Question

Hey,

I have a question about chronic forearm pain. My rock climbing partner has chronic pain in both (but more in one of them) of her forearms, radiating mostly towards the lateral epicondyle when climbing moderately hard. The pain is so bad she has to stop. I've heard of climbers suffering from this problem for long periods. But there must be some way to explain, rehabilitate and prevent it in the future.

I've tried reading up on this in books and websites, but I find nothing of particular use or great explanation. The best I've found so far is to stretch the forearm flexors and strengthen the extensors with reverse wrist curls, as there might be muscular imbalances. I know you did great work on the lower leg and knee joint in your book "Bulletproof knees," so I'd like to hear your thoughts on the forearm/elbows here.

Unfortunately, no ART providers in this area, also I don't think regular physicians would be of much help here.

Thank you for reading!

Answer

Karl -

 

Well ART or deep tissue massage was going to be my first suggestion, so don't rule that out. If you can find someone qualified to loosen up the tissues, that would definitely help.

Don't forget about impacting the ENTIRE upper extremity as well. So many of the elbow issues that I see are manifested due to neck, shoulder and t-spine issues. If things up the kinetic chain are out of whack, it doesn't matter how much isolative work you do around the elbow.

If you haven't already, check out the "Are you Dysfunctional?" article that I posted on Elite a while back. Chances are you/your friend could be suffering from some of the same issues, and it's a pretty general get healthy program.

Finally, read everything you can by Eric Cressey. I'm pretty confident in my muscle and joint anatomy, but Eric sees a lot more elbow stuff that I do. Run a Google search for Eric Cressey and elbows and I bet you come up with his six-part series, which is fantastic.

Good luck!

Robertson Training Systems

Thank you for reading!

Question

For rehab:

I have been having issues with my left shoulder for a while. I haven't done any pressing work in months (only back work). Feels like a pinching sensation in my supraspinatus, probably impingement. The movements that hurt the worst are external rotations and a front raise with the thumb pointed at the ground (AC joint closed). However, if I put a towel between my arm and my side and perform an external rotation, the pain is cut by around 80 percent.

The sleeper stretch also causes a painful/pinching sensation. Any suggestions? Thanks.

Answer

Unless you're horribly impinged, I can't fathom external rotations hurting. For now, perform them by your side to reduce the influence of scapular positioning/scapular upward rotation.

 

Next, PLEASE STOP performing exercises with your thumbs down. This is a provocative test for impingement - why on earth would you want to train like that? Thumbs up on EVERYTHING.

If I were you, my program would look like this:

- Follow the "Are You Dysfunctional" program
- 4:1 Pulling:Pressing ratio (if you press at all)
- Incorporate these exericses whenever possible

  • Prone I, T, and Y
  • Face Pulls
  • Push-up Plus
  • Prone Row to External Rotation

Video clips of these can be found on my YouTube page.

Let me know how this works, and please, stop doing the thumbs down stuff. I don't want to sound like a dick, but that stuff will chew up your 'cuff in no time flat.