Keeping My Head Down, Doing My Thing

Training Training Logs
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I’d do the complete warm-up and just eat the temporary decrease in output on subsequent sets if I were training the same way that you are. See it as lat contraction practice.

For the long duration hangs, how are your forearms coping? Are you getting a solid burn and are you approaching failure with your grip at all?

Just an observation, with the exception of lunges all of your exercises include the elbow. Depending on how you’re doing your reps maybe you’re relying on sinew more than muscle at some parts of the motion. Also, what do you qualify as failure here? Muscle failure or technique breakdown? Are your final reps shakey? If so, how do you think that affects a joint such as the elbow?

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I had to come back to this.

@oldnattychris are you sure what your elbows need is even more training stress? Because, while you’re following a rehabilitation protocol for something you might not even have rehabilitation is nevertheless something that necessitates recovery. That is why the protocol isn’t prescribed every day.

@Koestrizer @j4gga2 do either of you know what this could be?

@oldnattychris do you have access to a car? Seeing as you write

if you have the financial means, wouldn’t it be worth scheduling an appointment and driving there? You could go there and back in the same day if my extrapolations on road conditions here apply to where you are at, or stay the night at a hotel/motel/hostel/YMCA overnight.

There’s so much extra damage you could do from January to November.

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Medial epicondylitis (golfer’s elbow)?

Not sure based on that description tbh.

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As a sufferer I’d place my medial epicondylitis which is firmly on the inside of the forearm. Meanwhile, his description sounds like it is between the medial epicondyle and olecranon

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Ah I couldn’t really get that from the quoted description tbh.

If it’s a tendon issue it should still be from one of the forearm flexors, I would think. But it’s basically guessing without any additional information.

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@Koestrizer it’s how I parsed this

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@Voxel: Wow! Thank you SO MUCH for your everything you’ve written. I’m blown away by your generous willingness to help with this.

I can certainly do that! I’ll give it a try next time.

I’m struggling with the “curl your wrist a bit” part: For neutral grip, for example, I interpreted this to mean that instead of gripping the bar with a normal grip, you rotate the wrists slightly towards the body and then grip the bar, so you’re gripping it with more of the palms of the hands rather than with more of the fingers. I find this very difficult to maintain, and it makes my existing calluses somewhat painful because you’re gripping ON them because of the unusual hand position. So over the course of the longer-duration holds, I tend to “slide” down with my grip as the grip fatigues.

At this point I would say that I am getting forearm fatigue but the lats are giving out first, probably because they’re weaker. I feel like I AM getting a benefit from these hangs — but probably more as a way of compensating for weakness in the lats, which needed addressing anyway. For the grip, I might have to order a set of fat gripz . . .

Momentary muscle failure. A rep or two gets slow and grindy before nothing will budge any further. So when I record something like 8f, it means I completed 8 full reps and failure set in on the 9th which I did not complete will full range of motion, so I don’t count the 9th rep.

Not always. With pull-ups, they sometimes are shaky when the reps get high enough and with pronated grip, but I concentrate very hard on keeping the elbows in the correct position, precisely to avoid pain.

This is a very good point. I can easily reduce the frequency to the prescribed number of days per week. Your original posting made it sound like you do the warm-up before every upper-body session and before climbing. For me, the equivalent would be before PLP, which I do 5 or 6 days per week.

I can easily do the Phase 1: Unloading part only on days when I’m also doing an upper-body session, which would then be twice or three times per week (depending on how I’m feeling, I sometimes I skip a rest day and repeat the four-day cycle of push, legs, pull, and core a day early).

Certainly I can do what you suggest, and if the pain weren’t improving, or if it were getting worse, I would act on it sooner rather than later.

However, at the moment, the pain IS getting better, given the “small” changes I’ve made to grip widths, hand positions, and maintaining the roughly 45º angle between elbow and torso on push movements.

I only recently introduced these changes, and given that things are improving, I’d like to give it a few weeks to see how things go.

My goal is to learn and find a sustainable way of performing the work. At the moment, I feel like I’m on the right path. But should this prove not to be the case, I will definitely attempt to seek professional help rather than letting things deteriorate to the point of serious injury.

In the meantime, I’m also taking something @aldebaran said to heart:

Whenever I perform a movement, I’m asking myself, “Does this hurt?” and if the answer is “Yes, slightly” then I stop and adjust slightly to find a position in which the pain goes away before continuing. I’m definitely not just pushing through the pain any more as I was before.

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I would emphasize a similar approach depending on the actual diagnosis.
For example current research suggest that the best therapy for tennis elbow (lateral elbow pain) is:… Doing nothing. 90% of cases clear up within 1 year (Ikonen et al. 2021). 1 year is the bad case scenario though, it’s likely quicker! Most available interventions fail to do anything that time wouldn’t do without them.
Gradual exposure/ stress or load management is about the only thing that would be appropriate to install… Because it is for every single (orthopedic )injury.
Other than that you simply wait and endure the pain. If there’s anything that helps you with the pain, you pursue that because it makes you feel better. It will very likely not help the condition itself though.

I wouldn’t be surprised if this was true for something like golfer’s elbow too, although I would personally use eccentric training to manipulate the condition.

That all said: Without a clear diagnosis, I don’t feel comfortable giving out real advice over the internet.

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I do, but I do upper-body 2x/wk. And before, when I had more control over my schedule I ensured that upper-body day coincided with climbing. If I’m going to stress my elbow joint, I want that stress to be concentrated on specific days so that on the other days it can heal.

Since I’m dealing with golfer’s elbow as opposed to tennis elbow I don’t know how I’d warp the program I’m doing to address tennis elbow but at least for my own case I’m fairly confident that the wrist curls etc. didn’t have enough intensity to treat the tendon.

I was doing eccentric wrist curls, because so many sources suggested it, but now with the isometric hangs (which are just super slow eccentrics) I’m seeing better progress than I was before. I tried different frequencies, rep ranges, etcetera. but progress would eventually stall out.

I had that problem before the form tweaks (curling the wrist over), as I’d have to have weights attached to my person to reach anything proximal to failure within the target duration. They’ll improve.

One thing I haven’t done myself, but have had suggested by the person that designed the rehab protocol (Tyler Nelson btw) suggested I could do isometric wrist curls. When I wrote to him about failing at the lats first, which were mostly killing my CNS, he responded,

The goal is really to get a slow stretch to the forearm. If you use the fat grips you could grab the bar with a slightly flexed wrist, kind of like using an open hand grip, but your wrists would be flexed over the grip a little. The other option is a dumbbell wrist flexion isometric. Get a heavy dumbbell and fed the wrist and hold to failure (30-45s). The “failure” isn’t fully necessary. As long as your getting some muscle pump in your forearms each set that is what matters. Make sure you back of some of the full rang climving [sic]stuff as well.

I already knew I couldn’t accomplish that with a dumbbell but I did find that I could do it with a kettlebell, because then the weight provided some extra torque.

But, if (and that is a big if) you have golfer’s elbow there are other muscles that could be the cause. I learnt a lot from reading “Overcoming Tendonitis” by Steven Low (just the blog post, the book is overkill for most I reckon).

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Yeah I’m not sure about golfer’s elbow atm and don’t want to put out wrong information.
That it gets better while doing a rehab program isn’t the same thing as it getting better because of the program (just in general, not necessarily in this case).

There are certain steps to take for tendon rehab. Isometric loading - eccentric loading - concentric loading - dynamic loading (one building on the other). Sounds like that program is doing that.

I don’t know that person but the program sounds interesting. I’ll have a look if I have a minute and don’t forget.

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It has a final stage I haven’t shared yet because I haven’t done it yet and since I’m just sharing my experiences I prefer to have done the things first. But I think it’s more for climbers as the velocity component is brought up even further. Its not exactly plyometrics but that might give an idea of what it entails

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@Koestrizer: Thank you for the information you provided. For me, it provides some badly needed perspective.

I also work in a professional field (not medical), and therefore completely appreciate (and would expect nothing less than) your caution about making recommendations without the opportunity to come into full possession of the facts, for example, by examining the patient.

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This is a good point. In my case, let’s say that I’ll keep the elbow stress to a practicable minimum whenever I can.

Thanks for forwarding the information. I have a set of light dumbells at the bottom of a cupboard here at home. I’ll dig them out and give this a go. I’m not sure if they’ll be heavy enough to achieve the desired effect, but it’s worth a try. I think it’s a fairly safe guess that my forearms are considerably weaker than yours, so in my case, this might work.

I will look for the blog post as suggested. Many thanks!

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That’s ulnar nerve, if I’m not mistaken @Koestrizer

If it is ulnar nerve, it’s not the end of the world, but internet rehab programs probably won’t do the trick.

@oldnattychris since you’re 300km away from a physio, I would definitely try to book a therapist that supports telehealth

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If nerval, then yes absolutely. I didn’t read any symptoms besides pain (without any specifics to the pain even; haven’t been following this log @oldnattychris ) until I was tagged. That’s why I didn’t immediately jump to nerves.

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After the year-end break, I began to suspect this too, mostly because I often also had numbness in the fingertips. However, the numbness soon subsided, leaving only the pain. I later wondered whether the numbness couldn’t have been related to the shoulder rather than the elbow, but of course I have no idea.

There are so many variables at play . . . For the record, I wrote:

I never thought of that! If the symptoms don’t improve on their own (which they slowly appear to be doing) I will look into the possibilities for this. Many thanks for the suggestion!

@Koestrizer: Certainly no-one can fault you. I’m only slowly coming to a proper understanding of the symptoms myself and how they connect to my actions, so who knows which of the variables I’ve tweaked is resulting in the perceived improvement I’m experiencing at the moment, and whether that perceived improvement will last? I’ll keep everyone posted.

In the meantime, thank you so much to all of you for all the wonderful information and advice! We’ll see how it goes.

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Yeah actually for what it’s worth that spot you’re describing is unlikely to be a sensitive ulnar nerve (although yes, nerves can produce pain without any sensation changes, we call this mechanosensitivity). It sounds more like an actual join pain, which can occur in the elbow. Any recent trauma?

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None that I’m aware of. I do sometimes have the tendency (when driving, for example) to lean on the armrest, which can be a little hard on the elbows at times, and so some pain comes and goes as a result of that, but with COVID I’ve been driving a lot less than usual. The pain I was describing is also not in quite the same place — the leaning-on-it pain feels more like a bruise to the elbow itself, whereas the pain I’m describing is either side of the large elbow joint.

I should clarify from the posting I quoted above that this pain . . .

. . . is now completely gone, and this pain . . .

. . . is now also completely gone, however . . .

. . . this pain persists IF the elbow is not roughly at a 45º angle to the torso. I know this because as part of my warm-up each morning, I do lunges to stretch the groin muscles and the hip flexors, and I lean on a table next to me while doing them. If my elbow is at 90º to my torso, I have the pain I most recently described. If the angle between elbow and torso is closer to 45º the pain goes away.

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Yeah man, at the very least this isn’t a simple case. Telehealth is 100% the way to go if financially available. The especially good thing with telehealth is it allows you to select a clinic/practitioner based on ability, not proximity

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Yes, I think you’re right. Given the small tweaks to grip and hand position I’ve introduced, the symptoms do appear to be improving slowly. Should this turn out not to be the case, I will definitely look into what options are available via Telehealth.

Thank you again for giving this your time and attention, and for the valuable suggestions! I’ll keep you posted.

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