Poor elbow health and stretching?

[Azz]

Hi

 

I am currently working through many of Kit's stretches in an attempt to correct years of mindless strength work and heal the many niggles that has come along with such a regime. I think that most of my issues will resolve with more mobility, however, I have one problem with my elbow that I'm not sure how to deal with and was hoping for some advise.

 

The problem is a clicking elbow on pushing movements, particularly dips, and worst on bench dips where your hands are behind you. It's not a painful click, but it does get sore after repeated popping; it really seems like something is catching? I didn't think this was a problem, but then I came across someone on the gymnastic bodies forum who has exactly the same issue as me and the (less than helpful!) reply from Christopher Sommer:

 

Hello!

 

For about a month now the joint on the inside of my left elbow has been popping with almost all pushing movements. The three exercises that make it act up the worse are dips, bodyweight triceps extensions, and pushups. It only pops on the negative portion of the rep, when, when my elbow forms a 90 degree angle. It is not an extremely painful popping, but rather uncomfortable. It happens on 90% of the reps. Is there a way to fix this, because it is rather uncomfortable and the elbow does become sore due to the repeated popping/snapping?

 

Thanks!

Sam

 

Sam,

 

- Excuse me for being direct, but it was quite foolish to continue these movements for a month when you were repeatedly experiencing elbow issues from performing them. 

 

- You will now need to rest the elbows for at least several weeks. There are no shortcuts. When imprudent decisions are made, there is no escaping the price that must be paid. Next time, check your ego at the door.

 

- Triceps extensions are a terrible exercise choice for someone with sensitive elbows; discontinue them immediately.

 

- Focus on building up to pain free pushups first. Then and only then should you proceed on to working dips.

 

Yours in Fitness,

Coach Sommer 

 

He gives no information on how to build up to pain-free push-ups! Anyway, I am wondering if this is a mobility problem, and if so, how does one go about trying to rectify it?

 

All the best,

Aaron

 

[Kit_L]

Hahahaha; that made me laugh. I agree about triceps extension, though; many many elbows have been hurt this way.

 

Re. pain-free push-ups: start here:

 

http://kitlaughlin.com/forums/index.php?/topic/643-livs-bodyline-sessions/?hl=bodyline

 

Might not look like much, but looks are deceiving: scapular stability is THE place to start. 60" in all the holds, when you can actually do this with all cues applied, will make you really strong.

 

One more thing: the first poster did not mentioned if there is any pain associated with the clicking itself, only the aftermath of the workout—if not (like my ankles or Olivia's knees) might not be a problem at all.

 

Start with bullet-proofing the shoulders with the Bodyline stuff, then—when you feel ready—begin your push-ups from the plank position and make sure you are actively pulling the scapulae down towards the hips and hold them there while you let the elbows bend. Re-check before even thinking about coming out of the bottom position. Thus cue (scapula depression) is essential for the other exercises too (dips, etc.). Not doing this sets the anterior capsule up for possible injury. And if you do not have mobile shoulders, consider the Master Shoulder Flexibility program; all the necessary material is there.

 

Wanted to add: elbow problems of most kinds have there genesis in the shoulders or wrists; this is because unlike shoulders or wrists, elbows only move in one plane. If shoulders or wrists are restricted in any way, the elbow takes the strain.

[Azz]

That's wonderful, thank you! I will keep you posted on my progress.

 

Can I just ask one more question though, please: you mention shoulder mobility; when I do attempt a bench dip with my lats engaged and scaps depressed as hard as possible, I cannot get anywhere near 90 degrees without releasing my lats and allowing the scaps to rise--in fact, my shoulders end up somewhere near my ears! What exactly is preventing this motion, is it the scaps themselves?

 

All the best,

Aaron 

[Craig]

Azz,

 

for this kind of flexibility in the shoulders, I highly recommend german hangs.  Keep the shoulders active and depressed, and over time open through the shoulders.  Gravity helps massively in this! Also recommend holding the bottom of a dip position for time (something I don't see many doing)

 

Let me know if this helps, remember it will take time

[Kit_L]

+1 what he said. What you report is exactly what happens, and it is the resulting anterior scapulae tilt that exposes the anterior capsule to injury. It is inflexibility (i.e., insufficient working ROM, not just the available length; the extension has to be controlled) in pec. minor. If the shoulder, while depressed, cannot move the way the movement demands, you lose the depression (lat. activation) as a direct consequence—the body has to get the movement somehow, if you make it do the movement (full dip).

 

The dip itself (if you rest your feet on something to take some of the weight) is an excellent mobiliser IF you only work in the ROM where scapulae depression can be maintained. This takes precision and awareness.

 

The German hang can be eased into the same way; this is how I learned it, on rings that were about shoulder height. As you loosen, lift the rings; this will takes months.

[Azz]

Thank you, both; I will definitely keep you informed of my progress.

 

One more thing I'd like to add though: it is my understanding that straight arm work, like the German hang, can put stress on the elbows, and so in light of my problem, is it a safe movement to do or is there proper form that will protect the elbows?

 

All the best,

Aaron

[SwissDanny]

Im on a journey to sort out this RoM too.  I find the German hangs too intense still, even supported, they just make me really internally rotate my shoulders (and presumably failing to depress scap) in "self defence".  I have found the single arm ring exercises in the shoulder master series a great ST style progression to be much less threatening.   Even then, I spent a couple of months with almost daily Yuri bands, dislocates and lying shoulder stretches before moving to those even.

[Azz]

Good to know, thanks!

 

May I ask what you mean by "internally rotate my shoulders"? Sorry if it's a dumb question, but I am very new to all this; the skin-the-cats I have tried in the past have always had my palms facing each other at the bottom of the movement as palms facing away put lots of pressure on my elbows. Also, is one supposed to keep scap depressed during a German hang? Is there a reliable video/description of this exercise so that I can test it safely and properly to see if it is too intense for me? I'm betting it will be!

 

All the best,

Aaron

[Craig]

Hi Aaron,

There are many ways to do the German hang. With palms facing backwards is definitely the most challenging and one you can work towards in the future.

At this stage the best thing for you to do is to do it in a way that does not feel compromising for the shoulder or elbow and SLOWLY explore with the different shoulder and hand positions, exploration that can take weeks or months. Put your feet on the ground to begin with as kit suggested and only take them off when you feel ready. When you find a challenging position work on that position until it no longer feels challenging, you can then find a new challenging position, deeper or with different shoulder or hand positioning.

MH

[Azz]

Thanks again; will keep you updated on my progress

 

All the best,

Aaron

[Ciaran]

Haha such a love/hate relationship with this forum. Just when I think I have a movement right I find out I've been doin it wrong! Time to go back a few dip progressions!

[Tones]

How is your rib and scapular relation?

[Richard Hamilton]

Aaron,

 

I hope you're making some progress since you posted four weeks ago. It's a shame people get responses like that, but it's standard fare at the GB forum these days. It's no wonder people give up on their health and fitness goals so readily when they're met with negativity like that. Suggesting that Sam, the previous poster needs several weeks off and is unable to make careful choices reinforces anxiety they may have already had about pressing and feeds dysfunctional movement. This approach to working with people belongs in The Stone Age.

 

I had (and still have, occasionally) a similar experience to you regarding elbow clicking, I think I posted about it elsewhere on the ST forums ages ago. Don't worry about it too much, it is what it is, a signal. Try focussing on what pressing you can do without the clicking and what you feel rather than how may reps and sets you've done. You'll probably notice improvements by engaging the lat as suggested but be aware that as you fatigue your body will try and revert to an existing movement pattern to get the work done; it's efficient like that.

 

Kit's comment about elbow issues being born in the hand and shoulder are right on the money and this is exactly the experience I've had; with hindsight, I had dominant upper traps and was lacking lat activation. When starting incline press-ups my left elbow constantly clicked, by the time I got to 5x12 the clicking had stopped in the first 6 or 7 reps, so I tried to hone in on what I was doing differently, went back to 5x6 and rebuilt until I had 5x15 with no clicking. I use incline press-ups during a warm-up now but still get some clicking during the negative phase, though it's intermittent and dependent on how well rested/recovered I am. Regular press-ups seem to be less problematic, and I'm yet to start on dipping movements. 

 

I can't add a lot to the advice Kit and Craig gave you, it's spot on; I'd suggest going easy with German hangs, though. If your shoulders or elbows feel compromised in that position, take a look at the prone pec minor, and bicep stretches along with the partner stick stretch into extension. Other than that, keep at it and you'll make improvements.

 

BTW Kit, the new website looks great.

[Kit_L]

@ Richard; great to see you here. Re. the new site: thanks to Miss O: the look is 100% hers.

 

@ the OP: I had forgotten the one-arm hang, even though a bunch of is worked on it for a long time. The OAH will literally realign every tissue involved in the hanging movement. Use two arm version, then one arm with some leg support until you can really hang, and hang completely relaxed, in time. Takes real grip strength, too.

 

Re. German hang: what SD mentions is spot on; if you do not have the active under load ROM, the body will have to protect itself and it does just that, by internally rotating shoulders, usually. In time though, everyone can learn to do this movement. The ways in to the full movement are all the pec. minor stretches including the OAH, and the floor biceps stretch (this is a half-German hang, in position, without the traction).

 

Using as much support from the legs you need is the way to explore this safely.