Unexpected sharp elbow pain

[TalEphrat]

Hello Rip,
I am dealing with a shoulder injury for already way too long, about 3 months now, and finally I improve. This is a long story but irrelevant. Because of the shoulder injury, I only press, don't do the bench, and I increase the weight really slowly, according to symptoms.
Long story short, I am pressing 70kg for 3 sets of 5 for already ~4 weeks. My PR is 90kg for 3 sets of 5, so 70kg is not heavy and definately adapted to, since I'm doing the same weight for already about 4 weeks.
Yesterday at the second set, a small pain at the elbow started at the stretch reflex at the bottom (Press 1.0) and nothing more. I have done the third set, but afterwards there was a small pain at the posterior side of the elbow, where the triceps tendons are attached (Olecranon?).
At the dinner after the training it was a bit painful to put the elbow on the table, but it got worse.
I woke up from pain at my elbow. It was really, really painful. Extending the elbow is very painful, but also fully flexing it. The flexion movement doesen't hurt, only the position where the elbow is fully flexed. Pain is only behind the elbow.

It was way too painful for me to handle, I could barely drive to the pharmacy. I used only my right arm and took Ibuprofen 800mg. After ~1 hour pain went down but it's still very painful. It feels like it's swollen, but it doesen't appear to be. Yesterday it was painful to touch only the tendon itself, now it's painful to touch anywhere near the tendon. And extending the elbow against a ressistance it very painful.


Does it sound like something you have seen?
What, in general, characterize injuries that you feel only the day afterwards? Is it typical to tendons, cartilage?
Shall I continue the Ibuprofen protocol? I took it at first to reduce the pain, and wanted to get an idea whether it sounds relevant to the protocol you suggest sometimes.


Thank you very much in advance.

[Mark Rippetoe]

Get an x-ray. You may have a fracture at the tendon insertion on the olecronon.

[TalEphrat]

Get an x-ray. You may have a fracture at the tendon insertion on the olecronon.

Got it. I'm not sure they have done it at the best way possible, but it's here: link1 , link2

The orhoped said the bones are fine, and no tendon rupture. She also did some range of motion tests, and touched behind both elbows to try and diagnose.
She said there's no fracture, and that the tendon is attached. It didn't seem as she's confident with her statements. She said it's a muscle damage, which to me, would be weird. The pain is not like a muscle-pain and it's where the triceps attach to the elbow, not the muscle itself.
Anyway, I would guess it's nothing more than a damaged tendon.
Right now, 7 hours after 800mg Ibuprofen for the second time, pain is definately tolerable. I can drive and use my left arm. Definately not lifting at the moment, but it seem to improve in terms of hours (maybe it's the Ibuprofen that kill the pain and not a real improvement. 800mg affect me quite much in terms of pain killing, but now it's already 7 hours after the second time I took 800mg).


How shall I rehab that condition? Ibuprofen for 5 days? what about training?
I have seen only protocols for a muscle belly damage (the starr protocol), but no general method for a tendon damage.



Thank you very much in advance,
Not an obvious help. Thanks!

[Mark Rippetoe]

See how it feels tomorrow. Might not need rehab.

[TalEphrat]

See how it feels tomorrow. Might not need rehab.

Thank you very much.
It has improved quite much, I have pressed the empty bar with pain level 2/10 only 2 days after the injury.
Tomorrow will do it just a bit heavier, say, 25kg. Chinups were painful only at the top where the elbow is fully flexed, pain level also about 2/10, just to be careful I added no weight and did an easy bodyweight 3*5.

That's a really weird thing, I'm a competitive athlete, start competing internationally about 3 years ago, I'm definately familiar with pain / injuries from training, but I have never had such a painful thing that got away so quickly. It's not 100% now and I will definately not press heavy, I will add ~5kg every session according to symptoms, but hell, the pain level at the night didn't feel like anything that will let me be painless during the day after only ~48 hours.

I stopped the Ibuprofen after 2 days since the pain is definately tolerable, and improving.



Thank you very much for the kind help :-)

[Mark Rippetoe]

Pain is a funny thing. I've had knee pain so acute that I limped over to the squat rack, took the work set out, and then squatted the damn thing with no pain. When I was a kid I remember coming home from the gym with my foot hurting so bad I got back in the car and drove to the emergency room. Nothing on x-ray, they sent me home with a NSAID prescription, I got up the next morning and it was a half hour before I even remembered that it had happened the night before. I have had my back hurt so bad on several occasions that I couldn't breathe, and I remember going into a convulsion in the hospital from the pain of a knee surgery, and very nearly panicking as the nerve block wore off from my cuff tendon repair -- hurt so bad I could not talk. I know about pain. But sometimes you don't know what causes it or how long it will last. If you're going to be an effective person, pain cannot be your primary concern.

[Scaldrew]

Pain is a funny thing. I've had knee pain so acute that I limped over to the squat rack, took the work set out, and then squatted the damn thing with no pain. When I was a kid I remember coming home from the gym with my foot hurting so bad I got back in the car and drove to the emergency room. Nothing on x-ray, they sent me home with a NSAID prescription, I got up the next morning and it was a half hour before I even remembered that it had happened the night before. I have had my back hurt so bad on several occasions that I couldn't breathe, and I remember going into a convulsion in the hospital from the pain of a knee surgery, and very nearly panicking as the nerve block wore off from my cuff tendon repair -- hurt so bad I could not talk. I know about pain. But sometimes you don't know what causes it or how long it will last. If you're going to be an effective person, pain cannot be your primary concern.

I had two wisdom teeth removed last Tuesday. Sucks.

[TalEphrat]

Pain is a funny thing. I've had knee pain so acute that I limped over to the squat rack, took the work set out, and then squatted the damn thing with no pain. When I was a kid I remember coming home from the gym with my foot hurting so bad I got back in the car and drove to the emergency room. Nothing on x-ray, they sent me home with a NSAID prescription, I got up the next morning and it was a half hour before I even remembered that it had happened the night before. I have had my back hurt so bad on several occasions that I couldn't breathe, and I remember going into a convulsion in the hospital from the pain of a knee surgery, and very nearly panicking as the nerve block wore off from my cuff tendon repair -- hurt so bad I could not talk. I know about pain. But sometimes you don't know what causes it or how long it will last. If you're going to be an effective person, pain cannot be your primary concern.

I definately find myself saying it to people every now and then, so I agree 100%.
That's a good method to live by.

Thanks again :-)