Where exactly do I have to move?
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South of Franceā¦ it snows once every five years here ahahah
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What do you say Koestrizer? Start a EU T-nation gym-branch in the south of France?
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Haha yeah we had a few days of above average warmth break the right way. Itās down to around 25* F now, so however that converts to C. Iāve been out on a few days that were just over 0*C and while uncomfortable the friction is fantastic.
Whatās the rock over there? Limestone?
We get the calling of the grit when the temps drop. If you catch gritstone in perfect conditions you can waltz up some problems with amazing friction. Staying warm can be a battle though.
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We have granite and schist primarily.
My feet are typically the weak link. I can tough it out with my hands, and never have problems with the body, but my feet are wimps haha.
I do the ultimate faux pas. I wear socks in my shoes. Keeps them from smelling like beached whale too.
And to keep the shoes warm I have to carabiners (dirt cheap ones) helt together with a piece of paracord. I attach the carabiners to the loops on my shoes and put the rope over my neck and close my sweatshirt/jacket around the shoes making them warm during the approach. Put them their in-between attempts too.
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Dude Iām so in, Iām practically through, haha.
I have no money and can only say two things in French. Both very similar, both insults (had Latin in school).
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Haha thatās brilliant dude! Definitely going to steal that. None of my shoes have enough space for socks, but adding a pair of āwinter shoesā sized up a little to the quiver isnāt the worst idea.
TLDR: Not really
To be honest, both terms are now considered outdated in regards to tendon pain. That said, tendinosis is probably the preferred term over tendinitis, especially for longer-lasting tendinopathies, for reasons stated below.
The favoured term to describe tendon pathologies is ātendinopathy,ā which is used as a blanket term for both tendinosis and tendinitis. Because they are all considered tendinopathies, they are both managed the same with the same four key areas:
1- Manage loading
2- Optimise tendon integrity
3- Optimise biomechanics
4- Assess and manage features of chronic pain such as hyperalgesia and psychosocial factors
As Iām sure youāve read by now, the suffix ā-itisā denotes inflammation, and ā-osisā denotes disrepair. Although pathological tendons do have slightly elevated levels of inflammatory cells and markers, it is currently agreed upon by clinicians that inflammation is unlikely to be a major contributing source of pain in tendon. Therefore, tendinitis is not a popular term anymore. Additionally, tendons can be painful without being disrepaired. This is because tendinopathies are currently thought to progress through three stages:
0- Normal tendon
1- Reactive tendinopathy
2- Tendon disrepair
3- Degenerative tendinopathy
As the tendinopathies persist, they move through the three stages. āReactiveā tendinopathy is an acute response to overload. Tendon disrepair occurs in response to chronic overload. Degenerative tendinopathy describes (probably) irreversible tendon changes. This is why tendinosis is a preferred term to tendinitis, in reference to longer-lasting symptoms. Thatās not to say that one with degenerative tendinopathy will never improve their symptoms however, as addressing and optimising the remaining tendon still shows great efficacy if done correctly. This paradigm has since been called ātreating the doughnut (the healthy tendon), not the hole (the degenerated tendon)ā
You could easily run a site Iād frequent with articles that aim to reduce the noise regarding these topics. Considered running a Patreon? X) Thanks for all the free help! What do you think about the Rippetoe Elbow Tendonitis Rehab Protocol? 20 sets of 2 chins like daily? I can see that it might have benefits, as it stresses the tendon but it is an odd ball in relation to other material Iāve read.
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@flappinit you were not being abrasive in that thread, just FYI.
Thanks man! Thatās really kind of you to say 
Iām not sure how I feel about it to be honest. Tendinopathies usually occur when the load demand of a tendon exceeds its load capacity. As a result, you have to figure out whether the tendon is symptomatic because it is too fragile, or being asked to do too much.
If itās the former, than lots of chin-ups would help. If itās the latter, lots of chin-ups will make it worse.
I havenāt read enough of your log to know what sort of climbing volume youāre doing currently, but Iām fairly certain that youāre more likely to exacerbate your symptoms than alleviate them by doing lots of chin-ups.
One thing to check when it comes to medial epicondylalagia (the fancy name for what youāre experiencing) is your available forearm pronation and supination. Sometimes when this gets jacked up your elbow gets funky.
Try this:
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I genuinely do believe there could be a space to fill here. And, even if you might feel as if you are just rehashing material you know as long as you refer back to wherever you learned it I think it shouldnāt present any moral qualms. Some things simply wonāt be novel, but presenting it in a slightly different way can make all the difference. I find that T-nation publishes articles by authors I feel are just rehashing Christian Thibaudeauāearlier articles and they do that completely unapologetically.
As a reader trying to learn about my specific injuries (obviously, a strong motivator) Iām still not āinterestedā in the topic. Unlike with training, where I have some queer creative/systems programming deep fascination with the topic. And the struggle has been āokay, cool, all of these sites prescribe these things but are these derived from a decent set of first principles and how current is this?ā Just because something was published online in 2020 does not make me trust that Iām looking at the most up to date rehab protocol.
I think vertical pulling caused the issue. It wasnāt from climbing but I was exploring a pull-up protocol that had me include that in every single warmup session. To be fair, the elbow problems did arise initially earlier this year but have been coming and going. Mostly I believe the root cause is overgripping while climbing. Iām a strong climber, and rely on being pulling strong too much so Iāll bend my arms unnecessarily just because I can and have the ability to do so. Iāll upload a screenshot from a book I have later highlighting what this looks like in a climbing context.
I watched the video, I tried it despite not truly understanding how that was screening for anything or fixing anything but I can apply force through my thumb into the ground. It did however illicit some pain where the levator scapulae attaches to the scapula
But if that is the actual thing thatās hurting I donāt know
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Using a more neutral wrist is also key for me presumably. Iāve noted Iāll take irradiation to an extreme and wrist curl almost to be able to pull even harder.
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This definitely does seem like quite a plausible contributing factor, just having a look. The bi thing to consider is volume and changes in volume over time.
Have you dropped your climbing volume since symptom onset? Whatās your current volume?
Thats unfortunate but not exactly a shock. The vide demonstrates a technique that can help address pronation/supination at the forearm. It was a bit of a hail Mary approach but worth a shot
Not uncommon, and not at all a problem
This reminds me. Try this:
My climbing volume is more or less the same, been doing more vertical climbing and more technical routes to de-emphasise the āpull-upā action.
If I consider my current volume, historically, and donāt include the ādo pull-ups as part of your warm-up in the gymā-period Iād argue that my volume is below average.
I can do things like barbell rows, and dumbbell rows without any pain sensation if I donāt let my ring and pinky finger participate in the pulling.
Does this relate to inward shoulder rotation at all? When I went for dry-needling the practitioner made some notes with regards to my right shoulder being inwardly rotated. After treatment was the first time in a long-time I could do one-arm KB overhead presses at >= 30 degrees on that arm,
whereas before I had to work almost entirely in the frontal plane
Tons of sensation in the webbing of the thumb, and the rest really didnāt produce many sensations at all.
With all that said, I wouldnāt be surprised if the biceps is involved somehow.
When I first began rehabbing the medial epicondylitis I came across a note with regards to eccentric only wrist curls to try and find the elbow angle that aggravated the tendon the most. And after I got my therebar, which lets me do eccentric only wrist curls while also extending the elbow [0] was something I perceived as being even more effective at producing pain than wrist curls with a fixed elbow angle, I took the same idea and I experimented with extending the elbow during wrist rotations with a frying pan yesterday and found that to be more āeffectiveā than wrist rotations with the elbow fixed at a certain angle.
And that to me indicates that the biceps is involved, somehow.
[0] imagine elbow to ribs, hand to shoulder, extending the hand straight ahead
Iāll just be over here silently absorbing all this information. Dealing with similar elbow issues myself. Thanks @j4gga2 for your thorough write-ups!
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