Elbow popped during OHS

[Wayne Welsh]

I am an almost 51 year old average Crossfitter (since 2010) and experienced an elbow pop (inside of left elbow, non dominant) for the first time in any exercise....this time happened to be during overhead squats. We were in the midst of approx 35-40 total of these at different weights....pick the weight appropriate for the set. I was on a 2nd set of 3 doing 145# (my 1RM is 165# which is BW for me). On the 3rd rep coming out of the bottom I got a little forward (i think) and tried to correct and that's when I felt the pop. Scared me into bailing on the rep. No sharp pain associated with the pop and I think it was more the sensation and knowing I had 145# overhead that scared me into a quick bail. Now 2 days later, I have some tenderness on the inside of my left elbow. That arm is slightly bent and I have a little discomfort when trying to fully extend. A movement like turning the steering wheel with my left arm bothers the elbow. I am applying the RICE therapy and hope that I didn't tear or partially tear something. No swelling or discoloration. Curious what kind of things can cause that pop and how concerned should I be that I actually injured something.

[Vilan Natanzon]

If it hurts during daily activities it's a significant injury. Leave the ICE out of RICE, compression is better. And make sure you don't have muscle imbalances and tightness that will prolong the healing or make it worse. All the stuff MobilityWOD talks about.

[Sean Rockett]

Things that I have seen do this are full or partial tears of the medial collateral ligament of the elbow or the flexor tendon attachment site. When locked out overhead there is a lot of stress on the medial structures of the elbow. I would favor an X-ray to make sure a small fleck of bone was not pulled off at the same time. Don't want to scare you but i would get it checked out by an orthopedic surgeon.

[Wayne Welsh]

Thanks so much for the replies, Vilan and Sean. It wasn't looking like anybody was going to reply so I had stopped checking for a while.

I took 8 days off from doing anything in the gym before starting to ease back into things. I still have some soreness and tenderness there and I am about 17 days post incident. I am able to do things involving the elbow and seem to be OK but still very conscious of this. Haven't put any real heavy loads on this. First wod back in the gym called for toes to bar...I did knees to 90. I have since done toes to bar and the elbow felt ok. I just did 16.1 and managed that but the load wasn't too heavy. I still believe this wasn't just a strain for me so I guess I need to get it evaluated. I just wish that process was smoother. I know the first diagnostic is probably a x ray but the x ray isn't going to paint the whole picture for me if I have a tendon/ligament injury, right?

[Sean Rockett]

right, but an exam and xray are very helpful when combined

[Wayne Welsh]

Had my appointment today with NC Ortho in Durham. Based on my description of the distinct event I had in the gym and the doctor's exam of me today, he believes I have a problem with my ulnar collateral ligament...quite possibly a tear or rupture. It's been about 2 months since the incident and he would like me to wait another month and then check back in with him. If it hasn't gotten any better, we will schedule a MRI. If the MRI confirms the suspicion, it's Tommy John surgery. They did x-ray me today and as expected, the xrays were normal. Wants me to lay off the pullups, push-ups and dips type movements over the next month along with heavy overhead lifting. Until confirmation, I am classified as a sprain of the UCL.

[Sean Rockett]

Good luck with it it sounded suspicious for that. Sean

[Wayne Welsh]

Well after waiting a little longer (a total of 3 months since injury) I called back to the office with symptoms not improving. Had MRI and follow-up last week with the ortho doctor. MRI stated the following..

There is partial tearing at the distal insertion of the anterior band of the UCL, at the sublime tubercle. Specifically, there is tearing involving the anterior aspect of the distal attachment. No retracted full thickness tear. Mildly increased signal of the proximal fibers is compatible with a mild proximal sprain as well. The remainder of the ligament structures about the elbow are preserved.

Also noted mild insertional triceps tendinosis and minimal chondral thinning extensor and common flexor tendinosis.

So based on how I feel doing certain barbell movements and the fact that I have not seen any improvement in my level of discomfort doing these movements, I am leaning towards having the surgery.

My brother, who is not a doctor but well read, mentioned to me about a local clinic doing FDA approved stem cell shots....need to look into this more..is a ligament tear a good candidate for something like this to avoid the surgery?

[Sean Rockett]

not enough research to say yes definitely. If an elbow is loose or unstable then surgery helps that

[Suzanne Campbell]

I tore my UCL also during an OHS 2 years ago. Did not have surgery. Can do most things fine. Push ups, bench press, snatches and OHS cause numbness and tingling in my hand and I have a sensation that that arm is different, though I wouldn't even call it discomfort. Since I am not a competitive CrossFitter, I just scale and live with it. Good luck with your surgery if you decide to have it.