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