10 ways to overcome Elbow Tendonosis - Golfer's Elbow

Vlog #19 Elbow Tendonosis, Golfer's Elbow, is a very common injury among climbers. In this episode, I go through ten ways you can both prevent and/or treat this very troublesome condition. I suffered with Golfer's and Tennis elbow for many years before finally resolving it completely three years ago.
The full details regarding the science and rehab exercises and protocols I discuss here are detailed in my book Make or Break:
www.davemacleo...
I also make reference to a recent interview on Andrew MacFarlane's channel, dealing with injury prevention more generally:
• Dave MacLeod Interview...

[@joe1195]

Following a lot of the recommendations from this video in combination with your book has made my tendonosis be nearly non-existent. I climb plus play a lot of disc golf which also causes a lot of intense strain on the elbow. This has basically saved my athletic life, and I cannot thank you enough.

[@climbermacleod]

Brilliant, great to hear you've had good recovery!

[@upchucksduck]

@Onyx Forest I can assure you, no one gives a shit.

[@bentonclayton2385]

Instablaster...

[@rustyturner]

@@climbermacleod I watched the video and your theory to me is sound . I've heard so many other theories, about dialing back and resting. But sounds counter productive. If I use my muscles less , I will get weaker . If I can get stronger, and push on carefully , something that was hard yesterday should just get easier . I am a new climber at age of 43 . I'm in good health though. I climb 3 times a week . However the elbow pain has came . I am going to approach like you explained in your video. I will also address diet too . Beacuse resting just doesn't sound logical . I will just weaken my overall body and muscle mass . Then you have start again when you return. If I get my overall strength better than it was before , the levels should get easier.

[@jorgealexandremoreira1792]

Which book did you follow? Thanks.

[@Drinkyoghurt]

Dave has like the calmest demeanor ever and explains things so well. He deserves much more than just 14k subs.

[@mortenlund1590]

Could not agree more! I'm looking for real good answers to the common q's, and he provides tons!

[@lobomalsano]

this is the nicest stannis baratheon has ever been

[@tunaficiency]

Now 45 k

[@mihaitzabaws3619]

now 55k

[@crzy1gs]

Here is a quick TL;DR but please watch the video because Dave is a fkn boss :) 1) Take ownership of the injury (8:10) 2) Be strong. Strengthen (condition) body, esp upstream arm/shoulder. (10:36) 3) Develop awareness. Note & listen to how your body feels. Adjust volume/intensity or session type accordingly. (13:27) 4) Don't stop moving. Maintain steady level of fitness/activity without typical 'Western' prolonged sedentary tenancies (17:25) 4.5) Difficulty of identifying causal factor. Sometimes change of routine/scenery can help. Trial and error methodology. (21:32) 5) Rest professionally. Top quality sleep, nutrition, reduce life stresses (22:56) 6)Respect your circadian rhythm. Increase quality and duration of sleep. (23:16) 7) Keep training. Possibly do more! (25:36) 8) Do heavy resistance training all the time! Incl typical eccentric wrist curls with heavy load (some pain might be required) and high frequency (daily!) and possibly more modern evidence of isometrics. (28:21) 9) If its not working, keep searching and try again however its tricky to decide timescale for each protocol. Lots of the data is weak/uncertain, such a nuanced issue. (34:24) 10) Tendons are made from what goes into your mouth. Nutrition. Collagen synthesis from Glycine, Proline and Vit C (comments on the recent hype train for this) but he relies on mostly eats whole foods (39:05)

[@climbermacleod]

Thanks for that summary!

[@neo778]

Thank you so much! This helps a lot to get the key information and go back to specific points.

[@jaydee4988]

People majorly overlook the whole function of the thoraic spine, for example the lats connect to arm at the humerus and that muscle is connected to 11 vertebrae. Lower stability and the functioning of the quadratus loborum to free up tension in the shoulders flowing into the arms

[@TristanCleveland]

@@climbermacleod Enjoyed the video. It seems important to note that "keep training" shouldn't be "give yourself an overuse injury" or it won't heal. Also, it might be worth adding that it is especially important to do a long warm up when you have tendon injury. I say "might" because I'm not aware of any science on this, but it seems to have helped when my finger tendon was healing, and I find it greatly reduces the risk of a sudden, sharp pain - the sign of making further injury.

[@ann-mariebrennan1455]

People who break down videos like this are my heros! TYSM

[@AndrewMacFarlane]

This was perfect Dave! Thank you for our interview and for diving deeper into the topic!

[@smuir6104]

Thank you to Andrew for the interview and introduction to Dave. I love this community!

[@viktoriakireeva5860]

I’m a masseuse and have been suffering from it for years. Stopped working for long periods, got better, but once resumed massaging - it all came back again soon. Now I understand - training and loading every single day, not just special physio exercises but general resistance training. I love the voice and accent of this presenter. So soothing and pleasant to listen to.

[@coachgarryclimbing]

I love how the advice is based on current evidence and acknowledges the limitations of the available research.

[@fluttergrrl]

This is the best video about tennis elbow on KZbin. Finally, the simple explanations makes sense. These are my questions: how can you manage your nutrition when you’re in too much pain to cook consistently? How can you get good sleep when the pain wakes you up? How can you consistently exercise when the pain is excruciating, rather than mild, so exacerbations feels like you’re in the bowels of hell? And I have tried multiple conservative treatments. Thank you for this.

[@stefanp2883]

Thank you for this very informational video! As there are factors where we don't know every detail (based on science) there will always be room for an educated guess. I injured my wrists (TFCC) a few months before and feel a bit golfers elbow since a few weeks now, ironically the typically rehab excercies for the TFCC are mostly equal to the ones for golfers elbow, so I try to keep on bouldering, climbing and training as long as it does not get much worse. For the TFCC Injury I saw a doctor but only was told to rest for 4 weeks. I did and it didnt' get much better, so I continued doing the things I usually do but tried not to overdo it when there was pain. It's getting better over time, but slowly. The golfers elbow luckily isn't too bad, I stopped doing pullups but I think I will move on. I think strenghtening instead of just resting is a good advice, just do it carefully and listen to your body.

[@nuevozealand2]

Well done sir! I've recently started getting some medial epicondyle pain (and I'd rather call it climbers elbow) for the past month and have been working on rehab, exercises, therapies, etc. but Dave's discussion was the most coherent, broadly-ranged and thorough discussion on the topic. I have a good grasp on anatomy, physiology, mechanics, proprioception and understand my body very well, so any good advice is appreciated. I agree with Dave's comments on how much in sports medicine is speculative at best, many docs really don't know much about such topics and each patient must find what works best for them by listening closely to their own bodies. Excellent work and thank you very much!

[@FreshWaterWindsurfer]

You read my mind on many topics and opened my mind to many others. Climbing and physical activity is such an important part of my life. You have given me so much hope for the future and information to fix my golfer's elbow. Thank you so much.

[@doubleunderfire7964]

Thanks for the video. I suffer from golfers elbow and after seeing this video I decided to follow the rehab protocol. It’s helping! I also read “Make or Break” and am halfway through “9 out of 10..”. Love your content!!

[@Will-kt5jk]

I had tennis elbow in one arm & I’m glad I found the info on eccentric exercise - my initial just load it up (concentric focussed) made it far worse. I also did take a break from climbing for a few weeks, then gradually increased it back, but the eccentric stuff allowed me to have better control over how much load I put on it (even if I pushed it too hard a few times, causing a step back). I also increased overall protein intake & knew the vitC requirement for protein to increased leafy greens & a vitC protein, just in case. Only just got back to full load in all directions with barely any pain left manning I started climbing much harder again… …at which point the other elbow decided it wanted a turn. Now have tennis elbow on the other side (triggered more on thumb grips/pinches whereas last time it was more the last 3 fingers that triggered it. I would say the recovered elbow tendon now has far more thickness than either before injury, or than the tendon on the other arm. I’m hoping with that experience, I can get a faster recovery on the newly injured arm, but not confident I won’t end up with golfer’s elbow once I’ve resolved the tennis elbow.

[@slickdanger_]

I started climbing at 18 and within my first year I was sending multiple V5s and several 5.11s at the local crag... I think I developed golfers elbow in the first 6 months of that period and 10 years later I’m still dealing with it and not much stronger. It’s been the curse of my climbing career while I watch other, less injured climbers, get stronger and stronger.

[@climbermacleod]

This is actually quite common. At some point you'll need to identify and address the causes to make progress.

[@Headrum]

this is some of the most comprehensive and reassuring tendon info out there. thank you so much.

[@joeyr4869]

Ever since I saw this video a month ago, I have dramatically increased the volume of eccentric rehab work I do on my elbows. It has helped me make more progress with my tendonosis in one month than I have in over a year and a half of resting and avoiding aggravating exercises. Thanks a million Dave!

[@climbermacleod]

Thats brilliant Joey. Good job and hope it continues.

[@noahlanger2429]

Could you please do a video demonstrating some of the rehab exercises described here, and pictured in the book (which I own)? I'd love some more detail, since I've decided to commit to your recommendations on what could be a long ride! Thanks for the video, and for the book!

[@BryceU]

This is the first encouraging message I have heard in regards to my elbow tendonosis. I've enjoyed your other videos previously but this one has truly given me hope as I have been struggling with this issue for the past 3-4 months. Thank you for your opinions, time, research, and willingness to share your story.

[@daviddobedoe]

Thanks Dave, like others I have a tendon injury and this has helped me think about my approach to it

[@smuir6104]

I have never heard any of this before, I have gone to all kinds of medical professionals, and they all say rest. That said, I took 10 years off of both climbing because of my elbows, shoulder, and running (patella tendon), and it never got better. I finally decided I didn't care, I was going to wear them out and get all I could out of them before I was completely crippled. I decided to train for a marathon, running 30 or more miles a week, lifting weights, and then started climbing, a lot, 4-5 times a week. It hurt really bad at first, one day I even dropped to my knees out of pain, and prayed for strength to continue, somehow stood up and kept going, now 6 months later, I feel great. my "Bad Knees" aren't bad they needed weightlifting and running. My super bad elbows, weight lifting and climbing. Shoulder, weightlifting and climbing; now No pain at all. Now hearing this said makes so much sense, almost mad at the doctors. Thank you

[@climbermacleod]

That's brilliant. Loading needs to be done carefully, but ultimately tendons cannot increase in strength and functional capacity without loading.

[@NicoleKrawczyk]

I only just found this video and realized I used pretty much all those techniques to get over my elbow(and shoulder/wrist) tendinitis. Resting made things worse and working out or doing things I wasn't supposed to do according to common knowledge worked extremely well. I'd also like to add hanging (from a pull-up bar- just letting gravity do it's work) to the list of things that seemed like a no-no, but were a game-changer.

[@KarelSeeuwen]

I'm 60. 2 years ago I got back into climbing, but had pain problems in my knees (don't know what it was), and tendon pain in my elbows (outside) and right wrist from over extending in a jump to a jug. These pains persisted but progressively went away after I switched to a Carnivore diet (and climbing only a few grades below my normal for six months), the last being my wrist, which was a 'true' injury. I wrote this comment half way through; interested to see what else is to come.

[@chrisdugmore2462]

I've currently got a wrist tendonosis (ECU) from campus boarding too soon and will definitely be applying the principles here!

[@danobable]

Hi Dave, I always love your vlogs, thanks for this one. I just wanted to add that I think that the way I was sleeping contributed to my golfers not clearing completely despite doing all the correct exercises. I slept on my side all night with my hand under my head, so elbow on full lock which puts apparently 40 times more strain on the tendon than when it's straight. I used to wake up with my golfers elbow aching ever day. I've trained myself to sleep with my arm straight, I now wake up with no pain and the last signs of golfers have completely gone. Just wanted to share in case it helps anyone else. Cheers

[@johns3106]

@danobable Oddly enough, I had the same thing. Had tendinitis in my elbow from various sources, but the way I was sleeping on it (arm bent with hand under my ear) prolonged the problem. Once I was aware of this and started sleeping differently,the problem gradually disappeared!

[@woobinz3061]

Yoooo this is huge thank you! Sometimes I have got golfer's elbow through exercise, but more often I wake up with it- even after a rest day. You've very likely identified my problem

[@BrunoFSBeber]

This is really interesting insight! I also sleep with my arm bend under the pillow/head and since I injured my left shoulder, I've been sleeping mostly on my right arm, where I now have tendonosis. I'll change that and see how it goes.

[@sethgilbertson2474]

This is just pure gold. I’m getting the books! Question: I have heard that there is some evidence that flooding the surrounding tissues with blood is also helpful. One of these methods would be blood flow restriction training for very high reps with very low load. I have used this from time to time when my elbows get a bit cranky with positive results but not necessarily to treat injury. Do you have an opinion?

[@anosnd]

I suspect that could be possible. I had golfer's elbow for 15 years and nothing ever changed the level of pain. My PT had me do an exercise with a strap wrapped very tightly around my forearm while i do various stretching motions to break up the fascia. After about 6 weeks of doing this religiously my tendonosis is now completely managed. I went from extreme pain 24 hours a day to no pain ever. I can't imagine that breaking up the fascia alone contributed to this. The amount of blood flow restriction during the exercise and the extreme rush of blood to the forearm after is actually addictive because it feels so good and nourishing. This is pure conjecture on my part as i had been doing eccentrics and heavy loading for a very long time beforehand, but if nothing else, it feels damn good.

[@monstercrx]

This is very helpful thanks for the comment

[@sethgilbertson2474]

anosnd That’s great that worked for you although it’s different than what I’m referring to. I’ve used that as well to a great benefit. An example of blood flow restriction is to wrap a band KINDA tight around the top of your just above the biceps. Use a light weight to do lots of curls of tricep extensions for between 20-50 reps. The idea is to restrict venous blood flow so blood can flow into the working area but not out. The pump is unreal! There is lots of personal evidence that this is helpful and I know there are studies that support it for muscle growth but I don’t know that there is evidence that it promotes repair of tendons and ligaments. Whatever the case, it does feel really good on my cranky elbows and I would recommend it highly!

[@danfletch7351]

Awesome vlogs they feel so personal and very thoroughly explained... I'd love to know what dietary changes you made, I've just watched the plant based diet vlog which was also very good..

[@pastaeatinrasta1]

This is an absolutely perfect video. Mine has gotten so bad finally I can get an actual solid climbers perspective and advice, thank you!

[@M3nPower]

Thank you. Great suggestions

[@simplycatsvets]

Very informative balanced video and super interesting well done Dave. Look forward to seeing some specific exercise videos and getting your book ;-). I suspect you will get many more views as we all try to train hard during COVID Lockdown!!

[@johnsheehan1611]

Had it 7 years finally got better when you climb lift weights pull ups got elbow pain bad that’s secondary it was my neck

[@joenic4303]

I'm a big weightlifter with a focus on pull-ups and got it bad in both elbows at 42 after doing many close grip pull ups.

[@jorgelvma]

Dave, did you control for total protein intake when you move to a more ketogenic type diet? I am wondering if higher protein may be the driving force for the improved healing. Thanks! Jorge

[@IsaacSMILE]

2nd time watching this as I am trying to recover from this very issue. I keep picking up new takeaway points each time. Thanks for such detail.

[@heoTheo]

You are my hero. I'm getting your book right now! I've been dealing with this exact injury the past 3 months and have been looking for answers. The story you told at the start is exactly what I'm dealing with and thirty something climber jadada. As a climber just didn't find it. I went to the gym about 2 months ago and started doing some simple body splits. I found having a dedicated arm day lowers my pain. I notice after my arm day I don't have any pain for 2/3 days. So, I think i will increase my workouts. I also do a leg and chest/back day. My arm day Form and weight, do proper form, choose the weight such that you can complete the first set of 15 reps. STANDING BARBELL CURL sets 4, number 15,12,8,4, then drop the weight and keep going on half the weight until you lose form. Skullcrushers , same protocol cable rope skullcrusher, same Rope Tricep Pushdown, same INCLINE DUMBBELL CURL,same I hope this helps other people. I definitely think, going heavy on the weights is the way to go. I have not gone back to climbing yet. However, I will pursue some climbing in september again after begin off for 4 months. I will try to maintain awareness on the wall to prevent injury, but definitely not all pain is bad.

[@marcooosization]

thank you for this incredible information!!!

[@willadams6217]

I'm 42 and thought I would have to give up climbing due to golfers elbow. I was recommended a book called the trigger point therapy workbook and after finding the trigger point in my lower tricep and after just a few minutes of massage of the trigger points (very painful) got almost complete relief. I rarely need to revisit the massage these days and have zero elbow pain at all. I've passed on this info to other climbers in my local gym who have had similar results. Life changing.

[@alexrixey975]

Thank you Dave, I really appreciate such an informative video. I’ve been trying to recover myself from medial tendonosis for the past couple months. I believe I identified it as a potential problem early enough to avoid making it worse, but found like yourself, that resting accomplished nothing. I’ve been primarily doing eccentric wrist curls (3-5 second eccentric, no concentric) a couple times a day at a low weight, as well as slow pronation and supination. After watching this video, I’m just really struggling to identify how much to push the pain? I identified the injury early enough where the pain has never been substantial, it was really dynamic throws / lock offs where I initially noticed it climbing, which then progressed to dull pain on and off throughout the day. As I get back into climbing - how do I know if I’ve pushed to hard? If the pain stays more or less consistent a day after climbing or a harder rehab.. I assume I’m good?

[@MrAfricaturtle]

Dave, would you have any suggestions for an isometric protocol to supplement eccentrics ? Many thanks for the useful video.

[@pembo555]

Great video! Is there any chance you could discuss finger synovitis? It seems to be an overuse injury that takes ages to heal through not crimping however comes back immediately when Its reintroduced. Any advice or personal experience would be greatly appreciated, keep up the good work!

[@climbermacleod]

Synovitis at one of the phalangeal joints, i.e. at the joint capsule? Any video would contain a lot of speculation and not a great lot of hard data. Do you know what your general metabolic health is like? bloods?

[@pembo555]

@@climbermacleod I have it in my right middle finger pip joint, as for my metabolic health I can't comment much as I haven't had my blood done however for context I'm a 21-year-old male with a moderately clean diet and I get plenty of sleep. I will definitely look at getting my blood done to check general health, are there any markers I should pay close attention to with regards to joint inflammation?

[@mtommy84]

Mr. MacLeod, I've always admired you for your climbing achievement and, from now on, you've also gave me hope, which I had lost after years of pain.

[@jdomsmith]

So underrated. This is THE most helpful elbow recovery video. I'll let you know when my right golfer's is cleared up.

[@Mistic00727]

How is your golfers elbow?

[@nbka8rs]

The more I follow your work the more I love and respect everything about you. Looking at the books on your shelves is a real demonstration of your commitment to being stronger, faster, smarter.

[@gedrooney9305]

Great video Dave, im 41 now and have had the dreaded tendonosis in my weaker right arm after lockdown that I've managed to back off by simply doing more........push ups. Ridiculous but that's the body eh. Many thanks ;)

[@robuzy]

Tie a rope around a pole with weight on the rope. Wrap the rope around the pole many times and lower the weight to the ground with your palms facing the sky. This eccentric exercise ( lengthening under load) saved my elbows. Results should be almost instant. Thank me later

[@valaudae1809]

UFOs, Loch Ness Monster, Bigfoot, Tendonosis Remedy; some claim to have seen them. The rest of us will wait for personal experience before we shout from the rooftops. As someone with 20+ years of Golfer’s Elbow coming and going; I long ago tried and gave up on the “professionals”. They seemed to be searching for answers on my money. Maybe Dave is on to something and l am certainly going to follow his advice. As for injuries to fingers, maybe we ask too much of them. Going back into the mists of evolutionary time, our arboreal ancestors were strangers to “crimping” and fingerboards and their digits (and ours) were designed to hold onto tree branches thick enough to hold their own body weight.

[@climbermacleod]

Haha I share your tendency towards scepticism regarding this difficult condition. But maybe not your argument about modern versus ancient incidence of these conditions. If this were an issue of simple overuse, why is golfers and tennis elbow so common in sedentary people who have never seen the inside of a gym or a fingerboard? And looking in more recent history even within sport, many of the common tendon and ligament tears appear to be rather rarer before the last few decades.

[@dutazoltan1784]

Just when I started doing physiotherapy for my elbows this pops up, awesome timing :)). Great video as always Dave, really enjoy all the content that you put up. I bought your books and they are well worth at least 1 read through. Keep crushing it on the rock, and keep releasing this awesome content. Cheers !

[@lobtyu]

If it helps anyone, I found a combination of eccentric rehab, using straps for pulling work, not going too heavy on antagonist exercises (aka bench pressing), continued light climbing, and self massage using an armaid solved my tendonitis. It took a while to get to this point of trying random recommendations from other climbers, doctors, and randos on the internet lol

[@driklol]

I cant tell you how happy I am that I found the channel, It's been a long time since I've felt a need to watch every video someone has. You're like climbing yoda, I love it. Thank you for all of the effort and knowledge.

[@davidospinanieto2093]

Hello Dave! I liked a lot your video. Can you facilitate the articles' names or DOI'S? Thank you so much!

[@TheCoastalForest]

My elbow tendonosis went away when I started doing ring muscle ups.

[@lovelife1867]

fat strong athlete ? I don't get it.

[@WyandWombat]

So I had pretty nasty elbow problems on my left arm last year. I bought your book, make or break, read through it and tried a lot of things for quite a while. However, I couldn't get rid of it. After visiting a doctor that specializes on climbing injuries, we found out that it was in fact my triceps tendon attaching to the elbow that caused the pain. It would prevent me from doing push ups, mantles and anything remotely resembling gaston moves. Unfortunately that type of injury was not covered in your book. HOWEVER, your principles revolving around excentric exercises with light weights eventually helped me resolve the issue. I had to tinker a bit to try and find an exercise that would load that specific tendon in such a way, but watching out for the cues regarding the mild pain you mentioned I managed to work something out that would quickly improve the issue and after a longer period of time resolve it completely.

[@climbermacleod]

Well done! Yes adapting the rehab from general principles to suit the individual is the way forward. I once had a little triceps tendon pain for a short period myself. I still find that dips (but not pushups) can aggravate it.

[@azadjalali1359]

with regards to fully embracing rehab exercises in volume, even in the face of pain, there's one thing that's mystified me. how do people plan their climbing volume around that? i can't imagine my tendons can handle much or any intense climbing if i'm doing 7 days/week of eccentric exercises... or is that another example of underestimating my body and overreacting to pain?

[@Isaiiahii]

I've had golfers elbow for 3 years and it's really getting annoying to live with. I stopped working out 2 years ago partly because of it with hopes it would heal, but it never did. Normal life activities and work do not both it too bad, but I recently started riding a road bike and it is sore for days after doing a ride. My last ride was 5 days ago and I only did 22 miles and it is still sore. Hopefully this helps.

[@jonathansweet4391]

Dave mentions a Hakan Alfredson interview for the BJSM where he discusses how he discovered eccentric exercise for rehabilitating tendonitis. Here for anyone who wants to listen to the story- soundcloud.com/bmjpodcasts/treating-tendinopathy-with Story starts from 3.50

[@thomasball1139]

Amazing vlog Dave! Really interesting about the surgeon who discovered that heavy loads helped to recover his Achilles’ tendon! I got golfers elbow badly in both elbows at the same time and it was very painful when I climbed, but I never stopped climbing, trained my extensor muscles, repeatedly held a 20kg kettle bell in my hand at my side and held it with as relaxed grip as I could and did open handed fingerboarding, 10 second hangs, 6 hangs, max effort with as much weight added as possible, training from 15kgs up to 23kgs by the time it was healed. Completely recovered after 8 months!!!!!

[@iBoardRepair]

This is the best climbing channel on youtube right now. This is the only thing I have found that covers so many recovery techniques so fully and by someone who you can tell did his research thoroughly and is intelligent enough to filter the bullshit.

[@asdfib]

Dave, would love to hear your current thoughts on brachialis tendonosis. I've read make or break and I remember it being mentioned, but don't recall any specific ideas on how to fix it. I have focused on eccentric curls and triceps strengthening without success.

[@climbermacleod]

I will put that on the list. An injury with crickets in the literature. Any video will have a lot of speculation. Like 'I don't have much idea why triceps strengthening didn't show an effect'. Perhaps some of the other basic principles in this vid, or Make or Break may apply? Or involvement of a nerve impingement?

[@thegrimpeeper8865]

Thinking about buying this book, does it cover lateral epicondyle tendinosis?

[@anvildo]

Mark Rippetoe a strength coach has a protocol of Dailey pull-ups done for one to 3 weeks . That he states has always worked for his clients with these elbow issues. I cleared much the same way 30 years ago .

[@kazhatfield1346]

Hi Dave. I’d buy your book if it wasn’t $44 on Amazon :) I also usually only watch the shortest videos on any given subject but as you can guess this one strikes at the very home of my heart. I moved back to Colorado about three years ago and acquired this a few months after. I climbed on and off with it for a little over a year before I decided to quit climbing. I haven’t touched rock in nearly a year. After some advice I have started doing eccentric exercises. There is no more pain but I am am still reluctant to do anything besides eccentric exercises. I wonder, what exercises if any do you still do for your elbows and were you doing pull ups all the way up to when it healed? Thank you so much for your time if you’ve happened to make it through this whole read. You rock! Thank you for inspiring! Cheers, Kaz Hatfield

[@tfo3038]

Excellent video Dave. I'd be interested in your take on alternative medicine in this context, given a recent disappointing video by Adam Ondra on the topic.

[@climbermacleod]

ooft, as if this video didn't cover enough controversial topics! I noted that on Ondra's IG recently but haven't had time to watch it. I'll take a look...

[@13Omega37]

Here's my TL;DR for people in a rush. I couldn't identify points 5 and 8 distinctly. 1. (8:12) Take ownership over the injury 2. (10:37) Be strong 3. (13:28) Develop awareness 4. (17:26) Don't stop moving 5. ??? (around 21:33) Have a change of scenery 6. (23:15) Respect your circadian rhythm 7. (25:37) Keep training 8. ??? (around 29:02) Eccentric vs isometric movement 9. (34:24) Keep switching up your routine 10. (39:04) Your tendons are made of what you eat

[@bestactionmovies1]

I was training for one arm pull-up and developed golfers elbow.. I continued with pulls , rows, always going further.. now it’s to bad.. now I do only straight arm workouts , stretches, frictions, .. it doesn’t go away.. I try to train with moderate pain.. I’m 50 and I train everyday.. maybe I will do more lighter training , and long holdings , and eccentric contractions ..

[@samps6510]

Just finished reading Make or Brake. Thanks so much for adding more information on this topic. It's a huge contribution! Learning how to "take over the rehab proccess" has become crucial for me.

[@ricothemanatee1882]

I reaaaaaally really appreciate the honesty when it comes to uncertainty in the research. I'm all for following the science, but people often don't realize just how inconclusive published research can be. Thanks for the wonderful explanation on the trial and error approach, and never reaaally knowing what fixed the problem when you are late in the game of guess and checking. Looking forward to less elbow pain in the future :):):)

[@andreiverdeanu1219]

Great content as always! Without going into much detail, as a climber, I never imagined I will be faced with tennis elbow myself (reading that sounds so naive), but here I am, after 3 months of gradual worsening and at least one acute episode, things have gotten pretty chronic and grim. I went for an ultrasound check yesterday and found out that I have partial tears in the tendon of both the affected arm (>30% of the cross-area of the tendon), as well as the healthy one (~20%). I tried eccentrics before going for the ultrasound for around 2-3 weeks, with mixed results, but felt like it was always worse after them and a bit better without them. My question is, knowing now that I actually do have tearing (or micro lesions) in such a percentage, is it still advisable to keep the eccentrics in the rehab process, or allow for some time to recover and then start them over gradually? Would greatly appreciate any input! Thanks, Andrei

[@danthompson8212]

Hi Dave, thanks for the brilliantly informative video always! Do you have a link to the study you mention at around the 30mins mark? Kinds regards Dan

[@climbermacleod]

Alfredson has done many studies on Achilles tendon rehab. You'll find them if you just type Hakan Alfredson on Researchgate or Pubmed.

[@danthompson8212]

@@climbermacleod thanks much appreciated.

[@DuncanAtkinson]

Im watching this hoping that he talks a bit in depth about tennis elbow. Currently doing some antagonistic exercises.. i think... with a theraband wrapped around my forearm and doing these punching motions...

[@DragonFighter92]

Great video! I wanted to know if anyone has experienced numbness and tingling in the little finger and ring finger after some time with the ulnaris problem? First it was "pain/irritation" and after 5-6 months i developed numbness and tingling

[@alexeymalafeev6167]

Myofascial release / cupping had immediate effects for me for this injury. Have you examined the research on this?

[@dark-o]

Has anyone used JM press? Armwrestlers have same issues and I have seen claims that JM presses conditioneded and strengthened the elbows.

[@hikerJohn]

What about when the pain is on the outside of the elbow and only when running? What the heck causes THAT? And yeah, it hurts when I make a fist after hiking 20 miles but not before? Then it goes away a day later but returns after another big hike (walk) on dirt roads. It seems to hurt more in a strait or near strait position then in a bent position.

[@Dogjitsu]

What is 'foot off climbing'? Is it the same as campusing?

[@RupertPupkinComedy]

When doing eccentric wrist curls for golfers elbow should u progressively overload overtime?

[@saulsug1066]

I dont really know what injury i have in my elbow but ive been climbing for 3 months and one night after climbing my elbow was seriously aching but ever since then the only pain ive felt was the temporary ache mid session after a hard boulder. At home i never feel it. Im wondering if i have tendinitis or tendinosis in my elbow. It only lasts for an hour and it doesnt bother me on my rest days at all

[@dannygrout92]

Really really excellent video, so detailed and thought out. Feel like I've just sat a uni lecture!

[@leoingson]

Right on time, perfect ;-))

[@ImagezAndWords]

I recommend your channel to climbers and non-climbers... awesome content. Keep up the great work!

[@simon41978]

I've had this problem for a long time. I believe the initial injury occurred when I did a set of Trap Bar Deadlifts which were too heavy and strained both elbows. The left one healed but the right one did not. I don't believe in daily weight training or three times a week training as there's not (in my case) enough time to recover. I've also noticed the hyperactivity which is ubiquitous amongst even the 'scientists' who give advice. I truly believe they cannot control themselves and their idiotic advice is a reflection of that. I'm not sure whether I'm a poor specimen. But, since my rehab approach was not working, I tried the train every day approach expecting to get worn out very quickly and expecting a big drop in strength along with disinclination towards training, headaches etc. All of that happened. My elbows were very sore and inflamed. I have a garage gym and used a cable machine to do hammer curl negatives and biceps curl negatives which was recommended. I'm sure that the cable machines are much rougher on the elbows than using a dumbbell. You get constant tension in the fully-contracted position... but the elbows are not meant to be loaded in that position. I also need to rehab my knees. I was experimenting with slant board squats and step-ups and they did not like it at all.

[@omaryehya1246]

Did your elbow heal completely?

[@stephensweeney5331]

I've just come across this video, and could not be more grateful. The way you manage to bring clarity to such a minefield of information is mega. Thanks loads - putting this into action immediately!

[@svenhellevik3458]

Hi Dace, can you mark the video into 10 sections to make it easier to guide through the video?

[@pavel3dimitrov]

Pro tip: try mark bell's elbow cuffs 😉

[@nikolasbbq]

Tap when someone is trying to rip your arm off with an Americana

[@joromo666]

Fantastic overview. I've been suffering from golfer's elbow and this has given me a lot of guidance and encouragement. Thank you Dave! 👌🏼

[@uploadsnstuff8902]

Bought your book based on this video, I love how it uses all the techniques I found over the internet, from Lattice training, c4hp, Hooper's beta, ... with detailed pictures and even more tips. Thanks a lot.

[@LokeSenpai]

Hi! My pain is outside can you tell me about the exercises is should do please ?

[@kettlebells-ez9xi]

The part about the shoulder deffs rings a bell with me too

[@hanneshuch8965]

Thank you Dave! I read Make or break, but unfortunately I still can celebrate the 2nd anniversary of my tendinosis in september. But that's certainly not because your book is bad, but due to "overall stress" as you mention it here in the video. From my point of view that's the biggest obstacle to overcome when you want your body to heal. I've got 2 questions: Do you still do the eccentrics even though you're healed? Would you recommend doing them on climbing days, too? If so: Before or after climbing? Thanks a lot Dave! Best from the Frankenjura, Hannes

[@climbermacleod]

I hope you can soon celebrate the anniversary of its disappearance. Yes knowing what to do is not doing it. I agree, it takes a real back to basics approach to rebuild your life from its foundations to address over stress. No I stopped doing my eccentrics when I recovered from GE. I see them as a very specific hack to target atrophied tissue that is being compressed by the healthy tissue around it, or otherwise not achieving tensile loading. I this problem is resolved I'm not sure there is a case to continue the exercise (but of course exercising the whole tendon in normal training is a good idea!). Yes my opinion is its fine to do them on climbing days too. I honestly do not know if it makes any difference if you do them before or after climbing. I would now favour doing sets spread out across the day, every day. So that would mean before, during and after climbing!

[@hanneshuch8965]

@@climbermacleod Wow, thanks a lot for your detailed answer! I'll let you know when I celebrate. Thanks a lot & all the best from the lovely Frankenjura, Hannes

[@rainbow-waterfall8519]

Is there a German copie of your book: make a break.?

[@Luchavox]

I love the time he spends making these videos. I enjoy them immensely. But I really don’t like the how to videos that spend over 10 minutes telling you why instead of how.

[@joolsgrommers1466]

Would the fact that climbers have a high occurrence of golfers elbow, and use static loads at high loads all the time not be evidence against static holds being suitable for recovery? (Not going to stop climbing, but the eccentrics make more 'sense' when looking at it that way.) I guess we just don't know the details yet, work to be done (on my elbow!)

[@joolsgrommers1466]

Ordered the book btw. ;)

[@climbermacleod]

I'm not sure I could make a good case for that. First, GE is associated with the common flexor tendon. Sure, the finger flexors attach there, but so do the wrist flexors and pronator. And those do move under load in climbing. Also, we see plenty of GE in other sports where the forearm moves. Also we see the most GE in people who don't do any sport or training. So yes I agree, we don't know.

[@TheHarmonicaBarge]

Just to add. I’ve added some Isometric strengthening recently and seems to help although there’s limited Evidence for elbow tendinopathy.

[@TheHarmonicaBarge]

Apologies, now I’ve watched the full video I see you cover this

[@jointz999]

I think Point 8 (@32:50), helped me a lot with golfers elbow. I was hooked on training so did daily barbell work despite golfers elbow. I stopped using grippers and stopped weighted chins and bouldering. A combo of these I believe caused my golfers elbow. But I kept up neutral grip chins, neutral grip T-bar rows, lighter dead lifts, and kept all my pressing work going. The elbow was seeing work 5 days a week. Yes it was painful at times, but I worked at it daily, and it did diminish to about 95% improvement. Then point 10, the nutrition. I was doing well with nutrition too at the time, to back up the muscular development. So Point 8 and point 10, combined with backing off the activities that caused a 6/10 pain or higher, seemed to work. I have golfers elbow again now and struggling with it. I haven't been training daily however like I was before and I wonder is a lack of moderate (to heavy) workload many many times week the reason. I've noticed that my elbow is more easily aggravated when I back off training altogether.

[@toddhambone]

You talked about how you saw improvements after doing more basic strength work and fingerboarding (in the video at 12:55 and 27:55) whereas in Make or Break (pg 127) you said you felt that basic strength work such as fingerboarding...tended to slow progress so you kept it to a minimum. Seems contradictory, or am I missing something?

[@richardray1075]

This is what I waanted to hear. Ive just started climbing again over the summer after a 10 year break. Ive been trying to build up slowly but got a little obsessive. 4 months in I've got a few niggles and now elbow pain. I guess my bidy isnt up to the demands i'm putting one it and get stronger overall is the answer. I'm not young any more, i havae goals in climbing and really dont want enforced rest.

[@ellavateify]

Detonating more truth bombs. 🙌

[@belgiumkiddo]

Pro-tip: Try and ditch the protein powder for real meat/fish/plant alternatives. I have experienced a great reduction of that typical annoying burning sensation that radiates throughout and away from my elbow tendon(s) after making the aforementioned change. Give it about a week or three before you start noticing the reduction in pain. --> Mind you, I am not lactose intolerant so it can't have anything to do with that. Just thought I'd drop what has been giving me some relief! :)

[@jiffypop247]

I swear, right after you mentioned Vitamin C and the other amino acids I went and ate an orange and had a huge improvement in my golfer's elbow, wrist pain, knee pain within an hour?! I've been working on my diet by incorporating a larger variety of meat, including liver. I've also been working on incorporating more greens, and a variety of beans, but I seem to have skipped any leafy greens that have vitamin C. My vote is with diet

[@TTT-Turbo]

Hi, I was hitting a ball out of the rough and my left elbow cracked. This was 4 weeks ago and it's still sore as hell. But it's on the outside of the elbow between the 2 bones that feels the sorest. If I hold my arm at 90° with the inner forearm facing upwards then hold onto the forearm and then my hand inwards it hurts really bad. But no matter what I do to massage it nothing helps. I've even tried massage guns the lot but nothing helps. Is there anything in there that can break? Thanks.

[@an7939]

Quick question, is the book recommended also for people that don’t climb? I mainly lift, don’t climb but I love Mr. MacLeod knowledge, and since being injured with tennis and golfers elbow, I wonder if the book is more about climbing or does it contain a lot of info about injury healing. Thanks in advance! Awesome video!