Golfer's Elbow Question Golfer's Elbow Question

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Thread: Golfer's Elbow Question

  1. #1
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    Default Golfer's Elbow Question

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    After doing a search and not coming up with an answer I decided to ask one here. I got golfer's elbow so bad last year from chin ups I had to lay off of them completely, as well as deadlifts. It was so bad I couldn't hang a grocery bag of 10 lbs of chicken from my arm, press a towel on my face to dry it off, brush my teeth, etc. While miraculously getting around that to still be able to do my pushing exercises (high bar squat, bench, OHP), my neck then started bothering me I had to stop working out altogether. My neck never bothered me before that very badly and I suspected I was causing a posture imbalance by only training the pushing exercises, pulling my shoulders forward. While I did find out it was a spur in my neck, my physical therapist confirmed it probably got worse due to bad posture.

    The exercises he prescribed completely alleviated the pain, numbness in hands, weakness in arms, everything involved the pinched nerve, and he gave me the ok to go back to weight training.

    Now that my elbow is better I want to do it, but here's the question;

    Is my elbow healed?

    A few months ago Mark alluded to the fact it wasn't even though I told him it didn't hurt anymore and I did a small test of 135 lb deadlift with no pain. But then he never elaborated on that statement and after further dialogue gave me the go ahead to resume training.

    I'd really like to know why Mark said that my elbow wasn't healed after over a year of lay off with no more pain. Is it because I didn't keep up with some therapy for it and go back to immediately training it? Am I doing to have to do that before resuming a full on NLP like I did last time?

    I just don't want any surprises after I've worked through another 3 mos of NLP and back up to over 300 lbs deadlifts to have to full on stop everything again.

  2. #2
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    Hey David, there are a couple of different ideas that need to be unpacked in your post, specifically what it means to be in pain and what it means to heal. Our default cultural belief is that pain is a signifier of damage and that if we are in pain it must be because something is damaged. This is not true. Pain is a signifier of threat or danger. It is an output from the brain that urges us to protect specific areas of our body by modifying our behaviors to escape it. In many scenarios there is a good chance that an image would reveal degenerative structural changes to the specific area in pain. This is common in the case of tendinopathies but it does not mean that those changes have anything to do with your current pain experience. Those changes may have started occurring years before you started to even have any pain.

    We also know that tendons in general don't structurally adapt/respond as well to training compared to other tissues like bone and muscle. This means there is a good chance an image of your tendon while you were having significant pain and now when you have no pain would most likely look very much the same. This is probably what Rip meant when he said it's not healed. The key thing here though is that your structural state of your elbow tendons, based on the history presented here, does not matter in deciding wether to train or not. What matters is wether you are in pain or not while you are lifting. Your elbow has not healed in the way a cut heals on your skin but your brain has decided that your current activity no longer poses a threat to the area so you can proceed with training.

    After a year layoff I would recommend starting back with an LP. When things start getting hard again after a couple of months switch to an intermediate program. For some more resources to understand pain I'm linking a couple of short videos below. Hope this helps and good luck!



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  3. #3
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    I suffer mild pain on my right elbow. However, if I wear a light weight pair of elbow sleeves, I can train sans pain.

  4. #4
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    As much as it contradicts what most people here say, mine goes away with rest. But then again, mine will return maybe once a year, so maybe mine isn’t actually “healed” but the symptoms go away and I can lift and live pain free with a week or two or rest

  5. #5
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    Quote Originally Posted by Johnsonville View Post
    As much as it contradicts what most people here say, mine goes away with rest. But then again, mine will return maybe once a year, so maybe mine isn’t actually “healed” but the symptoms go away and I can lift and live pain free with a week or two or rest
    This does not contradict at all my experience working with people who struggle with this condition. It actually is exactly what I would expect to happen. It really comes down to managing the load you are exposing your elbow too and gradually increasing it over time. Taking a complete layoff is a drastic form of load management and it has been my experience that it is common for people to relapse using that strategy but then again I've also seen it work wonders. The people that are most successful at overcoming training related tendinopathies usually change their attitude towards their pain experience in that they respect it but are no longer afraid of it. They understand the difference between nudging the pain and pushing through causing an exacerbation. They use how the affected area is feeling the next day as the primary marker for if they did too much. They realize rehab is a process that is going to take longer than they want but understand that they will improve and see the improvements in their training notes and load on the bar. They realize that healing as its culturally understood, or returning the tissue to its previous state before injury, is not the goal and that training effectively is the goal.

  6. #6
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    Quote Originally Posted by Nick D'Agostino View Post
    This does not contradict at all my experience working with people who struggle with this condition. It actually is exactly what I would expect to happen. It really comes down to managing the load you are exposing your elbow too and gradually increasing it over time. Taking a complete layoff is a drastic form of load management and it has been my experience that it is common for people to relapse using that strategy but then again I've also seen it work wonders. The people that are most successful at overcoming training related tendinopathies usually change their attitude towards their pain experience in that they respect it but are no longer afraid of it. They understand the difference between nudging the pain and pushing through causing an exacerbation. They use how the affected area is feeling the next day as the primary marker for if they did too much. They realize rehab is a process that is going to take longer than they want but understand that they will improve and see the improvements in their training notes and load on the bar. They realize that healing as its culturally understood, or returning the tissue to its previous state before injury, is not the goal and that training effectively is the goal.
    I feel that's where I'm at now. This isn't my first bout with tendon issues of the forearm (had one in the other arm though not specifically "golfer's elbow"), and I've dealt with major knee and back pains (whether they were just strains, pulls or tears IDK). I'm racking up so much experience with injuries I'm beginning to just lose the all out panic I once felt. All the other pains before this one went away permanently. Again the only concern this time was because of what Mark said and I needed clarification on. I think I pretty much get what you're saying though.

    I'm going back to LP and I'm just gonna be more careful. During my last LP I gained a lot of weight in a couple months, going over 200 lbs and having never done any kind of pulls up work before went full force into low rep LP and did chin ups with the supinated grip which felt unnatural, every single work out. Trying to get that extra bicep work in. I was ALMOST at bodyweight chin ups when the pain happened. In short I was doing even more work than Mark recommended in Starting Strength (8 rep range instead of heavy 5s) and was relentless about it. I won't be doing chin ups ever again. Thinking about neutral grip pull ups in higher rep range, less aggressive progression, and not every single work out. How does that sound?

    I could save all the extra work (pull ups, bend over rows, etc) for a few months into intermediate phase and just do the basics (squats, presses and deadlifts), but that will be very difficult for me because I have a tendency to push myself extremely hard when it comes to my interests and hobbies, if that's what you can call this.

    What would you recommend as far as that?

    Thanks for your input Nick!

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    I think you throughly explained a large part of the reason why this happened in the first place with your training history. As broad scope general advice I would try lat pull downs instead of chins. This will allow you more precision in incrementally loading the movement. I don't think you should blame the exercise here but more the programming you used. Chins are a perfectly safe exercise but doing too much, too soon, too fast for basically anything carries an increased risk of causing problems. The strategy you outlined in the last paragraph sounds like a good one to get started. I think it's fine to add in either pull ups or barbell rows right now but I would avoid the supinated grip when things are flared up. I would not add them both at the same time.

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    Quote Originally Posted by Nick D'Agostino View Post
    I think it's fine to add in either pull ups or barbell rows right now but I would avoid the supinated grip when things are flared up. I would not add them both at the same time.
    I've been avoiding supination for the past three months since I first got golfers elbow. I weighed about 206 at the time and was chinning at least twice a week. I had worked up to three sets of seven chins and was also doing barbell curls once a week. Niki Sims didn't say anything in her chinup videos about golfers elbow that I can remember. Nobody else warned me so I just went at it full blast and often.

    When the pain set in I was pretty messed up. Handling big plates was difficult and dicing an apple on my cutting board in the morning was a sumbitch.

    Now after laying off the chins the pain is about a third or less of what it was. My coach has replaced the chins with barbell rows and lat pulldowns and I'm feeling better about training around the pain. I'd like to chin some more but I think l will try working up from neutral grip lat pulldowns to neutral grip pullups. Only if I can do a few of those without a flareup will I take another shot at supinated chinups.

  9. #9
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    Very excited to get things going again and you helped clear up my only concern! Thanks again!!

  10. #10
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    Quote Originally Posted by Steve R View Post
    I've been avoiding supination for the past three months since I first got golfers elbow. I weighed about 206 at the time and was chinning at least twice a week. I had worked up to three sets of seven chins and was also doing barbell curls once a week. Niki Sims didn't say anything in her chinup videos about golfers elbow that I can remember. Nobody else warned me so I just went at it full blast and often.

    When the pain set in I was pretty messed up. Handling big plates was difficult and dicing an apple on my cutting board in the morning was a sumbitch.

    Now after laying off the chins the pain is about a third or less of what it was. My coach has replaced the chins with barbell rows and lat pulldowns and I'm feeling better about training around the pain. I'd like to chin some more but I think l will try working up from neutral grip lat pulldowns to neutral grip pullups. Only if I can do a few of those without a flareup will I take another shot at supinated chinups.
    That sounds like a good plan. When you want to implement them back in to your program ask for your coaches advice about how. I'm sure that they will be able to gradually expose you to the exercise while minimizing the risk of a flare up.

    Quote Originally Posted by David McClelland View Post
    Very excited to get things going again and you helped clear up my only concern! Thanks again!!
    No prob man! I'm glad you found the guidance helpful.

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