T Nation

Nagging Bicep/Elbow Injury


#1


Hi everyone,

I was hoping for some advice regarding a nagging injury/pain in my left bicep. I should add that I have seen both a doctor and a very competent physiotherapist regarding this pain: My doctor gave the usual 'rest it, its fine' speech. The physiotherapist did a few physical tests on me and said I haven't done any major damage, but I may have a very small tear or similar in my bicep, and I should lay off anything that's causing pain for weeks/months until it's better (it has been 2 months since this advice, which I have followed dilligently).

Now, a little about the injury. I have fairly bad pain in the area shown in the image (red arrow - bottom image) during the the very top position of chinups and pullups. See the top image for an example of the range of motion that causes pain when under tension.

Other stuff that occasionally hurts, but not as bad - usually when fatigued:

  • the hang position of chins/pullups (arms fully extended)
  • bottom of bicep curls
  • negative part of incline bench press
  • negative part of overhead press of any kind
  • overhead squats, after a few reps
  • bench press with a wider grip (close grip is fine)

deadlifts are ok, with a reasonable load (130-140 kilos hasn't brought on any arm pain whatsoever)

i have been 'training around' the pain for 2-3 months, not doing anything that brings it on, so no chinups etc. i've taken the opportunity to concentrate on legs/posterior chain, and recover from a knee surgery. however, the pain is still there, and doesn't seem to be getting any better.

sometimes when i wake up in the morning, the area feels a bit dodgy, but this usually goes away after 2-3 minutes (this seems to happen when i wake up with my arm in the awkward position - see top image)

it's worth mentioning that this pain appeared after a period of training where i was attempting to improve my ability to do chinups/pullups - this involved lots and lots of chinups/pullups, including adding weight to myself, and negatives. however, at no point did I experience any sudden pain during a gym session, eg a 'pop' / tear.

apologies in advance if i haven't given sufficient information - please feel free to ask more probing questions!

does anyone have any ideas as to what i may have done? having had 5 operations on my left knee due to an ACL recovery gone wrong, I am very very concerned that I've somehow done some damage to my upper body too!

Many thanks - any input would be greatly appreciated, as this is getting to be very frustrating.

A happy (and injury free) new year to all!

Best wishes
Jim


#2

Get some physical therapy. And stop doing straight bar curls.


#3

Did you read his post at all ?

Jim,
I've had inflamed elbows for 5 years now. They stay good most of the year, but every once in a while, when I'm making decent progress, something happens. Currently I have an overstretched nerve in the left one due to someone agressively twisting my arm behind my back.
While it's not the same, I do have some advice to offer you about elbow pain :

  • Be careful with stretching. Take it easy and don't overdo it. However, most of the times, forearm inflexibility causes an overdue stress on your brachialis muscle, which causes destabilisation of the elbow joint. So make sure your forearms are very flexible.

  • If it doesn't hurt, do it. You may know this already, but it applies greatly. You said you've been resting for 2 months now. That's plenty to heal any small injuries to the joint and tendons.
    Start building up exercise for your elbow(and forearms). Your recovery will speed up and scar tissue which possible causes the pain will decrease and be replaced by strong tissue.
    As long as you get blood in there, and work in a progressive manner, it's good.
    I like to do pushups and swimming. The pushups I start at a few a day, building up to 200 over the course of a day, perhaps in sets of 25.(of course it's possible to do more, but this is just to get the blood flowing and the scar tissue to break down faster)

  • Any total body activity will help too by the way. You'd be surprised how much running will affect the recovery of your elbow, simply because of the effect on your entire body.

  • Fish oil. Load up on it.

  • Easy on the carbs. Carbs cause inflammation, and I feel it in my joints when I'm high-carbing my way through training.

  • Ice helps, but only if there really is a swelling. After training I'd use ice, the rest of the day I'd keep your elbow warm.

I know it's a pain in the ass to not being able to train properly, and I admire you for being able to go 2 months without, but keep your chin up.
It'll get better.


#4

Like stated before, load up on the fish oil. Also, ice it whenever possible. I have a nagging shoulder pain and when I ice it whenever I have the chance (for a few hours after work, on for 20 minutes, off for 10), it seems to get better.


#5

There are common causes for the muscle in the bicep area to flex like a rubber band right where the bicep meets the fore arm. I don't think this is your injury. The injury I speak of usually happens after a bi workout, but could happen after pull-ups as well. The muscle flexs when performing basic functions such as putting shampoo on your head. The cause for this is a lack of potassium, in which you can supplement and easily fix.


#6

hey guys,

thanks for the advice - sorry it took me so long to reply. i'll give a quick update, then address the points others here have raised. so, how things are now:

  • the things i mentioned cause pain, still cause pain

  • ive noticed, if i flex my bicep and move it through it's full ROM, it feels kinda funky towards the top of the movement (like at the top of a curl - same position as the top picture of the 2 i posted) - like the bicep is moving slightly in the wrong direction? at least, compared to the other arm.

  • ive been doing very light bicep exercises. they dont hurt at all, but they dont seem to have helped.

i guess i'm worried that i have torn my bicep or something similarly bad? i'm very much feeling this is a bicep injury - the arrow in the first pic might be slightly out, having just done somethign to replicate pain i'm currently feeling it more towards the peak of my bicep, on the inside of the arm.

to address everyone elses points:

  • SlickID: I've raised my worries with a physiotherapist, and will be doing so again shortly. I don't do striaght bar curls - I haven't really done any direct bicep work for a long time, my upper body workouts revolve mainly around chins/pullups, bench, overhead press, rows, dips etc.

  • Leeuwer: you mention forearm flexibility. This is interesting, since I've previously struggled with front squats due to forearm flexibility. have you any links to stretching techniques you can recommend?

thanks again to everyone for the constructive feedback, hopefully some more folks might pick up on this thread with my latest reply.

yours frustatedly,
jim

ps: just to confound the frustration, i had an operation on my left knee yesterday - a surgical screw (from an old ACL repair) had drifted, and was touching my kneecap, so i had the screw removed. so i'm not walking so great either! sigh :slight_smile:


#7

This is a frustrating thing to go through, Im sure, but it sounds like you have overdone it on the chin-ups, and then possibly increased the damage by continuing to workout. It sounds like a possible partial tear, with a lot of inflammation.

It sounds like you need a good anti-inflammatory, like Flameout, and alot of time away from resistance training. Have you given any thought to swimming? It`s a great way to workout, without the pressure of weight bearing on a specific area. It will put blood to the painful area to help it heal without the unwanted strain. Just a thought.


#8

i've conceeded that i'm going to have to stay away from upper body training for a good while, and even some lower body (i don't think deadlifts will be the best idea??)

i figure i can still keep some resistance training: squats, good mornings, lunges (with bar), lower back and ab work.. i guess i can substitute upper body for cardio stuff, such as cycling, swimming, etc

if this is a partial tear, is that something that will heal on it's own, given appropriate rest time and care? i've been through so much crap with my knee (5 surgeries as of yesterday) that the thought of any more long term damage or surgical intervention makes me feel ill :o(

i'm guessing its not a full tear, since although they hurt a little, last time i checked, i was still able to do chinups?

thanks,
jim


#9

Sounds to me like an overuse injury, when you describe the pain coming on during a specialization period, while not feeling a traumatic damage. Probably then, tendonitis or tendonosis.

There was an article a while back about negatives helping the healing of tendons. Anecdotally, this has helped my triceps tendon (at the elbow), by doing push-ups with concentric focus on the healthy arm, and eccentric focus on the injured arm:
http://www.T-Nation.com/findArticle.do?article=body_114eex

You might want to try some negative curls with light-medium load, using the healthy arm to assist with the concentric movement. Good luck!


#10

ok, so far the plan is:

  • ice often
  • lots of fish oil
  • a strong anti inflammatory
  • lots of non-stressful activity to get blood into the area (swimming, possibly controlled eccentrics with low weight)
  • no upper body resistance training - even the stuff that doesn't hurt ***
  • divert gym attention towards lower body/midsection resistance training, and cardio

*** i figure anything involving a heavy weight and thus strain on the bicep could be preventing recovery??

does this sound like a good plan?

jim


#11

Yes