Elbow: Medial Epicondyle Tendonosis

I first got tendonosis in my right elbow (medial epicondyle) in 2001 bouldering on plastic. Resting, icing and stretching did not work. I tried cortisone, prednisone, a physical therapist who did massage and Ionto-phoresis for a few weeks (which in hindsight was hocus-pocus), with no long-term improvement.

By Rock and Ice | January 28th, 2010

I first got tendonosis in my right elbow (medial epicondyle) in 2001 bouldering on plastic. Resting, icing and stretching did not work. I tried cortisone, prednisone, a physical therapist who did massage and Ionto-phoresis for a few weeks (which in hindsight was hocus-pocus), with no long-term improvement.

Finally, a physical therapist did cross-friction treatments and the pain disappeared after four weeks.

Recently I have been bouldering on plastic with and now have the same problem in my left elbow. This time the PT treatment did not work and the pain got progressively worse, so I discontinued it.

I tried your recommended exercise therapy regimen (No. 156), doing eccentric contractions and rotations with a dumbbell every second day. I felt more pain in my elbow, so I dropped the weight, but it still hurt, and after four weeks or so I stopped.

I tried prolotherapy next. The only thing it did was lighten my wallet. I have had x-rays to rule out floating bone chips and major tears.

I don’t know what to do. All the locking off in trad climbing (which I prefer to do) is especially aggravating.

Stewart | rockandice.com

Oh, the woes of the unhealed. Life sux. Next, even the urologist will want a shot at your money.

The solution is simple: You are special.

You have been treated with formula-driven medicine, mine included, but you are not a formula kinda guy. A good rehab program is like a good suit, tailored.

Let’s focus on the program first as I have seen no other panacea for tendonosis. It would seem that the exercises are causing excessive aggravation and inflammation, which is precluding an effective eccentric protocol.

Try this: Two sets of 10 reps, morning AND night, of the eccentrics described in Rock and Ice, No. 156. Four days on, three days off. Complete both the tic-tock and the standard version. Use about 14 pounds for the latter, and adjust the leverage for the tic-tocks so that you are fatigued after 10 reps. Discomfort is normal — for the moment, persist.

In conjunction with this, it is paramount you check in with your PT again for a soft-tissue pummelling. Though I personally find longitudinal massage more effective than cross friction, any variety will help as long as it is wincing. Like pulling nose hairs, it will make your eyes water, but the end result is always worth it.

Ice, ice, baby! Every night after the last set. Three sets of three to five minutes. Like the massage, this will help settle the inflammation. Be careful not to ice behind the medial epicondyle as your funny bone (ulna nerve) does not laugh at the cold.

 

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