Tendonitis - Despite having strong base and skills

[Alexander Castiglione]

Hi, 

 

New to the forum, but not new to the bodyweight movement world. I listened to Barbell Shrugged's podcast with Coach Sommer, and he briefly touched on tendonitis. I recently went to the orthapedist after I had recurring tightness and pain both inside and outside of the elbow joint. About 8 months ago it was real bad - with pain and tension radiating from my wrist to my lower bicep post WOD. I dialed it back, rested, iced and heated and it went away - admittedly i was doing a TON of volume - both oly lifting a gymnastic work (rather advanced gymnastic work by Crossfit standards with lots of levers, strict MUs, bar MUs and ice cream makers). Occasionally it rears its head. The doctor said rest as needed, and I definitely have mild tendonitis in my outer and inner elbow (the clinical term he used escapes me). Being that I Oly lift, crossfit, and rock climb - i expected some strain on my joints and tendons. 

 

In the podcast with coach Sommer, he said something to the effect of if you don't have the strength, you will develop tendonitis. My question is what else can i do? I am not a competitive gymnast, but a pretty strong bodyweight athlete. The PT i went to basically said get a FlexBar and use that 3x a week to strengthen the area - since I'm an athlete already, she couldn''t do much more than say rest and do rehab/prehab exercises. 

 

My baselines are as such: 

 

Max Pullups (Kipping): 62 

Max Pullups (strict) 30-35 

Angie: 9:54 

Max Muscle Ups Unbroken: 15-17 

Max Weighted muscle up (kipping) 22.5 lbs

Max Strict MU weighted: 10lb 

Max Ring Dips: Haven't tested but I did 30 unbroken in a wod (without turnout) 

Max weighted ring dip: 75lbs 

Max Weighted ring pushupL 110lb + (couldnt safely test anymore) 

Max HSPU against Wall: over 20 

Max Pushups: 93+ 

 

I can bang out legless rope climbs all day, even with a vest (this seems to aggravate my wrist and elbow the most if i don't warm up for a long time). I have a strong false grip, but with kipping MUs obviously I don't false grip more than 1 or 2 reps. I can pull explosively enough to transition and catch pretty high. 

 

What else can i do to battle tendonitis/strengthen the connective tissue? 

 

Any and all advice is appreciated. The physical therapist wasn't much help, and all the doctor did was prescribe me NSAIDs.... I'm trying to avoid injury. Maybe I just have to dial my training back, but i wanted to see if anyone had any ideas or a similar issue. I'm 29 y/o, about 150, 5'7", background in boxing but trained basically my whole life prior to starting crossfit in Feb 2012 doing strictly bodyweight movements. Thanks! 

 

 

[Mats Trane]

she couldn''t do much more than say rest and do rehab/prehab exercises. 

That's what I would do.

[Colin Macdonald]

 

In the podcast with coach Sommer, he said something to the effect of if you don't have the strength, you will develop tendonitis.

 

So your take away from the podcast was that all you need to do is focus on max strength to avoid injury? I think you need to listen again more carefully...

[Joshua Slocum]

Dialing back on your training is exactly what you need to do. There is, unfortunately, no other good way to deal with tendonitis. Rest: let it heal; use rehab exercises, heat and NSAIDs to hopefully speed the process. 

 

Then when it's healed, you need to be more cautious with the volume. Build it up slowly. And remember: more must always pay dividends. What are you trying to get out of your training? How does high-volume 

[Jesus Rojas]

You need to hear the others podcast and listen carefully in the segment when Coach talk about programming around the connective tissue instead of programming around muscle. Remember muscle recovers faster than tendons.

[Alexander Castiglione]

So your take away from the podcast was that all you need to do is focus on max strength to avoid injury? I think you need to listen again more carefully...

No you misunderstood me. My takeaway was that alot of athletes, specifically crossfitters, try things they have no business doing and that's why they have injuries. I have a base with the strict movements-so I was wondering what ancillary work I could do? It seems the consensus tho is rest, rehab/prehab, and listening to my body is the prescription.

[Alexander Castiglione]

Then when it's healed, you need to be more cautious with the volume. Build it up slowly. And remember: more must always pay dividends. What are you trying to get out of your training? How does high-volume

Trying to get control mainly - insofar that control in advanced gymnastics moves translates into strength and agility. Half jokingly I say I want to try out for ninja warrior.

High volume I can take with bodyweight only. Like I've done wods with hundreds of pull-ups and been fine. But when I do high volume weighted movements and difficult static moves it gets aggravated. Rope climbs make it worse because its technically mild golfers and tennis elbow. I have been working on my oly lifts for power - but frankly I care more about being proficient/advanced in bodyweight.

Just trying to see if anyone had a similar issue and how they got around it or dealt with it?

I can always just back off oly work n only squat n deadlift to maintain.

[Coach Sommer]

The answer is simple. You are doing far too much at too high an intensity and need to cut back.

Until you do, the elbows are not going to improve.

Yours in Fitness,

Coach Sommer

[Alexander Castiglione]

"The answer is simple. You are doing far too much at too high an intensity and need to cut back.

Until you do, the elbows are not going to improve."

 

Thanks all, and thanks Coach Sommer. My question to you is if I want to achieve a high level of proficiency - my end goal is getting a solid Iron Cross, ring HSPU, great front/back levers; advanced skills such as those - I would be better off dialing back Oly lifting and doing strict and weighted work in low volume but concentrating on control, form, and static strength, correct? Or am I way off in that assumption?

 

For instance, a workout would look something like 10 x 1 Strict Muscle Ups - weighted if possible, or strict HSPU from a deep deficit, or strict ring dips with a full turnout? Maybe some tempo work with long eccentric phases, hold at bottom of position, explosive concentric phase, and a pause at lockout with a turnout if possible (ring pushups and dips)? 

 

I'm just trying to get a better handle on how to best train, as CrossFit movements are becoming too easy. Workouts like Mary aren't really a challenge anymore. I want to push myself with more bodyweight movements with a greater skill level. I'm not built to be a weightlifter, and I think I'd be better suited to concentrate on the gymnastics realm to achieve my potential. Planches and freestanding HSPU i still struggle with, but I just need more practice I think. 

 

Thanks again to all, and I look forward to engaging on this forum.

[Ronnicky Roy]

I think stopping to realize that tendonitis IS an injury would most benefit you. It needs to heal so you can do what you love, without hurting. Tendons shouldn't hurt.

What Josh and Coach said really is the best advice you can follow, even tho it sucks.

You could also listen to a fellow crossfitter Emily Schromm who said, "in crossfit, we don't rest enough"

[Cole Dano]

You have both golfer's and tennis elbow, that should be telling you something. 

 

Rest, heal, see a physiotherapist, tendonitis is not a way of life.

 

Later, if you decide you are serious about GST and aspire to do Iron Cross, Coach Sommer is your man, start working through the courses he's already published. Get to a seminar when you have the chance etc. It's extremely important to follow the right progressions to get there, or golfers elbow will be the least of your problems.

 

edit: thecolin lays out the process in more detail below

[Colin Macdonald]

No you misunderstood me. My takeaway was that alot of athletes, specifically crossfitters, try things they have no business doing and that's why they have injuries. I have a base with the strict movements-so I was wondering what ancillary work I could do? It seems the consensus tho is rest, rehab/prehab, and listening to my body is the prescription.

 

For inflammation, the presciption is simple, stop everything and rest. If you go back to what you were doing, obviously you'll get the same result in the end.

 

All Coach's recommendations for prehab/rehab are laid out in Foundation. For example, yes you can climb the rope. but if you can't demonstrate mastery of the 4 prerequisite Foundation courses for rope climb you're not ready for the rope according to his standards. It doesn't matter if you can do it and at what volume.

 

I obviously can't spell out all the details, but basically you need to establish a basic functional ROM in your whole body. Seeing as none of the moves you listed require any active flexibility worth noting, I'm guessing it's probably not a priority.

 

Along with establishing functional ROM, you start on basic static and dynamic movements. Once you've mastered all the flexibility, static and dynamic strength requirements in Foundation you can start to think about basic ring strength and kipping/explosive strength.

[Léo Aïtoulha]

if I want to achieve a high level of proficiency

It is time for you to get Foundation One and Handstand One

The Foundation Series and Handstand One are the only courses in the world that will allow you to have a real  solid basis in terms of strength AND mobility.

[Alexander Castiglione]

Well you guys sold me on Foundations 1 and 2 - Looks like I'll be doing that after I finish my OLY cycle. And thank you all so much for your candor and responses. I look forward to talking with all of you in the future and improving as an athlete. 

[Alexander Castiglione]

Ok ladies and gents, 

 

Just an update. I took many of your and coach's advice, and I dialed it back. I noticed that RCs were the main aggravators of the tendon issues, but after slow and steady progressions, flare ups are far and few between. However, I find myself doing alot of prehab prior to a workout where i know i will be doing alot of FBAS movements. 

 

I've been using a lacrosse ball and a 45lb bar to roll out my forearms, and it's been working. Do any of you have any novel ways of stretching your forearms to combat tension/golfers/tennis elbow? Does anyone have any novel warmups i could use? I'm been playing with Czechs, but did a straddle RC the other day with no issues. This stuff is no joke. 

 

Coach's advice was obviously paramount: Back off, you're doing far too much. Even moderate rock climbing sessions which used to trash my elbows and tendons have only relegated me to your standard issue forearm soreness. 

 

In this, I think the entire community. This GST path is truly humbling. Thank you all. 

[Sarah O'Byrne]

The wrist exercises in Handstand 1 completely resolved my golfer's elbow

[Rajesh Bhat]

When my son took gymnastics lessons at a local studio, he was not taught proper progression and always ended up with pain. now he is using GB progressions, and has little to no pain or injury. Coincidence much? I think not.

 

This simple anecdote is actually seen many a time with GB students, and is a telling sign that for pain-free, foolproof strength and mobility development, the GB series is probably your best shot.

[Alessandro Mainente]

When my son took gymnastics lessons at a local studio, he was not taught proper progression and always ended up with pain. now he is using GB progressions, and has little to no pain or injury. Coincidence much? I think not.

 

This simple anecdote is actually seen many a time with GB students, and is a telling sign that for pain-free, foolproof strength and mobility development, the GB series is probably your best shot.

I think that what your son experimented is more connected to the technical aspect. train with kid and train with adults is completely different. for what is concerned with GST you can propose all the foundations exercises and rings one and handstand1 and 2 using a decent spot technique for the different elements.

On the other side during technique aspect if the coach does not have a proper preparation there is high risk of injury.

From my perspective during the last years, foundations is extremely productive if you have young kids because they learn body control and they become autonomous , at least for the conditioning part. I remember the first year I started to coach sometime was frustrating but now I can sit on the pommel horse and give them orders about stations, exercises, set, repetitions etc. they learned planche, front lever, back lever, muscle up, press to hs, I usually prefer more spotting work with very young kids especially with posture and alignment. this is the way I love to work. also if you have talented kid all the things come easier.

[Florian Rebitzki]

The wrist exercises in Handstand 1 completely resolved my golfer's elbow

This applies to me as well. The explanation simply is that my forearm muscles were too weak for the load I was putting on them. So they remained always cramped and shortened thus pulling on the tendon insertions thus causing tendonitis. Well trained muscles though are able to relax after usage thus remove tension off the tendons thus allowing tendonitis to heal.