Understanding Climber's Elbow
When it comes to elbows, force vectors matter.
Maybe you learned in school that tendons attach muscles to bones across a joint, and that's it. Perhaps you've heard that tendons are made of collagen, and you need collagen and loading to keep them healthy? All these are good things, but there is more.
"It's a mathematical term, represented by an arrow with both direction and magnitude!" ...... VECTOR!
I like teaching my clients that tendons are made of dense regular connective tissue. Dense refers to the tightly-packed proteins, and regular refers to their directionality or VECTORS!
In addition, the tendon is not a homogenous tissue. Instead, the tendon at its muscle attachment is more "plastic" like the muscle (health portion as defined by Dr. Barr), and the tendon at its bony attachment is more "rigid", like the bone.
The transition between the tendon proper and the bone is called the enthesis. This tissue is slightly different from either the tendon or the bone and is essential for reducing tendon injuries. It's a type of fibrocartilage designed to offer protection against compression and shear stress. It is commonly considered the location of much tendon pathology, especially with chronic non-loading of the tissue.
what that looks like for climber’s elbow
Climbers elbow describes front sided elbow pain. In my opinion, it's a consequence of too much full range loading at the elbow.
If you consider the vectors of the tendons, how the muscle gets strong quickly (blood flow/nerves), and the shear stress, this should make sense.
In the image below are the most common muscle implicated with climbers elbow. All three are used while climbing, but the brachialis is most suspect with climbers elbow. It's the primary elbow flexor with the palms facing away from the face.
So, what can we do? There are lots of options:
Vary your pull training.
Use drop sets, cluster sets, power cut-offs.
Don't be a zealot for the "full range or bust" mentality.
Warmup the elbow tendons off the wall first (more tendon sliding).
Use isometrics as an alternative during your strength phase.
Do less overall pull training? You're probably pretty good at it already.
Key takeaways:
It’s about vectors. Science!
Too much full range loading at the elbow can cause climber’s elbow.
You can easily modify training to help with the pain.