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Tendonitis: Elbow Muscles Gone Bad

When it comes to pain, you gotta listen to your body. If you don’t, it’s going to come back and bite you.

I’ve been feeling pain around my left elbow the past couple of weeks. At first, I thought I just pulled a muscle after pulling hard on a semi-difficult route. Then it went away.

However, I noticed the pain more often after that, even though I was climbing two days a week. I thought something was wrong. So, I decided to do some research and find out what was causing it.

The Dreaded “Tennis Elbow”

So, what I’ve found is I may be experiencing “tennis elbow.” According to the American Academy of Orthopaedic Surgeons, Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. They say it’s an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. The overuse leads to pain and tenderness on the outside of the elbow.

This is a common condition that climbers are prone to getting. Hmm, wonder why?

Elbow Anatomy

Illustration of elbow muscles and tendons
Source: American Academy of Orthopaedic Surgeons

Let’s dive into a little anatomy. Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.

Lateral epicondylitis involves the muscles and tendons of your forearm. They extend your wrist and fingers. Your forearm tendons — often called extensors — attach the muscles to bone. (Remember the wrist article?) They connect on the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).

The Causes

What makes it so painful? Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The extensor carpi radialis brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight. When it weakens from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.

The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the tissue over time.

What Are the Symptoms?

According to the American Academy of Orthopaedic Surgeons, the symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.

Common signs and symptoms of tennis elbow include:

The symptoms worsen with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Or in my case, pulling holds and aréts. Your dominant arm is most often affected; however, both arms can feel it as well. Oddly, it’s not my dominant arm that’s feeling it.

Treatment

So then, what do I need to do to heal? In the meantime,

Rest. The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or substantial work activities for several weeks. I’m going at least 1-2 times a week to keep active.

Non-steroidal anti-inflammatory medicines. Drugs like aspirin or ibuprofen reduce pain and swelling. If I start to feel it, I’ll take some, but not on my rest days. I’ll also ice it as well to get the swelling down.

I’ve also read there’s physical therapy and stretches I can do to help strengthen and improve mobility. However, I’ll be covering that in the next article because there’s a regimen for recovery I found that I want to discuss.

Seeking out and learning about this condition is making me think harder about how I treat my body. I want to climb until I’m in my 70s, so I need to treat it right and let it heal correctly. That’s why I need to listen to my body better when it hurts. Until next time, happy bouldering!