By: John Crawley, PT, DPT, OCS
Elbow pain is a common reason rock climbers in Boulder, Lafayette, and Longmont have to take an unwanted “forced rest” from the crag. Whether you’re projecting at The Spot, sessioning at BRC, or hitting the local Front Range sandstone, elbow issues can sideline even the strongest climbers.
The most frequent culprits are pain on the lateral (outside) or medial (inside) of the elbow. Below, we dive into the symptoms, causes, and evidence-based treatments to get you back on the wall.
Understanding Medial Epicondylalgia (Golfer’s Elbow)
Medial epicondylalgia—often called “Climber’s Elbow”—refers to pain on the inner side of the joint. It is typically a localized tendinopathy of the flexor carpi radialis, pronator teres, or flexor digitorum superficialis muscles.
These tendons attach to the medial epicondyle of the humerus and are essential for stabilizing your wrist and elbow while rock climbing. The tissues of the elbow can become irritated by a number of conditions:
- Repetitive Overuse: High-volume gym or outdoor sessions without adequate recovery.
- Poor Mechanics: “Chicken winging” or over-gripping on steep terrain.
- Muscle Imbalances: Having strong finger flexors but weak wrist stabilizers.
- Work Demands: Repeated gripping or typing during your 9-to-5.
The “Strength Gap” in Climbers
Many climbers possess elite finger strength but lack the underlying wrist stability required for high-intensity movement. When you hit a small crimp, a sloper, or a wide compression move, the demands on your wrist stabilizers can exceed their capacity, leading to the degenerative tissue changes we call tendinopathy.
Common Symptoms of Climber’s Elbow
If you are experiencing the following, you likely have medial epicondylalgia:
- Sharp or Aching Pain: Located specifically on the bony bump on the inside of the elbow.
- Tenderness: Soreness when touching the forearm muscles or the bone itself.
- Activity-Specific Pain: Symptoms flare up when using small crimps, slopers, or during heavy lifting. Often compression problems will be particularly painful.
- Daily Irritation: Pain during fine motor tasks or repetitive gripping throughout the day.
Evidence-Based Treatment for Climbers
The “wait and see” approach beyond a couple of months rarely works for active climbers. Current research shows that a combination of manual therapy and targeted exercise is the gold standard for recovery.
1. Manual Therapy
At our clinics in Boulder and Lafayette, we use specific techniques to desensitize the area and improve mobility, including:
- Dry Needling: To address muscle trigger points and reduce pain in the short term.
- Soft Tissue Massage: To improve blood flow and tissue extensibility.
- Joint Mobilization: To ensure the elbow is moving through its full range of motion and to modify pain.
2. Progressive Loading (The Key to Recovery)
The most critical component of long-term healing is a progressive loading program. This involves:
- Isometrics: Initial low-load holds to reduce pain. They can be progressed to high intensity to alter tendon quality.
- Eccentric/Concentric Loading: Gradually increasing weight to promote tissue regeneration and “reorganize” the damaged tendon.
- Shoulder & Wrist Stability: Strengthening the entire kinetic chain so your elbow doesn’t take the brunt of the force.
Get Back to the Crag with Mend
Don’t let elbow pain turn into a chronic issue. If you’re looking for expert physical therapy in Boulder or Lafayette the team at Mend is here to help. Our specialists understand the unique demands of climbing and will provide you with a diagnosis and a clear, evidence-based roadmap to recovery.
Click Here to schedule your next appointment with the experts at MEND