How to Climb

Elbows and Wrists: Tendonitis and Tendonosis

More recalcitrant than Castro, though less charismatic, elbow pain is the most common and debilitating of chronic climbing injuries. It might be called golfer’s or tennis elbow, but it is climbers (and professional knitters) who are most likely to suffer the travails of blown-out elbows.

How many climbers do you know who have had elbow pain for long periods? They trawl desperately through web forums into the wee hours of the morning--: Someone must know something.

In fact, elbow pain is often easily explained. The bony lump on the inside of your elbow is called your medial epicondyle (Latin for small lump on inside of elbow), and the one on the outside is called your lateral epicondyle (Latin for small lump on outside of elbow). You get golfer’s elbow on the inside lump (even if you don’t play golf) and tennis elbow on the outside lump. I’ve never seen a golfer with golfer’s elbow and only one person who got tennis elbow from playing tennis. Go figure!

The vast majority of pathologies that affect your elbow fall into two categories--–tendonitis and tendonosis. Tendonitis is an inflammatory condition arising from acute aggravation, e.g., gardening or scrubbing holds for a number of hours when you are not accustomed to it. Tendonosis is a degeneration of the tendon cell itself, arising from microtrauma inflicted by a muscle that is too strong. Tendonosis may be preceded by tendonitis–one morphing into the other-–or it can occur separately. Unfortunately, most get diagnosed as tendonitis when they are actually tendonosis. The upshot: your elbow broods away like the bed-buddy you dropped so you could climb more in the first place.

For climbers, the cascade to injury usually starts with chronic overload. The classic scenario is a sudden increase in training. The muscle, having a greater blood supply, is able to increase its strength faster than the tendon, leaving the tendon comparatively weak. Further use leads to tendon damage and degeneration.