10 ways to overcome Elbow Tendonosis - Golfer's Elbow

and this vlog I'm gonna talk about 10 ways to prevent or overcome elbow tendonosis a very common injury for climbers just at the weekend there I was doing an interview 400 McFarland's channel he has a great YouTube channel talking about lots of aspects about training for climbing and because andrew was aware of my big on climbing injuries make a break he traveled up to to interview me on Andrews Channel he deals a lot with his own progress and claiming trying to move from there kind of med grades and climbing up towards the upper grades especially in bouldering and he is obviously worried about the prospect of injury injury is something that affects nearly all climbers at some point in their career and often it can be the deciding factor in your success that's actually why when I wrote make a break and the subtitle was don't let climbing injuries dictate your success because often it really does I will light into the interview that I did with Andrew and recommend that you you follow his channel and likewise if some of you have come from Andrews channel then please do subscribe to my channel and hit the notifications bill to make sure you see my new videos I regularly publish videos and we'll keep doing that on all aspects of training and improving it claiming that's why I love doing in the interview with Andrew we spoke very generally about injury and injury prevention and the basic principles of taking care of your body as an athlete and and making it last and all of those general principles I go through in my book make a break and I thought it would be nice to complement that interview by going into something a bit more specific and they interview with Andrew we went into a little bit of detail on finger injuries specifically pulley injuries and over say there's a whole section on that whole chapter on that and and make a break and but one of the things that we didn't really get into was elbow injuries in in detail they I went through a period of around five to seven years really five years of really suffering badly but with golfer's elbow as tendinosis of the common flexor tendon on the inside of the elbow and in both elbows and I also had some tennis elbow as well and it really bladed my claiming for several years and and so I thought would be nice to do going into the detail of my story around my progress through that journey of being injured and and recovering from it and I'll go through some specific concrete things that you can do both to prevent that injury and also to manage it and treat it and resolve it and that's actually the first point that I want to make if you have already got go for the elbow and you know for most people it's a very troublesome injury and it's very reluctant to clear completely and so the first thing I want to say is it is possible to resolve this injury I thought for several years that I would be suffering from golfer's elbow for the rest of my climbing career and as long as I was climbing it would keep coming back because nothing I seem to be doing seem to make any significant impact on it it just stayed the same or gradually got worse or extended to other tendons on my elbows but now I'm at the age of 41 and I have not had any symptoms and golfer's elbow for three years and I never even think abot my elbows even to this day when I do a deep walk off when I'm you know especially on an a sax where I'm placing gear or something like that and I don't even think about my elbows there's just no pain at all and and they're completely 100% better and so that's the first messages that you can get over this if you do everything right before I first got elbow tendinosis I was terrified of it I in my 20s as I observed other peers who I talked to in claiming some of the best climbers in Scotland who I would see at the cracks or in climbing wall and I still moved into their 30s and 40s one by one I watched them get this injury and I was terrified of it because it seemed to be the kind of Grim Reaper of your climbing career you would see these climbers come in and they were fat and strong and they've done a lot of hard rips and then you wouldn't see them for a few years and then you suddenly see them at an event or maybe at the climbing wall and they look totally different the the fet strong healthy athlete that you remember from a few years ago had moved on to a much older less fit with muscled climber that just looked just looked older old and not able to perform and you see how you doing and didn't say well okay but I'm not climbing much these days I've had this terrible go for sale bow and I just can't clean it and when I saw multiple climbers experience this problem I thought goodness I hope I never get that injury and so when at the age of 28 I first noticed in my right elbow I was dismayed and I thought I must get on top of this but nothing I seem to do made any difference I tried resting it stretching it and all of the substandard treatments which included things like taking anti-inflammatories from my basic sports medicine textbooks out 13 and none of that made any difference and a year later I think got another elbow and for two or three years it just got steadily worse no matter what I did they that first appearance of golfer's elbow started in the late 2008 when I was climbing really really well and it wasn't till about four years later when I was at a point of despair with this injury and I started to make some moves that finally led towards me resolving it for four years I avoided training really I I claimed and but I didn't really train properly then I stoped fingerboarding I stopped doing basic physical training I claimed a lot of hard fried slabs and all that was quite good fun but it wasn't what I was really wanting to be doing I hoped that by stepping back and the intensity of my training would give the tendon a chance to recover so I was told and approaching it with a this tendon needs rest mentality and and after four years I realized that that had failed in fact the tendon was just worse I also tried resting completely for a while and that didn't work either so after four years I got to this stage of thinking I need to really lean into this problem and attack it properly and it was through my own research that and I started to make some progress and that's why I decided to write this big because what I was finding in the research some of it was very detailed complex nuanced concepts that would need a fair bit of explanation and some of it was brain dead simple we have exercises super simple stuff that was just information that was in the research literature that wasn't getting out there to claim us and you know I didn't know about it and I could see that it could make a huge difference and it started to make a difference to my elbows and so that's why how I ended up rating Monica break I think it's fair to say that in previous decades there's been a strong focus in sports medicine on treating the symptoms of injury and that that has steadily moved on to looking at the root causes of injury and trying to address those and remove those in order that both injuries can be prevented but also treated so much of the ten things that I'm about to go through are relevant to both prevention and treatment now I guess that a lot of people who don't yet have gone for his elbow will not watch this video and I made this appeal in the book as well to say that you know prevention should be this sort of core strategy for any responsible athlete looking after their body and once you get an injury it's not too late but it would have been better if you had addressed these issues sooner so I would say that the first five points really quite strongly to prevention but also treatment and the second five points are more focused on once you have the injury so let's get into them point number one is take ownership over the injury this injury is about slower onset degeneration of the quality of the tissue itself it follows that there's something or a number of things in your routine or your environment that are causing that tendency to t generate and many are or potentially all of those are modifiable risk factors then you can do something about it now there are some headline piketty's that are common to many people and we'll go through them in a second and but there are also some individual factors that you know there's always a balance of all these different separate strands of inputs to injury and it's your job to try and figure a which ones are relevant to you I think it's fair to say that no one medical practitioner even if they are very very highly qualified and expert in their field are able to deal with that whole aspect you me and your journey through recovering from this injury see orthopedic surgeons who are very experienced at treating the symptoms of the century but they may not understand the the nuance and subtlety of how this injury could arise through training errors in a sport like climbing because they don't claim similar you may have a climbing coach who may be able to point out some obvious errors in your technique or your training set up and that may contribute to the injury but they may not know the intricacies of how to deal with symptoms once you have the injury so there are all these different strands and really you have to be the manager of all those things and that's something that I go into detail on and make a break is how to manage your interaction with medical staff just to give one example of that I have a whole section on how to manage your visit to the doctor or specialist that you're going to see to either for diagnosis or treatment of your injury sometimes doctors can be fantastic at and offering you the treatments that they are able to offer you that's great that's what you should do but one aspect that I drew attention to in make a break was that and medical staff really go through with you who else you should be seeing what other strands that they are no expert in but maybe they would suggest that you follow up on and that is they may not see what is your claim in court to see what is your physiotherapist see all these different things that role of managing it falls to you and you should take ownership over that point to is to be strong to strengthen the whole of reporting and actually your whole body generally one other thing that is queer in the research or in risk factors for injury is that just pure physical strength protects against injury the exact reasons for this are no actually a hundred percent resolved but logically if you're stronger then you're less likely to exceed the breaking strength of your tissue and therefore that may lower your engine you're also maybe more resilient to correcting a movement error or a technical error which made a weak to an injury both a macro acute ear but also the small micro tears that accumulate from from day to day and your training so as a general rule for a climber a comprehensive routine of strengthening your entire upper body and as I generally prudent idea for both prevention and also treatment of golfer's elbow once you have it from the available research is not really possible to identify single exercises that are the highest priority it's just very difficult and studies that teaser the signal from the noise with these things one of the concepts has been put forward in the medical literature relates to weakness further up and the kinetic chain in the core the shoulder and upper arm then forcing more force onto more distal areas of the body so in practice that means that if you have a weak shoulder you have less control over your movements and therefore the rest flexor that attaches to that common flexor tendon has to absorb more of the force and therefore because is more vulnerable to being overstressed I think it's fair to say that this concept has not been adequately tested yet but it is plausible and it does also Tolly was my own anecdotal experience once I got golfer's elbow as I said I tried to back off from from hard physical training I stopped doing fingerboarding I stopped doing rings or weights or basic body exercises and just at climbing with the idea that that would that would rest that tendon and that that correlated with the tendon injury becoming worse and not better and actually after several years of having the injury I have reached a point where I felt like I had nothing to lose and I started to experiment with doing the opposite and actually I started to fingerboard more and do basic body strength exercises more than I had been doing previously and that correlated with the injury improving so I started to reintegrate a program of basic pull-ups and push-ups floor exercises like plank rings exercises like front weaver fly's skin the cat all these basic exercises and also tango boarding and also things like fit off bothering for sex or of a fashion tuning technique which is very effective point three is to develop awareness and then once you develop that awareness don't ignore it so what kind of awareness and I talking about a key skill for any athlete is to develop an awareness of the recovery state from I wrote to our day to day months and months how do you feel when you wake up in the morning do you have a feeling of soreness sluggishness tiredness and do you note aches and pains and your muscles and slowness and your and your movements and or do you notice the opposite a feeling of and you're ready to train and you feel like you have lots of energy you feel like your movements are fast and controlled this is a subtle difficult to quantify aspect of your readiness to train and state of general health but it's very very important medical staff the zero whatis universally recognized that although this aspect is very difficult to measure it's very important and it's a good measure so if you wake up in the morning or if you start to warm up for your training session and you don't really feel very good you feel sore tired then that may inform your adjustments for that day to the actual training world that you do potentially doing less or doing but does look there's there's several variables you can manipulate with your training you can manipulate your intensity or your volume so you could do still the same intensity of exercise but just less orbit or you could do less intensity but increase the volume or you could you know switch focus and do an endurance session instead of a strength session if you don't feel sharp when you don't feel good there are all these things you can manipulate but underlying that is basic awareness of how you feel and also when it comes to injury itself an awareness of of pain and the tapes of pain is absolutely critical I noticed from discussions with many athletes over the years that different athletes are much better than others are describing the pain from an injury and how it changes I wouldn't go into all the intricacies of the side I have later and make a break but there are many different types of pain I'm sure you recognize this the basic concept and that can help to inform you about the level of acute inflammation the virus's underlying damage you will not know this for sure it may not be a very objective measure but again it's a useful measure in the particular case of golfer's elbow which is a degenerative injury and it may not be advisable to only go to the limit of pin in your rehab or your normal claiming and it may actually be advisable to tolerate some mild level of pain during these activities and that is because there's a fundamental difference between an acute tearing of tissue and that slow onset injury and golfer's elbow or any slow onset degeneration there is an growth of blood vessels and nerves into the tendon which should normally have not much blood vessels and very few nerves so the tendon becomes much more sensitive and becomes much more pain sensitive so activities which are not necessarily causing additional rapid damage to the tendon and may cause some pain now that's not to say that you shouldn't even or open by any means I am definitely not saying that but there is evidence that doing rehab exercises that provoke a mild level of pain as acceptable and does lead to healing perhaps because the tendon is so sensitive that almost doing anything causes it something and that may be a better measure to track would be the directionality of the pain is it getting worse or better that might tell you more than the actual level of the pin point number four is don't stop moving one of the courts of Seneca Break comes from very prolific tendon researcher called Joel kook and the court was tendons don't like rest or change and I really loved that quote in a sense it's like a one-line summary of what my vicar's as all day fundamentally the human body is designed to move everything we know this from training everything about adaptation to training is about responding to movement or responding to lack of movement and what happens when you stop training you get weaker and this is true for tendons as well so rested tendons become weaker they become less resilient so we are trying to avoid periods of less and tense activity wherever possible both end prevention and/or school and treatment a key question in the space is why our tendon injuries so common despite our knowledge of training and our facilities to Train why why are we not making an impact on the incidence of of tendon injuries and really I think a prime suspect for the cause of that problem is our Western lifestyles which involve a lot of time not living at all they also have a lot of periods of inactivity because our lives are so busy with so many things going on so that can be very busy peers with work or family or injury itself and those periods of inactivity are really really bad for the body's health and specifically tendon health and strength so before you get an injury like gophers elbow then it's important to try and maintain a steady level of of claiming or training activity with as few breaks as possible now that's not to say that rest is no important rest is critical I'll come to that in a minute and this is also true once you have an injury if you think of the injured tendon and golfer's elbow when I had my own tendon scan with ultrasound to look for the areas of damage what became clear to me which I already knew from looking at the research was that the area of damage was actually a fairly very small part of the total tendon cross-sectional area that as almost all of the tendon more than 90 percent of it was completely healthy and it was only a very small area of damage that was causing all this pin it felt to me subjectively like the tendon must be very badly damaged and that is true when you look some tendons and pusher are badly injured but in in a lot of cases there's a lot of healthy tissue there and so resting the damaged area causes the healthy area to become pure in its tissue quality and more vulnerable to injury so in recovering from injury we are walking this lane between not exceeding the capacity of the damaged area to tolerate Lord and with avoiding a trophy in the healthy tissue so that's why as a general rule and sports medicine after an injury has been has occurred or has been treated even surgically rehab programs are starting earlier and becoming more aggressive than was previously done in previous decades where more rest was advised however all of that is not to say that rest is not important rest as absolutely critical most things in biology don't work as being either the on-state or the off-state is good usually fluctuations are key in many aspects of human health and physiology if you can think of things like wakefulness and sleep exercise and rest and in the case of injury that would be rehab exercises and rest there's quite a strong focus in the discourse in sports medicine on the amount of rest but I think a more important factor may be the quality of that rest so as your sleep quality given off and also long enough and as your nutrition good enough and I will come to that a bit later on there is also one point I'd like to bring up about training which is that sometimes you don't nor would never be able to identify what the key causative agent and your training routine or climbing routine may be this helping to make an injury worse so and maybe that if you just have a change of scenery and just do something else that you may find that your injury certainly improves you will never know why because it's extremely difficult to tease out the different causes and that may be important and but just having that change of scenery is enough there is a fair bit of trial and error any rehab program and that may be one thing is worth trying as just a total change of scenery change of climbing wall and a change of your training routine and ordering something but it's really quite different I could be just doing a different claiming discipline like if you're focused on sport climbing and bouldering maybe get a good team to do a season of winter climbing or a season of trad climbing or something like that or it could be something much smaller like just making a small change in the order of your training sessions or the amount of rest is you have maybe it's better to try and spreading your training into smaller sessions on on more days or maybe doing the opposite it's very difficult to know what would make the difference but the important point is to try but the overall goal here is to rest professionally have top quality sleep have top quality nutrition and and reduce the amount of total stress load that's in your life in order that you have room to recover from the injury you have and what follows from that is point number six which is respect your circadian rhythm there is more and more research coming out all the time showing really quite profound and amazing effects of just increasing the quality or the duration of your sleep or other aspects of circadian rhythm regulation that help to improve the quality of your sleep such as tain instructed feeding or manipulating the amount of blue light or the duration of blue light that you're exposed to during the day and all of this helps to turn on wakefulness and maximize wakefulness in the morning that is to have and a good high-quality breakfast and to see a door bright blue white in the morning and then in the evening to have your last meal I was over earlier to give yourself some time to start digesting before you go to bed and also to minimize your exposure to blue light in the evening this is really really tough and an error modern environment especially if you live in a city and there's a lot of weight pollution this is just all over the place and that's actually one of the reasons why I like to live in the mountains and when I first moved away from the city to the mountains I noticed that the effect immediately but still like everyone else I use a lot of screens I make sure that I have a blue white filter on my computer I also have my blue light blocking classes they look really really silly but they do work everything turns orange and you're filtering out the blue light and that helps you to make enough melatonin to get to sleep quickly and have a good quality sleep almost anywhere you look in the medical literature whether that be things like cancer occurrence or recurrence whether that be muscle growth or muscle retention whether that be recovery from a whole host of different diseases but also some research doesn't appear in the sports medical literature today with recovering from sports injuries that maintaining a good proper circadian rhythm with a good weight fullness during the day and good rest relaxation and sleep during the night is absolutely key I sleep is the best performance-enhancing drug that's ever been invented don't underestimate it point seven is to keep training in fact possibly two more the key piece of learning that I had from my own journey with with golfer's elbow was that backing off from my total volume and intensity of physical training had that the officer felt that I was looking for it correlated with the injury getting worse I can't say for sure whether that was causation or not but it could be as I was reaching the point of desperation to find some better answers on what to do is my rehab I actually went to see a couple of the most prominent researchers in the field it took a fair bit of work and also a bit of expense to get myself in front of them but it was more than worth it I was religiously doing my rehab exercises according to the protocols that were developed and the research papers that those researchers had published and I'm thinking of people like hack and Alfredson and Nicola Murphy and and I actually went to see both of them I could see that there was some different to cause being used in the literature for the rehab exercises some people were saying to three sets of 15 reps in a day some some people were saying did dub OVA or Tripoli and I wasn't sure what to make of it and so I was aware that sometimes having a face-to-face discussion with the researcher can give you a more nuanced opinion or also and their experience their clinical experience of treating patients that has not yet made it to the research and when I went to see those two researchers they both said the same thing which was incredibly useful which was to do the same exercises that I was doing but to do much more of them in fact to do them 180 reps of my eccentric so I'll come to in a second and and do that seven days a week and not have any days off because what I was doing was um I was doing the exercises they were causing the elbow to become more painful and because I still had that hardwired in my brain that pain equals you're going too far which does not apply in the same way to this type of tendon injury that I was backing off and and I just kept going back to square one and it wasn't working and when I started to push through that and and carry on with the Assizes despite some mild pain then I started to see some progress and also when I started to incorporate more basic strains work and and again I was told I think a water birth pain so I started to do things like pill box full of bouldering rings floor exercises and I did see some pain in my elbows at first for the first maybe six to 12 weeks but then I did start to see some improvement I could feel that I was moving the needle so that follows to point number eight which is to do heavy resistance training all the time and make a break I detailed the rehab exercises that are commonly used as a protocol for golfer's elbow or tennis elbow rehab and in the literature I also included a discussion of the available scientific literature that was there which and the reason I did that in such detail which because there is not complete agreement on what's the best protocol and maker Britt was published in 2014 and since then a number of other papers have come out and the field has shifted slightly but the same theme appliance that the data appears inconclusive so at the time of rating maker break eccentric contractions where the gold standard exercise for improving tendonosis of golfer's elbow but also other tendonosis and other tendons in the body in the case of golfer's elbow that would be to lift the weight was and add I have a dumbbell in your hand left the way to remove the concentric that is the muscle shortening phase of the exercise and then and then release it so the this under tension and then all lengthen the muscle and tendon under the tension as the weight drops back down and then lift back up to the start again so you're taking out that concentric part and focusing on the eccentric lengthening of the of the tendon and the muscle it's actually a great story of hay hacking elphinston discovered this in this protocol I will link to an interview on the British Journal of Sports Medicine website where he details how he actually stumbled upon this as a potential treatment he was a runner and as he was training as an orthopedic surgeon and he was suffering from achilles tendinosis as many runners - and and he was also learning to perform surgery on ruptured Achilles tendons the Achilles is particularly prone to rupture where the whereas their common flexor tendon doesn't really rupture very often at all and and he was unable to recover from the elbow from the Achilles tendinosis and and he was treating these runners with ruptures and seeing them returned to their running and yet he was unable to return to running so he had this idea that if his tendon with only rupture he could get the same surgery and then potentially recover like like his patients and and so he was trying to encourage his his professor he was tutoring him in surgery to perform the surgery and he said no I'm not going to do that you haven't ruptured a tendon so he actually did and the very heavy rewards eccentric contractions to try and stretch the tendon underlord to the point four it would rupture and this and and then he could have this surgery a classic athletes intervention it doesn't matter how extreme as I'm going to try it but to his surprise the tendon recovered on its own so he started to do some early research studies looking at this first and Achilles and then in elbows and and other tendons and there was some quite good evidence that it that it makes a difference the reason why it makes a difference is still not completely understood but it may be that that eccentric stretching of the tendon allows the damaged area to finally achieve some tensile would and the direction of the fibers and then start to adapt to become normal normal tendon tissue again know since 2014 there has been some other papers that have come out looking at isometric contractions now you can think of an isometric contraction just means that the muscle is not moving who else Underwood's so the classic cases up your fingers holding on to your hold you contract the fingers and then the muscle is not moving it's the fingers are not lengthening and closing they're just staying still so heavy load isometrics have also had some evidence of efficacy for treating tendonosis but it's fair to say in the past five years that the evidence on this has been mixed it is still unclear what the best protocol is so what should a claim our suffering from golfer's elbow right now do well I don't know the answer to that but I can tell you what I would do which is possibly to cover my bases and to both types of exercise in fact all types of exercise so I think the key aspect seems to be heavy wood and and also the frequency with which the award is applied so that would be daily exercise of quite high volume and quite higher would they possibly as a matter of prudence you could do both the concentric slow eccentric and isometric holds of of the resistance that you're using I don't know if that is best but it's the best available evidence we have right now a further point on this that's a bit more nuanced if you see research like this that's being done looking at all these different protocols for rehab and they all work for some degree but they're all much about muchness it seems unclear what she's really if any is really better this is a very challenging thing to interpret what should you do there is a number of possibilities it could be that eccentric contraction is best or isometric contraction is best but it's simply that those studies that have been done are not sufficiently powered they're not big enough or well designed enough to actually see the signal and the noise of the data that they're collecting so it may be that there is an effect but the studies have have just not shown it yet it's also plausible that these studies are essentially looking in the wrong place if you like and that the the mode of exercise does not really matter that much and the what matters may be something completely different so I think that's something to keep in mind and I always think the zoom a and continue to search for other things that work and that comes to point nine which is if it's not working keep looking for something else and keep changing and switching up the routines one of the things that I really noticed as I started to look through the whole of the physiotherapy research and tendon recovery research and basic tendon pathology as I was researching make a break was the weakness of a lot of the data there's a there's a lot in sports medicine that is unclear and we just don't really know that's not to say we should ignore the available data but it certainly doesn't tell us everything we need to know or tell the whole story or not even close and so I think when you're dealing with an injury rate may be that you have to try and recover from then trial and error still plays a really important role I think educated trial and error is the best way forward really and an ideally working with a range of other people who maybe have different perspectives or opinions on on on what what may be the best path when we have difficulty with this though as that slow onset tangent tendon injuries are slow to recover and so if you make an intervention if you change the rehab program and I won't we have to give it to to tell whether it's worked or not six weeks 12 weeks a year these are a long period to take a gamble and that's why I think you come back to that developing awareness develop a sensitivity to Harry the tendon is just responding in order to heal there has to be inflammation caused you almost certainly with any activity and you will have a short-term increase in pain and hopefully that's followed by a decrease the pain level may shift and change and I think it's critical to try and develop our really nuanced awareness of how you did the injury overall is progressing it's progressing that is a really challenging thing to do and a challenging thing to be objective but but but what else can you do but try so don't stop striving to optimize revisit and revise your rehab program according to how well intervention is working if it's not making much progress over significant timing you may have to give it time to really to really know then change it to something else and that was my whole experience so everything that I went and my research for making break and I was it I was able to make significant progress with my elbow tendinosis to the point where by 2016 I was back to normal training and essentially the injuries were not dictating my training or a climbing level to any measurable degree however the pain never went away completely and I did feel at the time that that was just an editable that those tendons were were old battle-scarred damaged and that some some pain was inevitable it was very very mild but it was still there and I was so I was kind of worried that well if its toll they are it could get worse many people that follow me online may have already noticed that I developed quite strong interest in nutrition because well changing my diet quite quite radically for a completely different purpose into my body composition I noticed that my general health in fact all aspects of my general health improved and one of those was my elbow tendons by the end of 2016 in the months after I made my quite traumatic diet changes my elbow tendonosis completely disappeared for the first time in over six years now I cannot see and will never know whether there was the diet changes or something else completely that caused the change and but a strong piece of evidence that it may have been related to it was that all of my health problems all and it moved significantly in a portent direction all at the same time so I mean I'm unsure how to how to view this perhaps you can view it as being like the kind of final piece of the jigsaw puzzle that I had all these other ingredients in place and this was one that I finally got on top of and it got me the last little bit to being fully healed another way to look at it could be that that was the problem all along and had I made that change earlier then perhaps all of the other stuff may not have been so necessary or even not necessary at all I don't know that for sure and I think maybe with decades before even longer than that before research actually answers that question definitively but nonetheless that brings me to the last point point 10 which is that your tendons are made of what goes in your mails essentially what any rehab activity does is transduce the Lord that you apply to a tendon and use substrate that is actual raw materials for building tendon and use that to actually build new tissue so if that raw substrate coming in from your diet is not via the adaptation cannot happen and there is some good recent research showing that when you provide ample substrate for especially collagen synthesis which is strongly dictated by the availability of two amino acids glycine improving and also vitamin C that there is significantly improved collagen deposition and increase in tendon strength when that's combined with a rehab program as a result there is quite a strong movement in the supplement world including actually within claiming and to promote the collagen as as an actual supplement I do not consume collagen supplement myself and I don't really see the need to and for for one quite simple reason which is that I prefer to get all of my nutrients from real food because as a general rule and obviously nutrition is an incredibly complex area the often the execution of it can be quite simple as a general rule a few whole foods which are generally healthy then you have availability of all the right nutrients and the right balance the only question remaining is what constitutes healthy food and that is an area of considerable controversy and debate but in brief I can tell you that and I make sure that I eat a lot of meat especially meat on the bone and other animal products and the reason for that is because the bioavailability of those basic amino acids likewise in improving but also all the other ones which must be consumed in balance are all there and all of the other micronutrients are all there also you might wonder what about the vitamin C well I do also consume some of the low sugar fruits things like peppers berries like anything but also I also eat some organ meats which contain vitamin C and the dietary pattern that I follow me or may not another matter of controversy it may were just the requirement for vitamin C for other metabolic purposes freeing up more vitamin C for collagen and tendon health I do not know if that's true or not true however I am trying to find an explanation for why my change in diet seemed to him promotes improved recovery and pre-existing injury that I have and those injuries just disappeared so I hope this video has been a nice complement to the interview that I did with Andrew which very much focus on general concepts and and showed you how you may dive into the details for one specific injury and and I will do future vlogs looking at other end but I really encourage people before they get injured to read make a break because prevention is really the cornerstone of remaining healthy and improving your climbing that you won't see future videos from me on this topic please do subscribe and hit the notifications bail to make sure you see them and I'll see you in the next video [Music]

Channel: Dave MacLeod

Views: 77,020

Rating: 4.9530845 out of 5

Keywords: climbing, rock climbing, bouldering, climbing injuries, injuries, golfers elbow, tennis elbow, elbow injuries, tendinitis, tendonosis, andrew macfarlane, climbing training, training for climbing

Id: _iMueqiCsVI

Length: 42min 43sec (2563 seconds)

Published: Fri Aug 02 2019

Reddit Comments

[u/crzylgs]

Here is a quick TL;DR but please watch the video because Dave is a fkn boss :)

1) Take ownership of the injury (8m10s)

2) Be strong. Strengthen (condition) body, esp upstream arm/shoulder. (10m36s)

3) Develop awareness. Note & listen to how your body feels. Adjust volume/intensity or session type accordingly. (13m27s)

4) Don't stop moving. Maintain steady level of fitness/activity without typical 'Western' prolonged sedentary tenancies (17m25s)

4.5) Difficulty of identifying causal factor. Sometimes change of routine/scenery can help. Trial and error methodology. (21m.32s)

5) Rest professionally. Top quality sleep, nutrition, reduce life stresses (22m56s)

6)Respect your circadian rhythm. Increase quality and duration of sleep. (23m16s)

7) Keep training. Possibly do more! (25m36s)

8) Do heavy resistance training all the time! Incl typical eccentric wrist curls with heavy load (some pain might be required) and high frequency (daily!) and possibly more modern evidence of isometrics. (28m21s)

9) If its not working, keep searching and try again however its tricky to decide timescale for each protocol. Lots of the data is weak/uncertain, such a nuanced issue. (34m24s)

10) Tendons are made from what goes into your mouth. Nutrition. Collagen synthesis from Glycine, Proline and Vit C (comments on the recent hype train for this) but he relies on mostly eats whole foods (39m05)

Edit: Reddit is good at formatting eh?

[u/crzylgs]

Awesome video, super informative. Potential addition to the wiki?

[u/saltesc]

I'd recommend his book, 9 out of 10 Climbers make the same mistakes.

I just got it and have almost finished it. At some points it's not written amazingly or there's sections that aren't relevant to me, but overall it's been an awesome read and changed my perspective and understanding on a lot of things.

Dude knows his stuff.

[u/de987man]

Thanks u/crzylgs for posting this, it's exactly what I needed. I just ordered his book and hopefully it can help with my upcoming rehabilitation. I particularly needed to hear the part about training more and powering through the pain. I'll let you know how it goes. Stay strong!

[u/[deleted]]

This is exactly what I need

[u/KSUzenmode]

Turmeric supplements with black pepper are a godsend for tendonitis

[u/KSUzenmode]

It's an anti inflammatory tool and there is plenty of research to support this claim