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Injuries Chronic & Acute

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Old 04-24-2009, 06:07 AM   #1
Pieter Janssen
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Location: Leuven  Belgium
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Chronic elbow injury - training upper body?

Hi all - first time poster, long time reader here. Quick introduction, because politeness is a virtue: the name's Pieter, "late twenties" male (with my "early thirties" just a few months ahead of me), currently living in Belgium (which is a euphemistic way of saying "apologies for the poor English"), long history of endurance running, long-ish history of strength training (at least up till a few years ago). Long history of training injuries and "congenital issues" as well: broken ankle, sports hernia (repaired unilaterally, well on my way to develop a second one on the other side), dislocated fingers, runner's knee, skull fractures, hypermobility in all of my joints. This post, as the title implies, is about my elbow problems.

I have a combination of ulnar nerve luxation and snapping triceps syndrome in my left elbow, and ulnar nerve luxation without complications in my right. Diagnosis was based on self-examination (I have an MSc in biomedical sciences, working on a PhD in exercise physiology at the moment) and was later confirmed by a sports doc. I've had these problems for as long as I can remember: I have a distinct memory of asking the trainer when I first started judo classes - at the ripe old age of six - whether that "funny feeling" in my elbow was normal. I continued training with those elbow issues for about 14 more years, until I finally self-diagnosed upon learning of ulnar nerve luxation in my pathology/anatomy classes at uni. I pretty much stopped strength training right away for fear of ulnar nerve damage (and the associated loss of hand muscle and finger control), focusing on endurance running.

Flash forward several years, and the itch for strength/cross training became unbearable not to scratch. I discovered CrossFit a while back, and have been incorporating as many ideas/workouts as I can. My endurance running has been severly decreased in frequency, I'm working on sprints, cross training, strength training... with the exception of anything that requires elbow flexion. Which means that I am missing out on a *lot* of exercises: no push-ups or pull-ups, no clean and jerk, no dips, and so on. I can (and do) squat, deadlift, core work-outs, and so on, but I am severly lacking in my upper body strength because I can't train my pectoralis muscle and my triceps (and my biceps is lacking, but I don't really care about that - it's the pushing power that I need and miss most in everyday life, e.g. my job).

So here's my question: does anyone have an idea of how I could train my upper body with a chronic elbow injury? My pectoralis, triceps, latissimus dorsi and trapezius muscle are all far too weak for me to comfortably go about my daily job, but I can't think of a way to train those muscles without having to flex/extend my elbow for several repetitions each - which is exactly what I can't do, for fear of permanent ulnar nerve damage. Any help would be enormously appreciated - I'm not exaggerating if I say that this problem is really starting to get me depressed the last few years. Thanks a million times in advance for any help, I truly appreciate it.
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Old 04-26-2009, 07:35 PM   #2
Steven Low
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Re: Chronic elbow injury - training upper body?

How much can you bend your elbows before it becomes a problem?

If you can bend like 20-30 degrees with problems you can probably do partials for a lot of stuff.

I know a lot of straight arms rings work and some gymnastics moves work a lot of tri/bis without any bending.. but it's more advanced and you'd have to work up to it. This may be your best bet.
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Old 04-27-2009, 12:32 AM   #3
Pieter Janssen
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Re: Chronic elbow injury - training upper body?

Hi Steven, thanks for your reply. I can comfortably bend my elbows up to about 40 degrees without having them snap. I can't believe I never thought of such a straightforward idea as partials, but now that you mention it, it makes perfect sense.

There's a gymnastics-for-beginners course organized fairly close to my regular gym, so I might drop in there some time. Thanks a million for your advice. The feeling of having your body putting severe restrictions on you is not a very pleasant one...
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Old 04-27-2009, 03:24 AM   #4
Bert Brams
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Re: Chronic elbow injury - training upper body?

Hi Pieter,

First of all, good to see another Belgian Crossfitter here! Over here you can find a few more of us:

Second of all, I have some experience with a similar(although perhaps your diagnosis is more severe)situation. I have been troubled by severe elbow tendinitis since my first year of weight training(about 9 years ago), but have since learned to control it.

There are exercises I must avoid like the plague, but there are plenty I can choose from. I've talked both in person and via email with several powerlifters and olympic lifters about their inflamed elbows, and their experiences somewhat run parallel with my own what concerns exercise selection.

What helps my elbow pain immensely:

- All sorts of grip training. I see that you have a Master's Degree in Biomedical Sciences, so you know that the brachioradialis and brachialis muscles support and stabilize the elbow joint a great deal.
With grip training I mean pinches, ulnar/radial deviation, reverse barbell curling, hammer curling(help tremendously, I recommend you start with these right away, and do them light at first, for 20-30 reps, get the blood in there), heavy holds(in the rack)are also great for this reason. A great exercise is curls while holding on to the top of a dumbbell.
Note: please don't get the idea that I love doing these exercises or that I'm a bodybuilder ... I just injured myself so many times that I know that I HAVE to do this, like it or not
Once your elbows get better, sandbag training and thick-handled training will help even more.

- SQUEEZING the bar. Grip the bar as tight as you can. This may not be possible yet, but keep this in mind in the future. The logic behind it(although my mind is a little fuzzy)is the general activation of the forearm musculature, which again offers support. This alone will help a lot. This applies especially for presses.

- Massage with Ice. Use a small piece of ice(you can buy a deep-freeze bag that can be filled with water and frozen so it forms ice cubes in your local Delhaise)and hold it with a towel and rub it on your elbow after training. Don't stay in one spot too long.

- Sled work. Can you do the positive phase of the exercises? If you have or make a sled, you can do the positive phase of a ton of exercises(especially rowing)for the upper body without using the negative phase. This helps a lot in the rehab process. I used this for my knees as well.

- Zercher Squats. Do them, and your upper body will grow stronger too. You will have to test these first, because I don't know how they will affect your elbows. Use plenty of protection around the bar, like a thick towel.

- Band pressdowns. These are similar to the sled, in that the negative phase of the exercise diminishes with lower band tension. Ease into them though, these can be tough on your joints if you do too much too soon, but they're a great exercise for rehab. Most powerlifters I know do these for pre-and rehab.

- What I can't do(this may be different for you, but just sharing my experiences): Straight bar curls or EZ curls(both wreak havoc on my elbows even after one set), Skull Cruchers, any sort of extension with a straight bar(DB's and bands work), Barbell Rows with a reverse grip, a ton of arm training(this kills my elbows - but I stopped doing it a few years ago and I'm much stronger now, no regrets)

Now, I also read you have hypermobile joints, so take it real easy at first. Especially the strengthening of the muscles surrounding your elbow at first will help. Stability is what you need.

Hope this is of some use to you.
Back Squat:517 - Push Jerk: 231 - Deadlift:550
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Last edited by Bert Brams; 04-27-2009 at 03:26 AM..
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