seemed even stiffer; though again affecting gait speed, though not significantly painful, especially compared to months ago.
Given the many limitations of the Internet, which I understand and explicitly hold you harmless, any advice?
The more stress you apply to the hip (relative to its current level of “tolerance”), the stiffer you’ll be post. If you had no stiffness after training, it would probably mean you’re not applying enough stress. If you move like the tinman for the next 2-3 days, it would probably mean you’re applying too little stress.
A good rule of thumb is a “maximum tolerable stiffness” of up to 24 hours post-session. Ideally, you would want to feel pretty good by dinner time the day following the workout
Quick question. My son is an 18 year old distance runner. (Track and field distance) He said he is having pain in his tailbone. He said he hasn’t had an injury but it feels like a bruise. Is there any advice you can offer me?
I don’t have any advice, but I used to get that early in wrestling season when we’d practice shots (think a bunch of walking lunge type movements) around the gym.
I don’t have any professional advice. But of course running is hard on the hamstrings and all runners need to stretch and warm these up before doing significant work. The hamstrings are three muscles at the back of the leg between the hip-bum and the back of the knee, as you know. Many other muscles between the hip and knee contribute too. Tailbone pain can also come from the lowest part of the spine, so pelvic bridges, planks and core stretches might help too. And shoes should always be comfortable.
You could Google “warm ups for sprints” and get a bunch of A-skips and such, like this:
Tailbone stuff is weird. Apart from when there’s clear blunt trauma (e.g. land onto tailbone) the two main options are:
Overuse-type pain, typically related to pressure from the lower glute max onto the tailbone (refer below). Most likely, this was the driver for @TrainForPain 's tailbone pain
The latter is a pretty big deal, as it sits on the way to a stress fracture. Sacral stress fractures will usually take at least 3 months to return to normal training and must be identified early.
As such, I’d recommend a good clinical exam ASAP, ideally with a referal for a pelvic MRI to visualise bony oedema across the sacrum.
Thank you. I had considered something muscular but hadn’t considered a stress fracture. When I asked him about it today he said it doesn’t “hurt” just feels like a bruise. I’ll contact his pediatrician Monday.
