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Kettlebell Medial Epicondylitis (golfers elbow)

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Kayodoubleu said:
Did you manage to get rid of it? I also have it now for round about 4 month. It doesn't hurt that bad and after a short warm up i can train everything without problem. But it still pains all the time. Really anyoing. And without a warmup it pains very much in the first few reps of any given exercice. I am not even sure if it is a golfers arm but i think it is.

So you are saying the flexbar is worth it? Did something else helped you?
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Therabands are popular because they eccentrically load the tendon. If your tendon has been bothering you for 4 months, it's no longer tendon-itis, it's become tendon-osis. The difference is that the former describes acute inflammation and the latter describes a state of chronic degeneration.

I read that rippetoe link and to be honest I'm not so sure about hammering yourself with chin ups to fix the issue.... the load is great and if your form isn't on point, it may make things worse. The issue with tendonosis is that your tendon structure is no longer healthy (described as being like a bundle of uncooked spaghetti). It's unhealthy, more like a tangle of cooked spaghetti. Which can you pull on harder without breaking? Eccentrics seems to have the effect of pulling the tangle back into a straight orientation.

I would use eccentric wrist curls and supination. For curls get a dumbbell or if the pain is really bad a soup can or water bottle. Place your forearm on a countertop or table. Use your non-working hand to pull the weight into the curled position and lower it for about 8-10 seconds. Do 8-10 reps this way. When I have done this I feel a mildly painful, stretching sensation in the affected area. Use a hammer or something to do the same things with supination.

Also, stretch your forearm flexors (palm side).

This is still my favorite go-to resource. Low even has a book out on it now, though I haven't read it.

stevenlow.org

Overcoming Tendonitis - Steven Low

Update – My book Overcoming Tendonitis: A Systematic Approach to the Evidence-Based Treatment of Tendinopathy is on Amazon, and the digital edition in my store. Update 2 – Medial elbow (golfer’s elbow, climber’s elbow, etc) 8-12 week Video Rehab Program has been released! Tendonitis is one of...
stevenlow.org stevenlow.org
 
I delt with it for months. Started after combining high bar squats and pullups. Tried everything from the theraband to massage gun and nothing kept it away. Stumbled upon Mark Rippetoe's "Pin Fire" method and after 4 weeks it was gone. Its not an enjoyable experience but it worked for me. YMMV obviously.
 
Birddog said:
I delt with it for months. Started after combining high bar squats and pullups. Tried everything from the theraband to massage gun and nothing kept it away. Stumbled upon Mark Rippetoe's "Pin Fire" method and after 4 weeks it was gone. Its not an enjoyable experience but it worked for me. YMMV obviously.
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Interesting. I wonder if it has to do with exposing the tendon to load to initiate healing and tissue reorganization. Stephen Low recommends eccentrics for pretty much any tendonopathy, including eccentric chins, I believe.

Dealing with tendonopathy in my elbows years ago I came across some articles about eccentrics that claimed to have great results by using a heavy weight that induced pain in the affected area (note that this was for elbows, not any tendonopathy). I tried it and sure enough it worked. I only advise caution with pain-inducing techniques because they don't seem to work for everyone. I had equally good results doing eccentric wrist curls with a lighter weight (but still heavy enough to feel the area work/stretch) that barely induced any pain. Low talks about it in the article I linked; the dosage seems to be either high weight, low-to-moderate volume, or light weight with high volume. I will say that in my case, I searched for the dosage that made a difference immediately after the exercise. That seemed to be the key for myself.
 
bluejeff said:
Interesting. I wonder if it has to do with exposing the tendon to load to initiate healing and tissue reorganization. Stephen Low recommends eccentrics for pretty much any tendonopathy, including eccentric chins, I believe.

Dealing with tendonopathy in my elbows years ago I came across some articles about eccentrics that claimed to have great results by using a heavy weight that induced pain in the affected area (note that this was for elbows, not any tendonopathy). I tried it and sure enough it worked. I only advise caution with pain-inducing techniques because they don't seem to work for everyone. I had equally good results doing eccentric wrist curls with a lighter weight (but still heavy enough to feel the area work/stretch) that barely induced any pain. Low talks about it in the article I linked; the dosage seems to be either high weight, low-to-moderate volume, or light weight with high volume. I will say that in my case, I searched for the dosage that made a difference immediately after the exercise. That seemed to be the key for myself.
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Exactly. The pull ups hurt during the PF sessions but as Mark explained it the tissues needed to be broke down again and heal properly. What happened in my other attempts at fixing it was relief after time but as soon as I tried a pullup it was immediately back again. I agree with caution on this approach however. I now do pullups everyday and its never bothered me again (knock on wood).
 
Birddog said:
I delt with it for months. Started after combining high bar squats and pullups. Tried everything from the theraband to massage gun and nothing kept it away. Stumbled upon Mark Rippetoe's "Pin Fire" method and after 4 weeks it was gone. Its not an enjoyable experience but it worked for me. YMMV obviously.
Click to expand...
Birddog said:
Exactly. The pull ups hurt during the PF sessions but as Mark explained it the tissues needed to be broke down again and heal properly. What happened in my other attempts at fixing it was relief after time but as soon as I tried a pullup it was immediately back again. I agree with caution on this approach however. I now do pullups everyday and its never bothered me again (knock on wood).
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I had the exact same experience. Nothing else seemed to help for more than a day or two, but within a few weeks of doing the pin firing chin ups it cleared up and has never returned.
 
BJJ Shawn said:
I had the exact same experience. Nothing else seemed to help for more than a day or two, but within a few weeks of doing the pin firing chin ups it cleared up and has never returned.
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Did the pin firing method take a few weeks to work, or did you see progress within a day or two with it?

I ask because even the method I outlined usually takes a few sessions to see much improvement. Then it starts to take off more.
 
bluejeff said:
Did the pin firing method take a few weeks to work, or did you see progress within a day or two with it?

I ask because even the method I outlined usually takes a few sessions to see much improvement. Then it starts to take off more.
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For me personally, I noticed a difference within minutes. The first 5-10 sets were extremely painful and made me question why I was doing it, but the pain eased by the end of 20 minutes. Then the next day the pain was much better and led me to do it every few days because I saw it was working. Each session the pain was less and less (always more painful the first few sets, but not nearly as bad as day 1) until I didn't even realize that in my day to day activity the pain was totally gone.

Now, I am NOT good about resting when I have injuries so I very well could have been making it worse for months ahead of time. I was still doing S&S 3-4 days a week plus OAPU and Pistols GTG daily as these things didn't hurt when doing them. For me it was pulling and/or twisting my arm that really hurt. I got to the point where I couldn't turn a door knob sometimes because the pain would shoot through my arm. After a couple weeks, so maybe 4-5 sessions of the pin firing doing 1-2 reps EMOM for 20 minutes the pain totally went away and never returned. I don't do chin ups that often but when I do they haven't hurt ever again.
 
In my experience that trigger for this type of condition is mostly caused by forceful pronation of the wrist with the grip fully loaded. Once it starts, any loaded rotation of the hand or loading at the bridge of the hand when supinated will make it worse.

Linear loading of the pronated wrist such as pulling in line with the forearm or holding a suspended load tends to make it feel better, but the key is to avoid loading the palms-up hand, or externally rotating the wrist under load.
 
BJJ Shawn said:
I had the exact same experience. Nothing else seemed to help for more than a day or two, but within a few weeks of doing the pin firing chin ups it cleared up and has never returned.
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This really seems to help. I just did my first week of this method. He says 3x 60 Chinups a week. I just did 2x this week but it allready feels much better. Incredible. I also did get a Theraband Stick in green. But i think the chin ups are the things that made me feel better.
 
Kayodoubleu said:
This really seems to help. I just did my first week of this method. He says 3x 60 Chinups a week. I just did 2x this week but it allready feels much better. Incredible. I also did get a Theraband Stick in green. But i think the chin ups are the things that made me feel better.
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Are you pausing all other training while doing it? Or are you still pressing, cleaning, swinging, etc…?
 
Brenton8989 said:
Are you pausing all other training while doing it? Or are you still pressing, cleaning, swinging, etc…?
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I’ve been wanting to do this but feel like I’ll have to stop upper body training and just do this for a month. That the case?
 
Brenton8989 said:
I’ve been wanting to do this but feel like I’ll have to stop upper body training and just do this for a month. That the case?
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I didn’t stop any other training but YMMV. To be thorough, this was the only bent arm pulling I did, but I continued with pressing and deadlifts and had no issues.
 
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Brenton8989 said:
Are you pausing all other training while doing it? Or are you still pressing, cleaning, swinging, etc…?
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I am still training my A+A snatches 3x week. My Golfers Elbow isn't very painfull. It just hurts now for over 4 month. But i don't have the feeling that it hinders me in training. So Snatches and Chinups are ok for now. In three weeks i will start ROP. Maybe it would be different than.
 
You've already found excellent advice. The dixie ice cup, Theraband Flexbar, strengthening the extensors, and correcting form.

Here's my favourite stretching method for the forearms. That finger wiggle during the stretch is key!

 
bluejeff said:
This is still my favorite go-to resource. Low even has a book out on it now, though I haven't read it.

stevenlow.org

Overcoming Tendonitis - Steven Low

Update – My book Overcoming Tendonitis: A Systematic Approach to the Evidence-Based Treatment of Tendinopathy is on Amazon, and the digital edition in my store. Update 2 – Medial elbow (golfer’s elbow, climber’s elbow, etc) 8-12 week Video Rehab Program has been released! Tendonitis is one of...
stevenlow.org stevenlow.org
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I was going to share exactly this, but @bluejeff was first.

Apart from Low's recommendation of eccentrics, I used "pump" work for grip and forearms without bending the elbow too much, and several procedures from Super joints (by Pavel).

I think combination of gelatin + Vitamin C helped me, too:
www.t-nation.com

A Cheap, Simple Stack for Healing Injuries

by TC Luoma Combine these two kitchen staples to increase collagen synthesis by 100% in as little as one hour. You could give a carton of malted milk balls to somebody with bad knees and just tell them that it’ll make them feel better and it’ll do more to relieve them of their pain than taking...
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I felt the difference, but I cannot gauge this objectively. It's cheap and simple, and glycine is important anyway.
 
Hey all,
I had both types of tendonits issues over the years as well as friends and clients...
my takeaway is:
1) Tricep to bicep inbalance
All joint pain starts with tight muscles upstream and downstream of the joint.
I found that when I would do too much pullwork and not compensate on pushwork or vice versa the resulting uneven muscle tension on the joint would cause tendonitis.
Solution: Train them equally and make sure to fully engage each one fully. I actually make sure to train push and pull on the same day for this reason
2)tight forearms
Quite often it is tight forearms that are pulling on the joint.
Solution: ART or Kelly Starretts lacrosse ball loosening or you can just hunt for tight spots and massage them by hand.
3)Not fully engaging all of the grip muscles
This was a biggy for me. I noticed that often i was not squeezing all of my fingers equally .Many times I was using my thumb and first two fingers or vice versa. This would unevenly tax some of my grip muscles instead of all of them equally.
Solution: Squeeze the bar as hard as you can with all of your fingers.

Hope this helps
 
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