Fighting Elbow Pain

Hello world!

Years ago, I injured my left wrist doing dumbbell cleans. Lack of rest and mistakenly believing that stretching would “heal” the sprain, actually left my wrist WAY worse. In fact, all of the stretching made my right wrist injured, too.

I guess it goes to show that compulsively stretching in extreme end-ranges of flexion and extension for months leave your ligaments permanently loose… Why do we find out everything the hard way?!

Angry.

Yes, I’m angry!

Anyway, after almost four years, I’m finally gaining back some resilience to bear loads on my wrists, particularly, doing pushups. This is fine and dandy, until some annoying “snapping” occurs every time I descend to the floor. Now I have elbow pain. DAMN IT!!!

Lo and behold, I either have snapping triceps syndrome or ulnar nerve subluxation. We’ll assume it’s the latter for simplicity.

Ulnar nerve subluxation isn’t your typical elbow pain. It’s an injury in which a nerve in your arm snaps around the bony segments in your elbow like a rubber band. At this point, I could no longer do pushups, or risk further irritation and possibly nerve damage. Awesome.

I decided to read up a bit, and in Eric Cressey’s 6-part article-series on elbow pain, and he mentions more than once the importance of tissue quality for elbow health. Specifically, he claims the benefits on Active-Release Technique and the Graston Technique for breaking crappy tissues and improving overall health for the elbow. So, I took this as my cue, sought out an expert who performed these treatments, and went to work.

I talk about my fun little journey on the Crossfit forums, which you can read below or right here.

(From the Crossfit forum)

For those of us who have the “snapping” in the medial side of our elbows, we’ve been pretty SOL.

If you search “snapping triceps” or “subluxating ulnar nerve”, you can browse years of threads across different forums in which people have to either give up elbow movement or get surgery. For those who are unsure of what injury I am talking about, check out this (WFS).

I’ve come to the conclusion that the medical community is totally lost when it comes to this injury. Totally effing lost.

Some people have mentioned massage and stretching being somewhat helpful, so I sought out a sports-based chiropractor who works with athletic teams. I’ve been getting Active Release Technique (ART), Graston technique, adjustments, as well as stretches to do at home.

Essentially, improving the tissue quality ad loosening up the surrounding tissues does improve the condition. The snapping I get as I descend in a pushup became less “forceful”. However, it didn’t completely do it for me yet, so I experimented with KT tape.

I used two strips of KT tape on my elbow like so (WFS) and I jumped into some pushups. The first few still created some snapping, but I messed around with my hand positioning (width and height) and am now able to do some pushups without snapping. I’m not even sure if I did the taping optimally, as I followed the video to a T and centered the tape around the medial epicondyle, not the groove where the tendon/nerve lies.

Regardless, I found something that gave me instantaneous results! The reason why I feel the need to share this is because if you see an orthopedic about this issue, you’ll either get: 1. surgery. 2. PT or 3. “lifting weights is bad, you should swim”. Surgery seems to be provide so-so results (some being 100% fixed, some being worse than before), PT doesn’t address the problem, and we’re not gonna stop lifting 😉

I really really really hope this helps you guys and gals out there whom have this elbow issue. Mine came about out of nowhere, and I’m glad it dissipated just as quickly.

Update:

Went back to the chiro today for some extra ART and massage, and tested some pushups WITHOUT the KT tape, expecting the snapping to return but surprisingly I was able to do it fine!

Who would’ve thought that the KT tape would stop the snapping after I had taken it off. The chiro says in addition to assisting with the mechanical load, the tape offers proprioceptive feedback to the elbow. The tape touching the skin and stretching during movement aids in muscle-recruitment, apparently. Whatever, it works for me!

So here’s an injury that the medical community tells us can only be dealt with through inactivity or surgical nerve transpositioning (just an illustration WFS), yet is seemingly improved with massage, stretching, and taping.

Brilliant!

Update #2:

The ulnar nerve subluxation came back with a vengeance.

After a few days of confusion and frustration, and dropped into some pushups again, and the snapping went away, Look at my hands as I did the pushups, I saw that I was putting all of my weight on the pinky-side/ulnar-side of my hands. I was practically rolling my hands into neutral, and afterwards, the redness from the weight-bearing was located all around the ulnar-side of my hands.

I told my chiro this discovery, and I was then instructed on rotating my hands externally when trying pushups, and this did the trick.

My conclusion is that the KT tape somehow led me to subconsciously compensate, which did in fact work in the mean time. With previously tilting my hands to bear the weight on my pinky-side, and now externally rotating my hands, I believe both of the changes in technique reduce the distance the nerve must travel throughout the arm.

If I’m correct, the subluxation we experience allows the nerve to relieve it’s stretch while the elbow undergoes flexion. When the elbow goes through extension, the nerve has a shorter length to travel and is less stretched (or under less tension), thus the nerve pops back into the groove.

Why the nerve is suddenly unable to stay in place while under tension, I don’t know. Possibly because the ligament responsible for holding it in the groove has gone loose, or even torn? One study says that possibly about 16% of the population have the potential for ulnar nerve subluxation (WFS). Well, you know what? That blows.

Maybe, the nerve has somehow shortened, and is under more tension during elbow flexion than the nerves of asymptomatic people? I’ve never heard of the ability for nerves to stretch or shorten, but I’ve never read anything that outright disqualifies the notion.

I hope this little musing has helped some people out there with this annoying condition.

September 2013 Update: I discovered that a good number of people on the internet have seen this post, and a few have asked over the past few months about my current progress.

Well, I’m exercising way more than I was before. I’ve increased my elbow range-of-motion during pushups, and overhead presses with dumbbells or kettlebells don’t cause me trouble.

I think one thing here that helped me out was supinating my wrist and keeping my arm between internal and external rotation during exercises. For example, when I do pushups, I turn my hands out and keep my elbows at 45* to my torso. If I were to  keep my hands straight and my elbows at my sides, my ulnar nerve would probably subluxate, as that was the case earlier on. The other thing that probably helped was soft tissue work. I stretched, massaged, and rolled my pectorals, forearm muscles, and triceps. I started this at the suggestion of my chiropractor, and it seemed to help.

Like I said on the Crossfit board, I find it extremely odd that up to 16% of the population experiences this issue. We all aren’t this dysfunctional, are we? I don’t believe that the general population can have this seemingly defective physical issue out of no where. My inkling is that tissue quality plays a huge roll in this. With tissue quality comes lots of stretching and painful massage.

Yuck, listen to that scraping noise!

Anyway, I hope this has helped. Good luck, everybody!

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One Comment

  1. Photo Credits
    Angry face. Author: Jan Tik. flickr.com

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