Coming off an Elbow Injury

Hello all, 

- As mentioned in one of my previous posts I am just now coming off of a case of bilateral medial epicondylitis and am excited but hesitant to begin training. 

- Its been a good 4 months of rehab, and as of a week ago my therapist said it was fine for me to start doing some LIGHT strength work. My goal is to start from the very beginning of F1 and working my way up accordingly. However currently going into pronation still feels uncomfortable on the medial sides of my elbows. Even just holding myself in the top position of a incline pushup doesnt feel all that great. However when I am able to hold myself up with my wrist in a neutral position, (with my hands in a fist for example), it feels fine. 

- I am curious if I should continue being patient with my rehab and wait until the pronation position feels solid before beginning the upper body portion of the F1 course or try and work my way around it WITHOUT aggravating it, as it continues to heal?

- And obviously I will be consulting with therapist as well just thought I would reach out and see if any one had any advice for me.

- also was thinking in the mean time I could begin progressing the lower body and core portions of the F1 and begin the upper body once things are 100%

What is the gymnastics bodies protocol when it comes to injuries? If your not 100% dont train? Advice? 

Thanks, 

Ryan 

HI RYan personally after an injury I ask always if you have pain in the daily activity. if not then you are welcome to begin slowly. if also with the easier progressions you cannot train pain free t, it is not yet the time to begin again.

2 minutes ago, Alessandro Mainente said:

HI RYan personally after an injury I ask always if you have pain in the daily activity. if not then you are welcome to begin slowly. if also with the easier progressions you cannot train pain free t, it is not yet the time to begin again.

I like this protocol, looks like I will continue with the rehab until I can get through my daily activities without random flare ups. Although things are wayyy better than they used to be, they still arent 100%. 

Thanks for the advice! 

Hey Ryan 

how are you getting on with your elbow issue?

im seeing a specialist tomorrow to Identify a similar sounding problem that I have. It sucks to not be able to do certain things but it's also a good time to get up to speed with  other things I seriously lack in ie mobility etc . 

just wanted to show my support and show there are other guys going through this with you mate 

 Good luck in your rehab 

Leigh, 

So my issue is a bit more chronic than most cases of tendonitis. It started back in the summer of 2015 when I jumped right into some ring work and handstands without any form of foundation. I kept training through flare ups, until it got to the point where I was in pain 24/7. 

after that I spent a year jumping from doc to doc being mis diagnosed several times and never being put on the appropriate rehab program. it wasn't until August 2016 were found a MAT  therapist who actually knew what was going on. Since then I've been making great progress, but continue to put myself in positions where I experience a setback.  ex// " trying"  things in the gym ( pull ups, etc.),  tried to play basketball  or go climbing with my friends,  or having to excessive keyboard work for school. All of these cause really big flare ups, and sent me back 2-3 weeks per episode.  so my recovery has been longer than it should have. 

 some important things I would note  for a faster recovery 

-  doing prescribed wrist exercises 3 to 4 times a week  and starting light ( once deemed ready by your doctor,  usually need at least 2 weeks of total rest before beginning this) 

-  being nice to your elbows, giving them the appropriate  rest they need, And not pushing it, or trying things out in the gym.  I tried this time and time again and every time I get the same results. The definition of insanity  in my opinion. 

-  once you try to go back to the gym start at a level that is all well below the level of which you left off. 

 As of right now, my elbows are feeling pretty dang good, and  my specialist says I should be able to return to doing some light inclined rows/push-ups  at the start of December. 

 its a very frustrating injury to have, especially having tendinitis in both elbows. Really gets in the way of everyday life, but stay patient and consistent.  most important thing  to know, is that you will get better whether it's three months or 18 months. Hopefully your recovery is much quicker  than mine. let me know if you have any questions,  I'm here to help!

Hi Ryan so sorry to hear of your problem Mate

mine is similar in the fact that I trained pretty hard in calisthenics for around 3 years  and although j thought I was being overly cautious in my progress I clearly wasn't slow enough for what my body could handle and had flare ups especially after ring work... I would  condition my elbows only through little bits of help I stumbled across here on the forums before i joined up but nowhere near to any degree that I now know I should  . So in October I completely stopped all my usual training and joined the foundation course . After a few weeks with nothing really hard on my elbows I had a handstand session holding for 30 sec sets (see my Instagram video lol) when I released my grip from the floor the hot burning in both elbows was quite apparent that clearly this is something more serious  than a bit of training pain as I hadn't done anything really in the last few weeks to have  aggravated it but the first time any real pressure was put on the joints they flared up bad . 

Strangely ring rows are ok and there is no pain when performing these . However my Scap shrugs after being in a locked out position for a period of time causes pain again when I release my grip from the floor 

I'm seeing specialist tomorrow so wait to see what his thoughts are too. 

Keep in touch mate and best wishes in your recovery 

Hey Ryan 

Just update on my situation . I saw specialist who has suggested i need X-ray and over here in England doctors appointments are not so speedy so booked in for 7th Dec and go from there 

thanks for all you advice man am already taking on board your advice and resting it and not doing anything that remotely causes pain 

dperessing but trying to look for  the positives 

Best wishes 

A step in the right direction, an x-ray will help see if there are any bone spurs that have developed which could possibly be aggravating surrounding structures. 

Absolutely take it easy until you have a better grasp on the pathology of your elbow. Big issue for me was that for the longest time we were thinking it was nerve damage or impingement which ultimately altered the way I would have gone about  training. So I thus continued to try and train and things only got worse, and further lengthened recovery time.  

Use this time to address mobility deficits and master any core progressions that dont involve loading of the elbows (ex: hollow body position) if you havent already.  

 Although progress is ultimately stalled on upper body work for the moment, dont get discouraged. This is a chance to go back and work on other weakness' so when you are back to full health you will be stronger and more mobile than ever before. 

Keep me updated, Im interested to see what the x-ray shows. Best of luck 

Thank you Ryan much apprexiated

yes it's always a worry like you have found that it won't be diagnosed correctly first time . I'll keep my fingers crossed . Ill definitely be using the time to correct my other weaknesses of which (GST has shownme ) there are plenty.

I'll definitely  keep you informed of my situation and be great to keep updated of yours too. 

Best wishes 

On 11/23/2016 at 11:03 AM, Leigh Kettle said:

Thank you Ryan much apprexiated

yes it's always a worry like you have found that it won't be diagnosed correctly first time . I'll keep my fingers crossed . Ill definitely be using the time to correct my other weaknesses of which (GST has shownme ) there are plenty.

I'll definitely  keep you informed of my situation and be great to keep updated of yours too. 

Best wishes 

 

Leigh, 

Just a quick update for you.... 

 so two weeks ago started doing incline rose incline push-ups and the results were not as expected. Mild flareups during and post workout, they were terrific but also meant that I was training above my elbows capacity. Had a scale everything way back. But now I have starting point. My days and training sessions have become relatively pain-free ( 96 and 99%). 

 currently working on

-light rows ( like superlight 5lbsx20rps light)  but at least it's pain-free.

-  elevated plank position for time, reintroducing weight-bearing load to the elbows.

-  some other  supine scab stability all with no all with no external load ( just arm weight) I,T, Y, W's if you're familiar those exercises

- and some light wrist exercises as well,   wrist flexion extension supination pronation with 1 to 2 pounds. 

 so basically it's a big ego check for me. Insanely weak at this moment which is upsetting, but encouraging none the lest because now I can finally go back to training pain-free,  just not level I wish/thought I was at.

- On top of this I am working tuck hollow and tuck ups along with side plank twists and all of the lower mobility work. waiting to start extension work as it does put a bit of a load on the elbows and in the past has irritated the tissue. Once elevated plank position becomes more comfortable I will begin playing with extension work.

Hope all is well on your front! Keep your chin up, stay patient and consistent  

40 minutes ago, Ryan Segervall said:

Leigh, 

 

Just a quick update for you.... 

 so two weeks ago started doing incline rose incline push-ups and the results were not as expected. Mild flareups during and post workout, they were terrific but also meant that I was training above my elbows capacity. Had a scale everything way back. But now I have starting point. My days and training sessions have become relatively pain-free ( 96 and 99%). 

 currently working on

-light rows ( like superlight 5lbsx20rps light)  but at least it's pain-free.

-  elevated plank position for time, reintroducing weight-bearing load to the elbows.

-  some other  supine scab stability all with no all with no external load ( just arm weight) I,T, Y, W's if you're familiar those exercises

- and some light wrist exercises as well,   wrist flexion extension supination pronation with 1 to 2 pounds. 

 

 so basically it's a big ego check for me. Insanely weak at this moment which is upsetting, but encouraging none the lest because now I can finally go back to training pain-free,  just not level I wish/thought I was at.

- On top of this I am working tuck hollow and tuck ups along with side plank twists and all of the lower mobility work. waiting to start extension work as it does put a bit of a load on the elbows and in the past has irritated the tissue. Once elevated plank position becomes more comfortable I will begin playing with extension work.

 

Hope all is well on your front! Keep your chin up, stay patient and consistent  

 

 

 

 

 

 

Hey ryan

sorry to hear of your setback tho I am happy to hear you have found a scale where you can still get some work in pain free.  Also getting in all your other work (core, lower body etc, stretch ) so there is always something to develop while the injury is in rehab . This is definitely the silver lining in all this 

With me I have found these last couple of weeks that I am able to do ring rows, Push ups and Scap shrugs with no pain now and am only feeling it very rarely during daily activities when my arm is bent tight and in bicep contraction . That said I know there are issues there in both elbows so I went last week for X Ray's and will be getting results of them next week (I wanted to rule out any kind of arthritic issues)  I haven't dared to hold a handstand yet as the last time I did really flared up the pain / burning that made me seek help in the first place . Small steps. I am actually meeting Wesley Tan tomorrow for the forma gst workshop in London so I hope I may get some invaluable Information from him regarding moving forward with this 

I've also ordered myself a Thera band flex bar which I read are an excellent rehab tool in itself for elbow issues . Have you heard or experienced these  ?

Thank you for your well wishes and wish you the best of luck in these coming weeks of rehab/prehab

3 minutes ago, Leigh Kettle said:

Hey ryan

sorry to hear of your setback tho I am happy to hear you have found a scale where you can still get some work in pain free.  Also getting in all your other work (core, lower body etc, stretch ) so there is always something to develop while the injury is in rehab . This is definitely the silver lining in all this 

With me I have found these last couple of weeks that I am able to do ring rows, Push ups and Scap shrugs with no pain now and am only feeling it very rarely during daily activities when my arm is bent tight and in bicep contraction . That said I know there are issues there in both elbows so I went last week for X Ray's and will be getting results of them next week (I wanted to rule out any kind of arthritic issues)  I haven't dared to hold a handstand yet as the last time I did really flared up the pain / burning that made me seek help in the first place . Small steps. I am actually meeting Wesley Tan tomorrow for the forma gst workshop in London so I hope I may get some invaluable Information from him regarding moving forward with this 

I've also ordered myself a Thera band flex bar which I read are an excellent rehab tool in itself for elbow issues . Have you heard or experienced these  ?

Thank you for your well wishes and wish you the best of luck in these coming weeks of rehab/prehab

 I do have a pair of thera band flex bars  but I was not able to use them due to both my arms being such a wreck.  The action of twisting the bar itself  in preparation for the eccentric portion was too much arms to handle and caused them to flareup ( this is about three months  ago however).  they are great tool, but the main thing they getting after is eccentric loading which helps  stretch the tendon, and guide fibroblasts cells when laying down new tissue. Ive just been putting extra emphasis on the eccentric portion of my wrist exercises instead.   Definitely give it a try!

 and please share any wise words you  receive on how to go forward with training! I'd be interested  to hear what people have to say.

Best wishes

9 minutes ago, Ryan Segervall said:

 I do have a pair of thera band flex bars  but I was not able to use them due to both my arms being such a wreck.  The action of twisting the bar itself  in preparation for the eccentric portion was too much arms to handle and caused them to flareup ( this is about three months  ago however).  they are great tool, but the main thing they getting after is eccentric loading which helps  stretch the tendon, and guide fibroblasts cells when laying down new tissue. Ive just been putting extra emphasis on the eccentric portion of my wrist exercises instead.   Definitely give it a try!

 and please share any wise words you  receive on how to go forward with training! I'd be interested  to hear what people have to say.

 

Best wishes

Of course i will Ryan. I'm excited to hear what I may be told by Wesley .

i will see how I get on with the flexbars then and take caution as to what you've said . I've also incorporated the wrist exercises from handstand 1 regularly now  . We seem to be doing all the right things mate so fingers crossed we will see the results soon enough 

On 12/10/2016 at 0:10 PM, Leigh Kettle said:

Of course i will Ryan. I'm excited to hear what I may be told by Wesley .

i will see how I get on with the flexbars then and take caution as to what you've said . I've also incorporated the wrist exercises from handstand 1 regularly now  . We seem to be doing all the right things mate so fingers crossed we will see the results soon enough 

Hey there just checkin in to see how you are getting on with your elbow injury and if there was any wisdom you obtained from Wesley. 

Things on my end are improving slowly but surely. No huge leaps forward but no steps backwards either. Continuing to stay consistent.

Hope you are enjoying the Holidays and resting up for another year of progress in 2017

On 26 December 2016 at 5:25 PM, Ryan Segervall said:

Hey there just checkin in to see how you are getting on with your elbow injury and if there was any wisdom you obtained from Wesley. 

Things on my end are improving slowly but surely. No huge leaps forward but no steps backwards either. Continuing to stay consistent.

 

Hope you are enjoying the Holidays and resting up for another year of progress in 2017

Hey Ryan 

good to hear from you 

Wesley gave me the advice you and I had both given each other really to not train through any pain and to take your time with all movements . 

Ive been using my flexbar daily and have to admit it seems to be doing a great deal of good ,even after a couple of days use I already felt it feeling better.

im still taking a lot of precaution in all movements and never ever working through pain. I do still get the odd "twinge of something not right" when my arms are completely bent and i squeeze my bicep so I know I still have a way to go. 

My X-ray came back showing no abnormalities so at least that was a good start . Not sure if I should push for an mri or continue as I'm doing 

So good to hear you are still progressing well Ryan albeit steadily but slow and steady always the best way I'm just so frustrated I didn't learn this from the start . 

What is your current pain throughout general daily activities then mate ? Is it subsiding ? 

Happy hilidays to you 

Leigh 

On 12/29/2016 at 9:11 AM, Leigh Kettle said:

 

My X-ray came back showing no abnormalities so at least that was a good start . Not sure if I should push for an mri or continue as I'm doing 

So good to hear you are still progressing well Ryan albeit steadily but slow and steady always the best way I'm just so frustrated I didn't learn this from the start . 

What is your current pain throughout general daily activities then mate ? Is it subsiding ? 

Happy hilidays to you 

Leigh 

Leigh, 

 great to hear things are better!  as for the MRI, it wouldn't hurt to get,  and would give you a sense of how much damage is actually done to the tendon.  That is if it doesn't break your bank of course.  After MRI getting some tissue work done would also a good idea to help break up some scar tissue, you can also do this at home without the aid of a professional, but a professional would likely do a better job (no offense). Just depends how much money your willing to poor into this, trust me it can get expensive really fast. 

 as for me, each week I'm beginning to notice small increments of improvement.  my elbows still get agitated when I do things such as cleaning the dishes, folding laundry, and really hands-on activities that require a lot of finger dexterity,  But nonetheless they are getting agitated less easily.   also making conscious effort to try to work around things that typically cause them to flareup. Avoiding major set backs as much as possible as there have been many in the past. 

 continuing with daily wrist exercises : 6 second end range isometric contractions for mobility improvements ( seen big gains here) and light high repetition wrist flexion and extension supination pronation.  progressing the load or volume every week. Once I reach 3x25rps on each exercise I increase load by 1lb starting over at 2x15rps.

as for my other training I am currently training all the  upper body PE1  exercises found from  foundations 1 (twice per week),  but using  dumbbells instead.  this is allowing me for a little more control over the load and placing on my elbows, and a more easily quantifiable measurement.  Starting super superlight and working my way up in a progressive overload fashion.

 currently using a 7/2 pound dumbbell for all exercises, and  plan on progressing in 2.5lb  increments every third workout.

 Using a bathroom scale,  I found at the top of a push-up position, it is roughly 120 pounds of  body weight.  this means that I got some work to do.  planning on continuing to use dumbbells as a substitution until I'm comfortably using 50-60lb  dumbbells on all my exercises.  likely to be a 6-8 month process. 

 just happy to be making progress in some way shape or form now :)

best of luck to you. Keep me updated

-Ryan 

On 11/23/2016 at 11:03 AM, Leigh Kettle said:

I'll definitely  keep you informed of my situation and be great to keep updated of yours too. 

 

Leigh, 

Just thought I would update you on my progress. I am happy to say this first month of 2017 I made huge progress in my recovery. Using dumbell modifications of all the upper body exercises starting with very light loads(7.5lbs x 15rps x 3 sets). Been able to increase load by 2.5lbs every week with no real issues, minus a little discomfort when locking my elbows out at the top of my presses (going to discuss with physio). Programing in a de load week every 4th or 5th week to make sure the connective tissue in my elbow has plenty of time to super compensate.  

But the most important thing is that I am out of pain. If there is pain its usually very brief subsiding after 10 minutes and the intensity is around a 2/10. So So happy to finally be getting my life back after a painfully long 18months of being in a constant state of pain and frustration. 

I hope you've been making plenty of gains on your end. Keep me posted!

On 26 December 2016 at 5:25 PM, Ryan Segervall said:

Hey there just checkin in to see how you are getting on with your elbow injury and if there was any wisdom you obtained from Wesley. 

Things on my end are improving slowly but surely. No huge leaps forward but no steps backwards either. Continuing to stay consistent.

 

Hope you are enjoying the Holidays and resting up for another year of progress in 2017

Hey Ryan 

That's great news !!!!!

so pleased to hear you doing so good. I'd be intrigued to see some videos on how exactly you use your Dumbbells for your substitute exercises . So glad it's all working for you minor the little discomfort . 

Im doing ok like you I'm just taking it steady . Really disappointed to have  spent a lot of money on seeing "specialists"  for none of them to actually diagnose what's going on. So for the time being im self managing it and just trying to take things easily . It's weird cos one day will be fine and then I'll do the same thing another day exercise wise and it can feel different again . Such a frustrating issue .

things like the table hold in the TB series can aggravate it so I'm mindful to really engage my biceps and this is really helping me thorough certain moves 

so happy to hear you doing well bro keep me informed 

All the best 

Leigh 

On 2/2/2017 at 8:08 AM, Leigh Kettle said:

Hey Ryan 

That's great news !!!!!

so pleased to hear you doing so good. I'd be intrigued to see some videos on how exactly you use your Dumbbells for your substitute exercises . So glad it's all working for you minor the little discomfort . 

 

- The modifications are as simple as a incline press on a bench, and a bent over row. I fyou want I can get some footage next training session 

On 2/2/2017 at 8:08 AM, Leigh Kettle said:

Im doing ok like you I'm just taking it steady . Really disappointed to have  spent a lot of money on seeing "specialists"  for none of them to actually diagnose what's going on. So for the time being im self managing it and just trying to take things easily . It's weird cos one day will be fine and then I'll do the same thing another day exercise wise and it can feel different again . Such a frustrating issue .

 

- I know the feeling trust me. My biggest advice would be to make sure your training at a intensity that is only causing a discomfort level of 2/10 at absolute most. It takes time but you will get there. I still got at least another 4months of dumbbell work until I can really start doing more body weight exercises. Benching and rowing 20lbs right now. waiting until I get up close to 50lbs to make the switch over to body weight. 

Stay patient, and best of luck! 

Keep me posted  

Instead of a thera bar flex bar I've used a dowel with rope and a barbell plate attached to it for eccentrics, started with 2.5kg plate moved up slowly. Roll up the rope while on the floor then bring up and lower weight slowly creating resistance so its eccentric work. Worked well last year for my elbow. Took about 3-4 months to be back to 100%. I hadn't beaten up too much though, about 2-3 weeks after pain started I took some rest and then started eccentrics. I also did eccentric only hammer curls, 3 sets of 10, going from 5-10-20 pounds.

https://www.youtube.com/watch?v=PfuBgU7NxZc

19 minutes ago, Benjamin Renaud said:

Instead of a thera bar flex bar I've used a dowel with rope and a barbell plate attached to it for eccentrics, started with 2.5kg plate moved up slowly. Roll up the rope while on the floor then bring up and lower weight slowly creating resistance so its eccentric work.

 

- how many times per week did you trains this/total sets per session? Appreciate your input!

I used the dowel 3 times per week, completely unrolling to the floor gave me about 12 reps with each arm (24 total) or so. Make sure you keep good form while doing it, glutes tight, nice abdominal bracing and shoulders down (lats engaged no shrugging). I did that for 3 sets. I changed the weight when I no longer felt light pain or discomfort in the forearm. When moving to heavier weight I had light pan when doing it but it subsided and felt a bit stronger everyday. I stopped at a 5kg plate.

On the next day I'd do slow eccentric hammer curls, 3 sets of 10. I used the same kind of progression, when I no longer felt any pain or discomfort I'd move up in weight. I stopped at 20 pounds.

I also did LIGHT stretches 3-4 times a week similar to what you can find in GST.

I'd alternate between one exercise and the other because I thought both would be too much to do in a single day, plus it allowed me to see if one was more useful/hurtful than the other going by how I felt the next morning. It usually didn't show right away if I was doing better or not, witch made it harder to know if I progressed too fast in adding weight, usually though if I waited for one weight to be pain 90% pain free then going up in weight was good.

I found these 2 articles useful in understanding and treating my elbow pain.

http://stevenlow.org/overcoming-tendonitis/

https://www.t-nation.com/training/tendonitis-cure (I didn't use voodoo bands but did try the gua sha a few times a week)

3 hours ago, Benjamin Renaud said:

I used the dowel 3 times per week, completely unrolling to the floor gave me about 12 reps with each arm (24 total) or so. Make sure you keep good form while doing it, glutes tight, nice abdominal bracing and shoulders down (lats engaged no shrugging). I did that for 3 sets. I changed the weight when I no longer felt light pain or discomfort in the forearm. When moving to heavier weight I had light pan when doing it but it subsided and felt a bit stronger everyday. I stopped at a 5kg plate.

On the next day I'd do slow eccentric hammer curls, 3 sets of 10. I used the same kind of progression, when I no longer felt any pain or discomfort I'd move up in weight. I stopped at 20 pounds.

I also did LIGHT stretches 3-4 times a week similar to what you can find in GST.

I'd alternate between one exercise and the other because I thought both would be too much to do in a single day, plus it allowed me to see if one was more useful/hurtful than the other going by how I felt the next morning. It usually didn't show right away if I was doing better or not, witch made it harder to know if I progressed too fast in adding weight, usually though if I waited for one weight to be pain 90% pain free then going up in weight was good.

I found these 2 articles useful in understanding and treating my elbow pain.

http://stevenlow.org/overcoming-tendonitis/

https://www.t-nation.com/training/tendonitis-cure (I didn't use voodoo bands but did try the gua sha a few times a week)

- Ive been doing wrist curls instead of using a dowel, but they are getting after the same thing. Been using the progression scheme of (2x10r, 2x15r, 3x15r, 3x20r, increase weight) Usually spend 3-4 weeks on a specific load before bumping up. That in combination with incorporating compound moves (starting in the 15rep range for 6 weeks, now in the 8-12) has really helped. I've been doing this twice a week (M Th). Will try adding another day and see how it goes ( M Th Sat) 

- that article was also really good and super helpful wish I found that earlier  

Thanks for your help!

- Ryan 

@Ryan Segervallkeep in mind that I was doing the eccentric portions only. If you do wrist curls and do the whole movement you might not get the same effect I did.

2 hours ago, Benjamin Renaud said:

@Ryan Segervallkeep in mind that I was doing the eccentric portions only. If you do wrist curls and do the whole movement you might not get the same effect I did.

- yes yes of course. Ive been doing both concentric and eccentric following a 3121 tempo. I've been making huge progress over the past 6 weeks so I dont feel the need to alter this sense i've made the most progress i've made all year (been dealing with this for 18months now). Finally creeping into pain free days/training sessions