T Nation

Training and Joint Pain


#1

Im having some mild joint pain in my left knee and my right elbow. I was working out within the 8-10 rep range and now as im trying to lean out Im using heavier weights for 4-6 reps. Im consuming around 30gr of fish oil with a good ratio of epa and dha. The question is what else can I do to avoid a future injury while using heavier loads. Can I use any exercise for these body parts any drills ?


#2

Also interested as I am feeling pain in my left wrist and a little in the elbows and arm tendons.


#3

Thibs does not answer injury-related questions last time I checked. I am no Thibs and wouldn't consider myself an expert, but from personal experience I can tell you:

  1. If a move hurts, stop doing it or change your range of motion to where it doesn't hurt.
  2. Work your rotator cuff, wrists, etc.
  3. For elbows, use light weight and lots of reps on tricep pull downs to get your elbow ready for pressure. For me, I notice it helps stretch and relax the elbows as well.
  4. For the knees, warm up with leg extensions (light weight and lots of reps) to get your knees ready. Don't go too heavy too quickly on things one would normally train heavy like squats or leg press.
  5. Make sure your form is good!
  6. Make sure you're not using too much weight!
  7. Transition into going heavier.

Also, you're dieting and right now trying to go heavier. I don't know if this is based on science or any methodology, but I would get my body used to lifting heavy without dieting and then gradually go into the diet. Perhaps your energy is low.

I hope that helps you.


#4

Thanks Loui.s,

I found this on elbow care:

Elbow Care by Dr. Michael Hartle

Occasionally I receive letters from powerlifters and see questions/comments on the Internet regarding elbow pain. The squat and the bench press, to name two exercises, seem to be the most common exercises that increase the elbow pain. These lifters usually state that the pain has developed over a period of time, not happening suddenly. On the squat, it starts most frequently while setting up for the lift and during the performance of the lift and for a short time after. When it occurs during the bench press, the athletes state it usually starts approximately 4-5" off of the chest during the descent and gets worse right before and during the pause.

Unlike the knee, the elbow is able to rotate more than a few degrees either direction. This presents possible future trouble for the elbows of powerlifters. During the squat, the elbow is under a lot of stress as it must help the wrist and hand stabilize the bar on the lifter's shoulders. It is especially under a lot of stress when the athlete places the bar on their shoulders in typical powerlifter fashion - low. By placing the hand on the bar during the squat, one must pronate (turn away from you) the elbow/wrist in order to grip the bar. Doing this over a period of time can sometimes cause chronic elbow pain, usually helped by not squatting. Another cause of this elbow pain during the squat is I see many powerlifters that will push up against the bar while they are holding it on their shoulders. A lot of them do not know they are doing this. This activates the various muscles surrounding the elbow and when done often enough and with enough weight, it will eventually overuse these muscles. This will then lead to microtrauma (small tears in the muscle/tendon) which will eventually lead to formation of scar tissue and then the muscle will become weak and the athlete will develop pain and possibly numbness and tingling below their elbow due to peripheral nerve entrapments of the upper extremity.

During the bench press, the hands are placed in another pronated position, yet not quite as far when compared to the squat. The elbow flexors must help stabilize the bar during the descent phase of the bench. Again, done over a period of time this could possibly wreak havoc on the elbow joint. This is especially true if the injured athlete's elbow is repeatedly subjected to the main cause (for example, the bench) and then utilized later in the week (during the squat), reaggravating the problem.

The main elbow structures involved in this problem are the biceps brachii, the brachialis, the brachioradialis, pronator teres and sometimes the triceps. As powerlifters we cannot get away from the hand positions we must use during the lifts. Therefore other measures must be taken. If in pain and you have a meet coming up that you need to train for, try a light-medium wrap job on the affected elbow while training in the gym. This will take some stress off of the joint and not aggravate it as much. I donâ??t recommend doing this too often as oneâ??s body can develop a dependency on this support and when it comes time for the meet, it wonâ??t be there to help support you. A second measure one can take to either help rehabilitate or prevent future problems is to strengthen the elbow flexors to handle more stress. As powerlifters, we tend to concentrate on the triceps (elbow extensors) more as they are one of the primary movers during the bench press. We must make sure that the elbow flexors receive good quality exercise to keep them strong. This helps keep the muscle balance around the elbow intact and help prevents future joint problems.

Examples of exercises to do are dumbbell curls (there are many variations of these - either one will work), and barbell curls with either the straight bar or the E-Z curl bar. While doing these to help rehabilitate the elbow, one must do these exercises with light weight, high repetitions (10-20 repetitions) and do this at least 3 times per week. This will force blood and the various nutrients it carries into the muscle/tendon areas and help heal the problem. Stretching the elbow musculature will also help to prevent problems as well. Sometimes elbow pain can come from problems with the wrist and the associated wrist flexors/extensors. If none of the above ideas help, either write/call me or seek the proper medical/chiropractic attention in your area for further advice.


#5

And this on shoulder care:

Written by PTAaron

I was reading the August issue of Journal of Strength and Conditioning Research, and it had a few great research studies in it... but one I thought I would post here was related to bodybuilders and shoulder dysfunction... (if this is in the wrong place please move it)

A study was performed comparing 54 men (29 bodybuilders and 25 nonbodybuilders) between the ages of 21 and 34, looking at shoulder range of motion and strength values between the 2 groups. Basically the study found that the bodybuilders had statistically significant loss of shoulder internal rotation (basically this was tested with the Apply scratch test... you try to touch your hands together behind your back with one arm coming from above and the other from below) which is characteristic of shoulder joint pathology. Meaning that there may not necessarily be a problem there now, but there is more likely to be one in the future.

The study also found that the bodybuilders were on average stronger based on % of bodyweight with most shoulder movements EXCEPT muscle testing of the middle and lower trapezius muscles - 2 muscle VERY important to normal scapular movement. There was only a 1.2% difference in strength of these muscles between the bodybuilders and nonbodybuilders. This suggests that the weight training programs most follow leave them with imbalances that can potentially lead to shoulder joint dysfunction.

How to fix the problem and prevent it from happening to you: This is the easy part... first is stretch, and stretch often. Be sure you are warmed up before you stretch, and hold the stretches 15-30 seconds and do not do bouncing movements. To stretch for internal rotation - hold a towel in one hand above your head like you were going to do a one arm dumbell tricep extension, grab the towel behind your back with your other hand and pull up on it with the arm above your head until you feel a "medium" stretch.
Second thing to do is strengthen the lower traps and middle traps - this is very simple: Lower traps - you lie on a bench face down with your arms hanging down. Lift your arms up like you are Superman flying and hold for a count of 5, repeat for 3 sets of 10. Add weight slowly as it gets easier. Middle traps - lying on your stomach on a bench lift your arms out to the side with your thumbs up (like doing reverse flyes, only do it with low weight and squeeze your shoulder blades together at the top) - repeat 10 times for 3 sets. Work your way up to doing all of these exercises for 3-5 sets of 15-20 reps - the goal here isn't high weight it is high reps for endurance.

Internal and external rotation exercises with the elbow at your side and a towel roll in your armpit area (puts the muscles in a more advantagous position), the middle and lower trap exercises that I described above, pec stretching, and internal rotation stretching typically help.
It is always beneficial to be evaluated in person by a professional to determine if you have any joint capsule tightness that is causing abnormal movement, because this is relatively easy to correct as well - if the exercises and correcting muscle imbalances don't work.

Also don't forget the importance of ice... fill a paper cup with water, freeze it, then peel off enough of the paper on top to expose the ice while leaving you enough paper to hold on to... rub the ice over the area of pain with moderate pressure for 5-7 minutes, or until it is numb and bright red. Then using your index and middle finger on the other hand, press in to the tendons and rub across them with moderate pressure - this isn't going ot be comfortable - the idea is to irritate the area to speed healing (sounds backwards, but it is a proven technique). Try doing this every day, and you should notice an overall decrease in the irritation as well.


#6

Thanks guys !

In my case the issue is kind of weird, it hurts a bit when im warming up as I up the weight the pain stops so I want to know if there something I can do to fix this, I�´ve been training for 5 years and this is the first time im having joint pain... its very mild but i dont want it to turn in to an injury over time !


#7

Curcumin 500 and Flameout or high quality fish oils (which vary A LOT depending on what company's oils you use...)


#8

Im actually not taking curcumin, but Im trying to avoid relying too much on suplements as Im trying to find a solution not a quick fix. Regarding the fish oil Im using the one I cycle on and off with Flameout...this is the info:

Serving size: one teaspoon (5ml) I use 9 servings a day, when the pain started I upped the dose to 15. Im very sure you know which brand it has a great lemon flavor :P.

Omega 3 fatty acids: 1600mg
EPA: 800mg
DHA: 500mg
Other O3s: 300mg

What do you think ?