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Mysterious Tendon or Ligament pain in arm

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  • Mysterious Tendon or Ligament pain in arm

    Hello,

    Super noob here. 25, Male, 245 lbs. Not very strong.
    Overtime, what I assumed was just bicep soreness, I have realized is nothing of the sort. Somehow I had not noticed, until it got painful enough that I looked it up. What people said was Bicep Tendinopathy, was a different location of pain than what I was experiencing. In short, usually if I do some kind of pulling motion, whether it is pullups, barbell rows, curls, etc. a portion of my inner elbow becomes very sore and tender. This came to a head after some post injury rehab for my leg, my PT's had me do a 5-6 exercise bicep workout that left me unable to extend my arms for like a week. That was coupled with the fact that I had to do that same workout 2-3 times in that week.
    The pain has never been in the distal tendon of the Bicep, except for that rehab incident. The pain has always been, including the rehab incident, deep in the inner arm somewhere near or inside the brachioradialis. Using the right arm as an example: if extended and palms up, it is to the right of the bicep tendon but not on the outside of the arm. Like I said, near the brachioradialis. Maybe even the brachialis. It usually is not debilitating, just a soreness. It's location and tenderness is what concerns me, especially when considering it is the only part of my arm or back that ever gets sore or feels worked after a rowing/pulling exercise. Is this a technique, grip strength issue? Where is this pain coming from? I am honestly very confused, and I cannot find anyone else dealing with this other tham tennis/golfers elbow and distal bicep pain, which is not what I have. Or at least that is what it seems.
    Last edited by Thanothan; 05-11-2022, 08:13 PM.

  • #2
    Hi Thanothan,

    5-6 bicep exercises 2-3 times per week (if I'm interpreting that correctly) sounds pretty intense. This is one of those common scenarios where we likely did more work than we could recover from (more on this here) and unfortunately got symptoms as a result. The symptoms you're describing (gradual onset, pinpoint tenderness along the inner elbow) are consistent with a potential tendinopathy (more on this here), though I wouldn't get too caught up on the diagnostic label. In regard to management, give this article a read first to learn more about our general approach for addressing these types of pain based issues in training.

    Depending on the exact location of symptoms, you could try introducing some specific loading for your elbow such as wrist curls or preacher curls with a slow and controlled tempo (3s on the way up, 3s on the way down for example) for 2-3 sets x 10-12 reps close to failure (RPE 8-9) prior to your pulling movements. This will serve both as a good warm up and help to limit weight selection with some pre-fatigue. With your exercise selection, you can experiment with altering your grip, rep ranges, ROM, tempo, etc to reduce symptoms as well. For example, maybe try lat pulldowns instead of pull-ups using a higher rep range (ex. 12-15) and selecting a comfortable grip (underhand, neutral grip, or overhand) to limit loading along the area. As time passes and you start feeling better, you can gradually start to progress back to normal training.

    If you continue having issues despite these strategies, we do offer consultations and individualized rehab programming where we can dive deeper into your training history, your goals, and come up with a more specific game plan on how to move forward. Here is the intake form

    Hope that helps,
    Charlie

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