Hello fellow climbers,
I'd like to introduce you to Tatiana, she is a registered acupuncturist that specializes in treating sports injuries, including those pertaining to climbing. Take it away Tatiana.
It’s rare to meet a climber that hasn’t experienced elbow pain at least once in their climbing career! Climber’s elbow, also known as golfers elbow or medial epicondylitis is an all too common injury to us climber-driven bunch. However, with the use of orthopedic acupuncture, combined with specific exercises incorporated into your training regimen, there may be a solution to your elbow pain!
Medial epicondylitis: “A repetitive stress injury characterized by inflammation and irritation of forearm flexors and possibly the pronators. This injury is often referred to as “golfer’s elbow” as well as “climbers elbow.” (Whitfield Reaves, the Acupuncture Handbook of Sports Injuries & Pain)
First, a quick anatomy lesson on climber’s elbow, aka medial epicondylitis:
It is important to remember that the elbow is surrounded by large muscles, connected by fascia ( a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs) from the arms, chest and even the trunk of the body. The area surrounding the inside of the elbow is the connecting site to the flexor muscles of the wrist and fingers as well as the muscles of the biceps, pecs and latissimus dorsi (lats). With the excessive overuse or incorrect use of these larger muscles, pain at the elbow can become pronounced.
Therefore, elbow pain is most often the cause of repetitive strain due to overworked muscles in the arms, chest, and trunk of the body. I’ll give you an example, think about the mechanics of a weak shoulder; you attempt a pull up but due to weakness or overstrain in the shoulder, the arm muscles then have to compensate by working extra hard to pull the body up in order to avoid injury. As a result, overstraining and micro-tearing occurs, causing pain and stress in both the muscles and the elbow. Similar events occur with a weak core, pore posture, or weak arm muscles: the body must compensate to avoid injury, but in turn results in pain and strain in the elbow.
How can Acupuncture help?
Orthopedic acupuncture is the branch of acupuncture medicine that deals with the treatment and rehabilitation of bone and muscle injuries. The main goal of an orthopedic acupuncture treatment it to first reduce pain, and secondly, strengthen the surrounding tissue in order to prevent recurrence and allow the body to heal.
When treating muscles with acupuncture, points specifically chosen are usually in the belly of muscles, where they are highly innervated with motor nerves. According to neuromuscular biology, stimulating a point at its highest concentration of nerves, in this case the belly of the muscle, by a conductive material (i.e. an acupuncture needle) elicits a muscle twitch or fasciculation. In short, due to receptors in the body, a message is relayed to the brain telling it to relax the muscle being stimulated as a safety reflex. Once relaxed, the muscle can relieve its tension and pain.
Allowing your acupuncturist to insert tiny, sterile needles into specific points, the larger overworked muscles are able to relax, more blood flow is brought to the site of injury, and the stressed tissue is given the opportunity to heal itself. Combining acupuncture with rehabilitative exercises and periods of rest, results in relief from pain and injury followed by climbing at peak performance!
Exercises for climber’s elbow:
1. External & internal rotations with elastic band: These rehabilitation exercises strengthen the rotator cuff.
- These rehabilitation exercises strengthen the rotator cuff.
- How (external Rotations): Tie one end of a resistance band around a sturdy base such as a pole or handrail at waist level. Stand at a distance equal to the length of the band with the side of your body facing the end of the band. Feet hip-width apart, take the opposite end of the band and hold it with the arm that is farthest away from the base. Keep the elbow bent and close to the body to form a 90-degree angle with your fist centered across your body to start. Slowly move your forearm outward to the side and slowly return to the start position, maintaining the 90-degree angle throughout the exercise. Perform 2-3 sets of 10 to 15 reps.
- How (Internal Rotations): Similar to above but this time hold the end of the resistance band not tied to the sturdy base with the arm closest to the base with your fist to the side. Slowly move your forearm inward until it reaches just beyond the center of your body and then slowly return to start. Perform 2-3 sets of 10 to 15 reps.
2. Y, W, and T’s: This exercise focuses on strengthening the shoulder stabilizing muscles.
- This exercise focuses on strengthening the shoulder stabilizing muscles.
- While activating the shoulder blades, first bring arms up into a ‘y’ shape, next a ‘w’ and lastly into a ‘t.’ Start without weights and when you feel your body is ready slowly add weights.
3. Wall crawl with external rotation.
- Using a resistance band, loop the bands around your hands and stand facing the wall. Place the side of your forearms against the wall vertically (in external rotation) shoulder-width apart. Maintaining that external rotation and forearms completely against the wall, slide your arms slowly up and down the wall keeping control. Slide your arms together and individually. Repeat.
4. Wrist twists: This exercise loads the flexor muscles attached to the inside of the elbow.
- This exercise loads the flexor muscles attached to the inside of the elbow.
- How: Holding a flexbar with wrists in flexion, begin to twist the flexbar with the non-injured arm while holding the wrist (of injured arm) in flexion. Bring the flexbar to horizontal. In a controlled movement, follow the direction of the twist with the injured arm by bringing the wrist in extension. Repeat 2-3 sets or as body allows without pain.
Disclaimer: Acupuncture is not a one-size-fits-all medicine and what may work for some people may not work for others. If there is more injury expected, referral to your medical practitioner is recommended. As an acupuncturist, I am always happy to answer questions or have conversations about finding out whether acupuncture is right for you!
The Acupuncture Handbook of Sports Injuries & Pain by Whitfield Reaves
Manual of Orthopedic Acupuncture by Conrad Crockett
Esther Smith, Doctor of Physical Therapy articles
Tatiana Martins is a Registered Acupuncturist with the Manitoba Professional Acupuncture Association. As an avid climber herself, she enjoys treating musculoskeletal and sport injuries with her extensive studies in acupuncture and sports medicine. You can find her at:
Via Natural Medicine www.vianatural.ca
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