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Treating Injuries: Climber's (Tennis) Elbow


 

by Editor

December 29, 2001

Lateral Epicondylitis


(Climber's Elbow)

What is lateral epicondylitis?

Lateral epicondylitis, frequently referred to as "tennis (climber's) elbow," may be a work-related disorder a sports-related injury and is caused by inflammation and degeneration of the origin of the extensor carpi radialis brevis muscle, a muscle group in the forearm, and is called a ̉tendonitis".

Who gets (climber's) tennis elbow?

The groups most commonly affected are manual laborers such as auto mechanics, painters, nd carpenters who develop the condition in response to repetitive trauma or overuse. However, the condition also occurs in less active individuals as a result of weekend home repairs or unusual activities for which one is not conditioned. The other common group affected are vigorous athletes, in whom symptoms sometimes occur suddenly, and often with real intensity.

What are the symptoms of (climber's) tennis elbow?

Often the pain is associated with activity and can be so severe that even such activities as filling a glass, turning a door knob, brushing the teeth, shaking hands, or pulling off a V12 becomes difficult. The pain is well localized and originates over the outside part of the elbow but can also radial up and down the arm.

What can be done to treat (climber's) tennis elbow?

In order to reduce the irritation from tennis elbow, there should be a period of rest from climbing. Other measures include the local application of cold or warm compresses, nonsteroidal anti-inflammatory drugs, conditioning and stretching exercises to improve flexibility, and wrist extensor strengthening and endurance exercises. If the pain is so severe as to significantly limit activities of daily living, and there is demonstrable grip strength weakness, an injection of a corticosteroid at the site of maximal tenderness may be beneficial. Surgical treatment may be indicated if other measures fail after a period of time.

Casts and braces

For patients with resistive symptoms, use of a long-arm splint for 7-10 days with the wrist supported in extension may help provide absolute rest for the inflamed area. Depending on the severity of the symptoms and occupational requirements, a removable splint may also be used to rest the wrist extensors and to allow for resolution of the inflammation and pain. A tennis elbow forearm strap can also be used to decrease irritation and is worn while working or during a sport activity.

Exercise

Rehabilitation is an integral component of the management of acute or chronic (climber's) tennis elbow. Use of warm or cold compresses, massage, ultrasonography, and electrical stimulation to the affected area may help to decrease the pain enough to begin a rehabilitative program. The initial aims of physical therapy are to reduce the level of pain experienced, restore flexibility and strength, and prevent recurrence (see exercises below).

Surgical management

In general a 6-12 month trial of conservative management should be attempted if the injury is severe. However, surgery may be indicated when conservative management fails and the pain is incapacitating.

Exercises for the Elbow

A strengthening program may begin with use of lightly resistive therapeutic putty. This exercise allows strengthening of the muscles with little stress on the joints and soft tissues.

As the pain begins to diminish, usually within 3-6 weeks of initial treatment, a progressive resistive exercise program is begun, with the goal of strengthening specific muscle groups. Restrain yourself...stay off the hard climbs for a few more weeks.

Gradually isotonic exercises are introduced, which involve the muscles working against resistance through the available range of motion. Free weights or exercise bands may be used.

Warm-up exercises which stretch the wrist and elbow, prior to climbing, are most important in preventing lateral epicondylitis. A typical cause of this problem is from climbing harder or more often than you are accustomed. When you are coming back from an off season, take it easy for a few weeks. Build the strength back in your muscles so your tendons don't take the abuse.


See What Other Climbers Have To Say


from rec.climbing...

RIC. I don't know that Elevation helps, but rest, ice, and compression do. Speaking of compression, it may be a placebo effect, but the little tennis bands seem to help me sometimes (there's a mechanical theory behind them). Ice and Vitamin I(buprofen) certainly do. Keep your elbows warm when you're using them. Wear a jacket, and put it on as soon as you are done moving, before the heat escapes.

I'm not a (medical) Dr. but I play one on Usenet. Dr. Sue will feed me penalty slack if she disagrees with me.

Cheers, -bw

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Icing it down for 20 minutes right before going to bed for a week or 2 helps, also. But taking a month or 2 off of climbing is the only real hope.

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I have had a series of elbow problems over the years. If the insertion point is inflamed then you have a significant overuse injury.

If you take anti inflamatories you will likely mask the problem, train/climb and make it worse. You need to break the cycle of exercise, inflamation, exercise etc etc.

Go see a physio, find out about massage and frictions. They may help as will stretching. Sadly Rest is the best cure.

I have had the works. Physio, tablets, Homeopathy, acupuncture, Cortisone injections. All led finally to some pretty serious surgery!

Give it a break, rest, rest rest.

Glucasamine is a replacement for cartelidge and won't help soft tissues such as tendon - great for dicky knees though!

Good Luck

Steve Blake



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