How to rehabilitate from triceps tendonitis

[Rory M]

Hi, I developed what it seems to be a case of triceps tendonitis in my left arm. It was cause by forcing myself in the low bar squat position. My left arm is less flexible than my right so it's under more tension than my right. It hurts in two heads of the triceps: the one over the elbow and the one over the humerus. If I bench, it hurts over the elbow when I lock out my arms and when I'm pushing it hurts in the other head. It has completely ruined my bench (cannot bench over 70% of PR), but for some reason it does not affect my press (maybe the triceps are less involved in the press).

At the moment I'm not training because gyms have closed in my area. I've just started to rehabilitate at home by doing diamond pushups every other day and taking 20g of collagen per day. I still get some pain when I forcefully lock out my arms hard and when I do triceps extensions (in the latter I think it must hurt because the tendon is stretch and over the bone). I get no pain when I do one arm push ups, but I do get some when I do regular pushups in an explosive way.

What would you recommend to recover faster?

Thanks

[Chris Palladino]

Rory,

Well if your gym is closed and push ups are your only option and their not causing an increase in pain or symptoms then continue. However, this may come back when you return to the gym. Below are some common faults I see with this issue.

Shoulder asymmetry is fairly common issue based on age, injury history, dominant hand etc. Most likely the asymmetry is not the problem, its the way you support the bar on your back and arms that's the problem. When you get under the bar and set up, a majority of the weight needs to be supported by your back (in the low bar position) and very little in your hands. In fact, your hands are just laying on the bar compressing the bar towards your body, not supporting from underneath. I would make sure that you address this by recording yourself and reviewing your videos.

Regarding the bench and time away from the gym your going to have to reset anyway. So I would reset with a conservative, pain free weight (may even be the empty bar) and avoid the lockout position early on. Start by completing 3 sets of 12 reps on session one, then add 5# and complete 3 sets of 11-12 reps on session 2, then add 5# and complete 3 sets of 10-11 reps on session 3 and so on until you return to a 3 sets of 5 and a full lockout position. This will take 4-5 weeks to complete.

Please be advised that its typically the handling of the bar on the back thats causing this type of tendinopathy and is exacerbated by the bench. So you must clean up the squat first.

Good luck

[Rory M]

Thank you for your reply. Sincerely, I don't notice anything wrong with my squat form (if I had a video I would post it). I'm not that old to have such flexibility issues (31 years old, work with computer all day) and I have never had an injury. There is definitely something wrong going on because I have also developed a tendonitis on the extensor carpi ulnaris (bottom part of the forearm) from pressing the bar over my back. I never hold the weight with my arms because my wrist kills me.

[Dust Devil]

Rip stated in a thread a few weeks ago that he's never run into a case of triceps tendonitis that wasn't caused by isolated triceps exercises.

(FWIW: I've read that taking collagen is pointless, because your digestive system just treats it as low quality protein, so it won't survive and travel to your tendons.)

[Erich Weidner]

I'm only in week 6 of the NLP, however attempts to force better low bar squat bar position over two sessions in week 5 really angered my left arm in what sounds like exactly what you are describing (so bad sleeping was tough... throbbing dull pain)
.
I couldn't complete my worksets of bench for two sessions, but was able to press without problem. Attempting to low bar squat would result in the throbbing pain in left shoulder/tricep/elbow. I'm a newbie, and trying to work through it.

My physical therapist (who I was seeing for back pain initially) and is the one who turned me on to Starting Strength suggested some stretches which in the two sessions which I've done them before training, the pain produced by the squat has helped (but not eliminated the pain, but it is much better. The one session I didn't do the stretches was massively painful after squatting). Note: I didn't have this pain in weeks 1-4, but as I kept reading and learning more (and watching SS videos) I kept trying to get the low bar position (which I can't do with straight wrists yet), and I guess I just really aggravated something in the left arm/shoulder.

I took a day off of bench (pressed instead), have been stretching, reverted to high bar squat. In the last two sessions, I've done Bench/Press as the first exercise, then squat then deadlift. (I know, not the correct order, but while I'm trying to unfrak my squat, this has allowed me to do all three exercises per session.)

Don't know if any of that is useful for you. But your symptoms seem to match mine exactly. I'll keep trying to get to low bar with proper form...

[Chris Palladino]

I recommend that you start here:
1. Confirm the squat form is correct with recording yourself
2. You may also want to adapt a paused bench press to help allow this heal.
3. stick to the program and leave out all accessary work

[Rory M]

Rip stated in a thread a few weeks ago that he's never run into a case of triceps tendonitis that wasn't caused by isolated triceps exercises.

(FWIW: I've read that taking collagen is pointless, because your digestive system just treats it as low quality protein, so it won't survive and travel to your tendons.)

Yeah, the thing with collagen is just in case it could be of some benefit, I lose nothing by trying (only money).

I read a VERY good book on tendonitis called "Overcoming Tendonitis: A Systematic Approach to the Evidence-Based Treatment of Tendinopathy" at some point it says this:

Screenshot 2020-12-14 at 11.01.08.jpg

[Dust Devil]

The image is a bit too blurry for me to read.