Elbow Pain from Muscle ups

[mowgli]

I've been following GB for some time now but I'm nursing an old injury that just won't seem to fade and I'd greatly appreciate some advice. I accomplished my first muscle-up rather quickly and I enjoyed it so much that I kept right on doing til I damaged something in my elbow. It first flared up when I was working Russian dips and now hurts whenever I do MU's and sometimes if I'm pressing through it fairly hard to balance during a handstand.

I've been backing off of it for a months now and icing but I'm still not confident in it and would be curious to know what anyone else might suggest. Thanks.

I'm adding a pic to demonstrate where I'm feeling the damage.

[Joshua Naterman]

You're going to have to work back into it very slowly.

This probably isn't going to be what you want to hear, but you have to stop doing anything that hurts it for a while, which is going to be a lot of things. Starting up with really light, high rep band work is a great way to start rehabbing this. The low resistance and high reps will get lots of blood flowing. Tricep extensions and if you can, some dip extensions are great beginning exercises. You really should stick to just this kind of work for at least a month before you try to even begin the process of reconditioning. At first, just one set a day of 10-30 reps should be plenty, 3-4 days a week. At this point, heating it is going to do more good than icing. You shouldn't be working it hard enough to need ice. You need the extra bloodflow from the heat!

Go nice and slow, and don't start the rehab until you can move your unweighted arm without pain or discomfort. If that's today, that's fine, but if it isn't then you're best off waiting.

Work with just the bands, only increasing the reps once a week and preferably stopping when you think that the next rep isn't going to feel right. If you can't feel that, stop the INSTANT you feel anything resembling pain, discomfort, or anything else that you know you shouldn't feel. This is super light stuff, ok? Not challenging. Challenges will only re-injure you. In the beginning you may even have to use partial ROM, but you'll need to build up to full ROM with the bands before you start reconditioning.

As you start back, begin with floor push ups. I want to make something clear: You're not going to lose hardly any strength, and by the time this process is over you're probably going to be better than ever if you stick to it. You must not think of this as strength work! This process is for healing. We want to stimulate HEALING. If you do 3 reps and that 3rd rep feels a bit funny, stop right there, don't even finish that rep if you can stop it in time. Do the band work. You now know your limit is 2 push ups. If you can do that 3x per week you should find that each week you can add quite a few reps before you hit that rep where it's time to stop and do the bands.

When you can do the set of 15 push ups with no issues, you can move to rings push ups. After that causes no issues for at least a week at 15 reps you can move to assisted PB dips. If you have to, just put your legs on a box in an L if there's no other way to assist the dip. The more of your legs on the box the easier the dip will be. When you can do 10 of these easily for 2-3 weeks with the heels only on the box OR very light assistance you should be ok to start doing a few reps of BW dips. Again, start slow here. Even if you feel like you can do 10, start with 3 or 4 at the most. Only add 1-2 per week, and if no weirdness or discomfort feels like it is building when you're doing 10, keep that up for a few weeks.

Now it will probably be safe for you to slowly work into false grip pull ups the same way. Assisted at first, and then unassisted. use the same progressions.

Note: This is not the only way, but this way will almost certainly give you the highest chance of NOT re-injuring yourself. TO truly get rid of a chronic problem typically takes just as long as it took to develop the problem. So double the time you have been feeling this way, because injuries are there long before we can feel them. That time is about how long you should expect the reconditioning process to take, though it could take longer. Don't think you're better because it doesn't hurt! It didn't hurt for a long time when you first developed this injury, yet you were doing damage. Pain is not how you know an injury is there, pain is how you know it's getting really bad. If you do stray from this and do too much too soon, just refer back to this post and follow the program without the rush! You should be fine eventually.

If you EVER feel anything wrong, take a few steps back. If that happens with a set of 8 BW dips go back to 5 assisted dips and build back up from there at a slower pace than before. ALWAYS do at least one set of the bands each day that you do this conditioning. Doing the bands as warm up is the best place if you're only doing one set. If you're doing 2-3 sets then do at least 1 set as warm up. I don't think more than that can do any good for you.

There are many methods of healing, this is simply one. You can also look into galvanic stimulation if there's a chiropractor or other specialist around who actually has a reputation for knowing how to use that for healing, because used correctly it can help heal injuries in weeks that take months to heal with other methods. Quite remarkable, really, and almost impossible to find it would seem. There are lots of TENS therapists, but many seem to not be familiar with the galvanic stimulation. It is also possible for TENS to be used successfully as a part of your recovery program, but again you need a practitioner who knows how to use that for HEALING, not massage warm up.

If you don't know what that stuff in the last paragraph means, google it. There's a ton of good info out there.

[mowgli]

Slizzard you're a god-send. Just as I was starting to lose hope I get some valuable feedback. I can't say thank you enough good sir.

[Joshua Naterman]

You're welcome. It just so happens that I am doing the same thing I am telling you right now lol! I have found that wall tricep push ups are an excellent second step after you have put a few weeks into the light tricep extensions.

I had found out a while ago that tricep (aka diamond or close grip) push ups ended up being really good elbow pre-hab for muscle ups. Once you're back at 90+% you should be able to start working these.

[mowgli]

Jeeze Slizzard. You have an omnipotent internet presence. I just checked your youtube account and realized you were the same guy who I picked up the Russian Dips from that I originally damaged myself with (even after you cautioned of impending elbow damage if you moved too fast). Now I find myself getting rehab advice from you. THAT'S coming full circle. Ha.

I also noticed you had "liked" the video on face pulls. Something I'd seen recently also. You aren't lurking the Grey Skull Elite boards too are you?

[Joshua Naterman]

What are those boards? I don't actually lurk anywhere, I just search when someone asks a question I don't have the answer to and I am good at finding answers!

I hope the board you are talking about isn't run by the guy who blogs on greyskullarticles.blogspot.com... I can't say I'm overwhelmed with respect for what I have seen. He has a very poor self-presentation in my opinion, and frequently makes off-topic comments that are both distracting and petty in his blogs, especially his angsty rant about crossfit and why he doesn't affiliate anymore.

Are the boards better than that?

As for the elbows... lol! What can I say, except "Hi!"

It's all good, I'm here to help. I learned the hard way and as much as I try to keep others from following in those footsteps I know many will do so anyways, so all I can do is help pick up the pieces!

"Face pulls" are something that I picked up a while back, probably close to a year ago at this point. I don't remember where, it was a part of some rotator cuff work that I was learning about. It's a good movement to have in one or two of the weekly warm ups once your shoulders are working correctly.

[ASForum]

Sizz - I did something to my right elbow... probably during a Pull up... Could also be added on due to my work on the computer.

Been off for a few days or a week now.

What do I do? For rehab..? Which of the basic FBE's can I do or not do?

[Joshua Naterman]

I think that the first thing you should do is a postural assessment. You can't fix a problem if it is caused by posture, which many problems are, until you fix the posture. Anything else is just a band-aid on a gun shot wound.

I would recommend "Pain Free" by Pete Egoscue. It's 14 bucks and will guide you through a complete self evaluation that is simple and quick, and then it will guide you through a very effective program to permanently correct whatever musculo-skeletal dysfunctions you find. If it makes any difference to you, Jack Nicklaus the famous Golfer wrote the forward to the book. The method detailed in that book(and Pete Egoscue, of course) is the reason he was able to return to golf.

[ASForum]

I think that the first thing you should do is a postural assessment. You can't fix a problem if it is caused by posture, which many problems are, until you fix the posture. Anything else is just a band-aid on a gun shot wound.

I would recommend "Pain Free" by Pete Egoscue. It's 14 bucks and will guide you through a complete self evaluation that is simple and quick, and then it will guide you through a very effective program to permanently correct whatever musculo-skeletal dysfunctions you find. If it makes any difference to you, Jack Nicklaus the famous Golfer wrote the forward to the book. The method detailed in that book(and Pete Egoscue, of course) is the reason he was able to return to golf.

For the computer usage or for the pull ups thingy? I got Pain free at your PC. Gonna go through anyways.

I think this time it was because of extended off time, inadequate warm up and enthusiastic energy rush while doing pullups?

[Joshua Naterman]

Both, but especially the pull ups.

It's definitely possible that your overzealous approach to the pull ups could have caused the problem! As far as elbow rehab, very light full ROM tricep extensions will help a lot, it doesn't matter what you use. Just do 20-30 reps at a fairly slow pace. It is important that this is low force. I prever a 3 second contraction and a 1-2 second negative but an overall 5 second rep is good. You'll notice that this actually takes you PAST the muscle fiber recycling time, so if you are pushing beyond or even to the limit of your strength endurance you won't be able to do this. You have to work very light. I'm using 40 lbs on the cable machine, and that's probably under 30% of my 1RM. If you're hurt you may want to start off at 10 lbs. I would do the same thing for bicep curls, to keep the joint balanced and to work on any underlying problems. Personally, I also do reverse curls, but you may not choose to do that.

[Gerald Mangona]

Follow-up question.

I have "tenderness" in the same place as the OP. But I don't think it's "injured". Let me show what presents, and if you think I'm injured and need to start rehab, let me know. If it's not injured, please let me know what I need to do (not do) to prehab the elbow to make sure that I'm not walking down the wrong road.

- Just to give you an idea of my relative progression, I have the strength to do 3-4 XR dips at a 3-1-3 tempo.

- I've been taking it slow since the 6 month break from overuse, so all I'm doing now are XR dips with legs on a platform. No pain is present during or after doing a round of these.

- I tried to see where I was on the muscle-up progression, and so tried them with my feet on the ground. I couldn't get through the transition phase and realized I just don't have the tricep strength yet.

- I tried doing diamond push-ups, and could feel the strain on the tricep tendon and so I stopped after the first rep.

- I tried doing the diamond push-ups on my knees and had the same thing.

- So then I tried holding the bottom of a diamond push-up as an FSP. Failed within 5 seconds.

- So then I tried holding the bottom as an FSP on my knees...Failure came in 10 seconds.

- FInally I tried leaning against the wall at a 45 degree angle. Failure came at 40 seconds, and so I've added 3 sets of a 20 second hold to my FSP routine.

- Also I hold a 3 lb. dumbell and do a set of 30 reps.

Obvs, I have the strength to do these excercises at the tricep, but when the arm is in a low-leverage position, it's hell at the tendon connect point, so I'm trying to strengthen there and let it catch up.

It's not tender to the touch, or even with light pressures. But all it takes is for me to dig a little and it definitely feels like adhesions and tightness and tenderness.

Any thoughts?

JM

[Joshua Naterman]

Time to do active releases for the triceps and forearms!

The strength issue is also relevant, you should be able to hold a diamond push up just off the ground for a good while, at least 30s. You should also be able to do, well, as many reps as you can do. You should be able to go to failure without pain in the triceps push ups. The elbow angle makes them a great conditioner as long as the tissues are not restricted.

Work the soft tissue any way you know how, and slowly work on your triceps push ups. Starting on the wall is great if that's where you need to be. Statics are probably best for now, but don't overdo it.

[Gerald Mangona]

Thanks Slizz...it looks like I just have lots of catching up to do on my tendon strength. (Or maybe I just have really long arms, making the leverage on the elbow really long. Who knows.)

Will start with statics on the wall until I can build to a 60 second hold. Then I'll move back to the floor and work it from there.

I appreciate the help - J

[Longshanks]

Once again very good advice Slizz. I just scaled the exercises I used to be able to do WAAAYYYY down and do them at tempo for SSC's. Push-ups on the table or chairs and rows with the rings quite high have been a turning point for recovering my elbows. Just lower to the ground a bit more each cycle as it feels more comfortable.

[Joshua Naterman]

That's awesome!

I'm doing the same thing, working very basic stuff. It is surprising to me how much strength I have gained just from stepping back. Muscle ups are easy now, though I don't train them. Just training scapular movement and stability under load has really upped my strength on everything upper body related.

Don't forget the soft tissue work, you can use the back of a butter knife or something similar that has a rounded edge to stimulate recovery in the muscles and tendons of the arms! It sounds ridiculous, but that's exactly what Graston Technique is. They have fancier tools that are more specific but the implementations are the same. Watch some youtube videos of how Graston is applied, they are all over the place, and copy at home with mineral oil, Cetaphil, or whatever lubricant works for you. Just make sure you have a nice smooth and round edge to work with, you don't want to shave the skin off your arm!

Done together with the strengthening this will dramatically improve your recovery. It has literally worked miracles for me and continues to do so.

[Troy Rodriguez]

Ever used astym Slizzardman? I have seen it referenced but not on these boards. I was wondering if it is a technology worth looking into. There are a few sports clinics around my area that offer it.

[Longshanks]

That's awesome!

Don't forget the soft tissue work, you can use the back of a butter knife or something similar that has a rounded edge to stimulate recovery in the muscles and tendons of the arms!

This sounds like you've made your own equivalent of the thera cane. I haven't tried them but have been told they're very good by a friend at work with long term back problems. Tho they are bit expensive for what is essentially a bowed piece of wood with a small ball on the ends. My tennis and cricket ball do me fine.

[ASForum]

Both, but especially the pull ups.

It's definitely possible that your overzealous approach to the pull ups could have caused the problem! As far as elbow rehab, very light full ROM tricep extensions will help a lot, it doesn't matter what you use. Just do 20-30 reps at a fairly slow pace. It is important that this is low force. I prever a 3 second contraction and a 1-2 second negative but an overall 5 second rep is good. You'll notice that this actually takes you PAST the muscle fiber recycling time, so if you are pushing beyond or even to the limit of your strength endurance you won't be able to do this. You have to work very light. I'm using 40 lbs on the cable machine, and that's probably under 30% of my 1RM. If you're hurt you may want to start off at 10 lbs. I would do the same thing for bicep curls, to keep the joint balanced and to work on any underlying problems. Personally, I also do reverse curls, but you may not choose to do that.

I let the workouts slide for a while. Let my elbows rest. Been doing minimal yoga. But there's a wierd quirk still remaining in the Elbow. It gets antsy if/when I workout / put load on it.

I just got a BMP Resistance Band Set to do Ido's & your Warmup, Rehab / Mobility stuff for Back, Shoulder, Etc.

I notice a certain 'quirk' in the right elbow in the last 5 Degrees of 'Extension'. But this click / quirk is not felt / observed all throughout in terms of 'Forearm's Rotational Position'.

Wonder what kind of Rehab to do here.. Its been months since I loaded this elbow with anything.

UPDATE: Actually, I just discovered its there even in last 5 degrees of Contraction.

I think its more to do with 'rotation' of the forearm in a certain 'rotational degree' at the same time the elbow is extended / contracted.

-- I have a video, lets see if I can post & I hope its clear. --

me9mgKQLYzo

- Starts with Rotation of my Left Shoulder - It has had a bad pop for a long time. What to do for that?

- Right Elbow Extension.. attempts to ascertain the extension angle at which it pops.

- Ends with Elbow Extension.. attempts to figure out Rotational angle where popping is there or not on how forearm is rotated

[Joshua Naterman]

That's awesome!

Don't forget the soft tissue work, you can use the back of a butter knife or something similar that has a rounded edge to stimulate recovery in the muscles and tendons of the arms!

This sounds like you've made your own equivalent of the thera cane. I haven't tried them but have been told they're very good by a friend at work with long term back problems. Tho they are bit expensive for what is essentially a bowed piece of wood with a small ball on the ends. My tennis and cricket ball do me fine.

No, very different from a theracane. I need to get a back buddy, which is another theracane type instrument, but that's for separate reasons. What I have made is a homemade version of instrumented assisted soft tissue release instruments. It's a crappy one too, compared to the real thing, but seriously it is awesome even as is. The biggest shortcoming is that you really can't get your posterior core, glutes, or really even hamstrings effectively by yourself so you still need to see a specialist for many issues and should really see one anyways so that they can do the deeper work.

ASTYM seems to be very similar to graston, despite their attempt to discredit graston. Their pictures and videos show the exact same techniques pretty much, with the clinically important (sarcasm) difference that ASTYM tools are clear. Seriously.

All you are doing is creating a very, very localized stretch that is perpendicular to the muscle fibers. This forces them to splay widely, and any type 3a collagen (scar tissue) in the area breaks because it is simply not strong enough to resist the local stretch. This concept is similar to psi, in fact it is exactly the same. By having a very, very small area that is deformed (as opposed to trying to stretch the entire muscle) you are stressing fewer scar tissue fibers and are stressing them in the direction they are weakest. Because the force is spread across far fewer scar tissue fibers the force per fiber is far beyond the breaking point. It is relatively comfortable in most places and more importantly it WORKS. This process actually causes type 1 collagen, the mature stuff running parallel to the muscle that we are supposed to have, to reform in the proper orientations. There is quite a reasonable body of science that backs this up. In my opinion, this is a very easy and very effective rehab AND prehab element for the arms and legs. Twice a week is what it takes, and you can do both arms in less than 10 minutes.

[Joshua Naterman]

Ever used astym Slizzardman? I have seen it referenced but not on these boards. I was wondering if it is a technology worth looking into. There are a few sports clinics around my area that offer it.

They are trying to make their technique sound radically different because they use clear tools instead of steel. Regardless, just to be sure I will be trying to get a Graston and a ASTYM treatment during the next 6 months.

[Troy Rodriguez]

This process actually causes type 1 collagen, the mature stuff running parallel to the muscle that we are supposed to have, to reform in the proper orientations. There is quite a reasonable body of science that backs this up. In my opinion, this is a very easy and very effective rehab AND prehab element for the arms and legs. Twice a week is what it takes, and you can do both arms in less than 10 minutes.

Is this something you want to expand upon or put up a video on? I have read and watched a few videos about it but some of them look pretty damn gruesome. Would rather not shred my skin if unnecessary. Also what oil or lubricant is used? Or does it matter?

[Joshua Naterman]

I just use Cetaphil lotion, it's 5 bucks for a big tub at Walmart. Mineral oil AKA baby oil should be ok as well, but I'm not sure.

I may put a video up at some point, but probably not yet.

[David Gardner 1]

Just wanted to chime in with something I learnt recently. I hurt my elbows trying to learn muscleups, and I found the info in this thread really useful but I just couldn't get the pain to go away no matter how much I tried to take it easy and progress slowly.

Eventually I went to see a sports med physio. It turns out that my ongoing elbow pain was due to over exertion and jamming up muscles in my neck because I didn't have enough strength in my arms when I was trying to do the muscleup. Apparently a lot of people tense up their neck really strongly if they are lacking strength in other areas, and it's a common injury she sees.

So I would recommend finding a good physio to anyone with ongoing issues - having professional advice has helped me a lot and the physio was able to get rid of the pain in a couple of weeks when I couldn't get rid of it in months.

[Joshua Naterman]

Just wanted to chime in with something I learnt recently. I hurt my elbows trying to learn muscleups, and I found the info in this thread really useful but I just couldn't get the pain to go away no matter how much I tried to take it easy and progress slowly.

Eventually I went to see a sports med physio. It turns out that my ongoing elbow pain was due to over exertion and jamming up muscles in my neck because I didn't have enough strength in my arms when I was trying to do the muscleup. Apparently a lot of people tense up their neck really strongly if they are lacking strength in other areas, and it's a common injury she sees.

So I would recommend finding a good physio to anyone with ongoing issues - having professional advice has helped me a lot and the physio was able to get rid of the pain in a couple of weeks when I couldn't get rid of it in months.

Excellent post!

When possible, getting professional help is always the way to go. There may be additional treatment options that can help, but on the internet it is completely impossible to properly assess a condition, even with video. We can try, and we can see and figure out a lot, but without professional knowledge + experience + a license to practice we are all seriously limited.

Always see a professional, there is a good reason that they make the money they do. Just make sure you see someone who specialized in competitive athletes.

[David Gardner 1]

Thanks Joshua. One of the hardest things for me has been finding good practitioners that know what they're doing.

The physio I'm seeing now is awesome and she really knows her stuff. Completely in another realm from physios I've seen in the past. I asked her what the difference between her and any other physio is and she said that working for many years in sports med she has seen a lot of very complex injuries, and that she is interested in finding out what the root cause of any injury is and dealing with that rather than just treating the pain.

She also works a lot with body structure and supporting muscles, apparently the reason why I hurt myself so badly was because I can't engage my muscles properly, and the wrong muscles are working to support my head / neck. I really like the idea of self coaching if you come from a sport background and know what you're doing, but I've found it invaluable to have an exercise program tailored to my specific areas of weakness, and I feel like in a couple of months with my physios support I've progressed a lot further than in a couple of years of trial and error by myself.