I’m dealing with some elbow pain (primarily in one, but present in both) and I’m wondering about next steps. Here’s the rundown. Thanks for your help.
I’ve been lifting since about the first of the year. In June this year I was doing barbell curls with a straight bar (something I had never done before). The following day I had elbow pain, primarily in my left elbow, but also present in my right. It’s on the inner elbow, at the little bone (medial epicondyle, if I’ve learned from google). The best way I’ve found to recreate the pain is take either hand and place it across my chest as if placing my hand over my heart for the pledge and press down. The pain is very localized to the little bone on the inside of the elbow. I’ve tried screening for nerve impingement and golfer’s elbow, but not sure about the diagnosis. No problems with numbness or grip, although deadlifts are painful. No real forearm or wrist pain. Squats are the most painful, but only when I rack the bar after my set and extend my arms (I don’t notice the pain while squatting). I’ve played golf once or twice each week without any issues. My arms are sore/stiff when I wake up from sleeping.
Most recently I took about two weeks off and didn’t notice any change in my day-to-day pain level. I just worked out (S/B/D) and hoped for some improvement, but it was more painful than usual. That could be due to the fact that I stopped taking ibuprofin a few weeks ago after I didn’t notice any improvement. I’ve also started doing isometric curls (the last two days). I spent the first month or so using a theraband flexbar and while it felt good at times, I didn’t really notice any improvement.
Based on the above are you able to suggest any at-home tests to confirm a diagnosis? I don’t want to waste months treating golfer’s elbow if I have some other condition. (But what else could it be?) For insurance reasons I’m trying to avoid getting imaged at my GP (besides, he would just tell me to rest/stop lifting until the pain goes away). Would a consult be worthwhile, or should I bite the bullet and see my doc?
I experienced the same elbow pain from doing straight bar curls. Except my elbow pain is on the outside of the elbow, lateral epicondylitis, or tennis elbow. It’s an old injury that was re-aggrevated.
From listening to Dr. Miles, Dr. Ray, Dr. Amato podcast. on tendinopathies I learned it’s all about managing load and sticking to a protocol. They also have a great monthly review specific to tendinopathies.
I’m finding what is working for me is following the research and protocols from the 2017 La Trobe University in Australia. They found what works for pain reduction is loading the tendon isometrically, 5 reps x 45 second hold, and progressing up the weight. Their research indicated that eccentric work didn’t not work in the initial treatment stages, as eccentric only work (aka theraband) is too provocative to the unhealthy part of the tendon. The second stage is loading the tendon with heavy isotonic exercise, 3 sets x 15 reps, with linear progression. Also, they recommend doing 24-hour test to see if it’s working. Don’t test your tendon the same day. My test is pick up the same weight in the same way and see if the pain subsides.
Thanks for the response. I don’t know how I’m supposed to manage load when even empty bar squats are painful. I am doing the isometric curls and other stretches/exercises, although I did a day of Rip’s “pin firing” which seems to have set me back. I’m looking to schedule a consult and hopefully get some instruction. Thanks again.
Regarding squats - it depends. If you are low bar squatting and we can switch to hi-bar with some symptom relief with the plan to reintroduce low bar at a later date, then that’s fine. You can also try SSB to keep squatting. If we struggled to find a load tolerable with an empty barbell implement then we can switch to goblet squats with dumbbells/kettlebells as this affords us more loading options. Long story short, there are a lot fo options for training/loading through and around symptoms but often this requires embracing the process (see: https://www.barbellmedicine.com/blog…e-the-process/).