Golfers' Elbow - My Experience

I've had issues with golfers' elbow since last August. Having talked to a fair few others in person and on facebook about my experiences getting on top of it I thought it was worth jotting a few thoughts down for others in the same position.You only have to take a glance at the online forums to see how common this issue is amongst climbers! One thing which I think is worth noting is that despite some people on internet forums claiming that the onset of golfers' necessarily means weeks/months of rest, I've managed to get on top of my injury whilst also getting stronger and fitter than ever - there is hope!

At this point I should make it clear that I am not a physio, doctor, expert blah blah...

The problem:
Last August whilst I was on a trip to Loup I started to have issues with the inside of my elbow. I've had issues on the outside before*, but never the inside. The sector we were climbing at has limited easy routes, so my warm-up routine involved a quite a few chin-ups and attempts at 1-armers. Despite the early grumble from my elbows I didn't change this. Clever huh?
When I came back to the UK I took a couple of weeks off, but after that they were worse than before and things continued to decline. I started to look online, did the usual cheapskate climber self-diagnosis and made slow progress for a few months...

Now read this:
http://www.athlon.com.au/articles/r&i_dodgyelbow.pdf
That will give you the background knowledge.
http://ukbouldering.com/board/index.php/topic,9343.0.html this thread is a long read but has some useful info.


Things which helped me:
Recently I've been making much better progress and feel like I'm really on top of my elbow issues, getting back to fingerboarding and so forth.

1. See a physio. I hate paying money for things like this, same as everyone else, but in my experience it was worth it. They will be able to (a) eliminate 'other' stuff as a cause e.g. back/shoulder issues and (b) identify whether the problem is the 'normal' (FCU) golfers elbow or the pronator teres one (see the pdf linked above). Answering (b) will tell you which of the eccentrics is the one for you (normal curls or the sideways twisty ones). I hadn't realised until I saw the physio that apparently doing both of the types of eccentrics is much less effective than just doing the right one for you. I've had much better improvements since I started just using the normal eccentrics following the physio diagnosing that I had the FCU version rather than the pronator teres one (incidentally, the opposite of my self-diagnosis). I'm fairly convinced that this has been a key factor for me getting on top of my elbow troubles. One big question is what number of reps to use. There seems to be a lot of conflicting opinion on this - 20 reps/day, 60, ~200... My best results seem to have come from doing 3 sets of 15-20 reps. I do them after climbing on every climbing day but not on rest days. I've also experimented with splitting the sets between morning and evening on climbing days, however this didn't seem to work as well for me.

2. Really work out what hurts it. Campusing and deadhanging were out for starters. For me the high volume parts of my training were aggravating the elbows more than the high intensity parts, however it took me a stupid amount of time to realise that. It also took me a stupid amount of time to realise that downclimbing was the part of my high volume sessions which gave me the most pain - I could still do a reasonable amount of ARC/Aero cap work if I did it only going upwards (e.g. top roping routes).

3. Stretching - This seems to ease the pain if nothing else.
This one in particular hits the spot for me:
 http://www.proactivefitness.com/stretching-golfers-elbow.html
The stretches my friend Tom wrote about here also seem useful for some: http://tomrandallclimbing.wordpress.com/2012/11/23/golfers-elbow-a-possible-solution/

4. Hard massage - The physio I saw really got to work on the elbow with some painful massage. I recreate this at home using one of these: http://www.decathlon.co.uk/hand-massage-iii-id_8211895.html


* The issues on the outside turned out to be to do with instabilities in my shoulders and were solved and are now kept at bay using theraband exercises for strengthening the rotator cuff muscles.