Author: Josh Martin
In part 1 of this 2-part series, we talked about the mechanisms behind the occurrence of elbow pain within CrossFit…or any other fitness regimen you might be following. Understanding how something occurs is the best course of action to prevent it from happening in the first place. But, we’re humans and stuff happens. And when it does, we need to be prepared to provide our bodies with the best course of action to get it back up to 100%.
(*Note: I am NOT, and would never pretend to be, a doctor of any sorts. If what I am telling you goes counter to what your doctor has told you, then you owe it to yourself to do your due diligence and take ownership of your own recovery to see what works best (for the LONG term) for your particular scenario. My advice stems from a career of more than 16 years of coaching every possible level of athlete, from the professional to the most novice. I’ve worked alongside plenty of MD’s, PT’s, and DC’s in that time. But I am also humble enough to stay in my lane and refer people to a doctor when something is above my head.)
As a quick reminder, in case you didn’t read the first part here, we are concerning ourselves with chronic pain – something that has developed over time. As opposed to an acute injury, like a broken elbow, in which case you should stop reading this and proceed directly to your closest doctor or ER!
When dealing with chronic injuries, the thing that you need to understand most is this: Be Patient.
An injury of this nature took a good bit of time to develop, and the recovery process is most likely going to be longer. Now, lets get right into it, how to fix yourself!
Step 1 – Rest: I prefer to see someone stop using (in an exercise sense) the injured area for at least two weeks. Now this comes with a gigantic caveat – if you’ve been working out for a few weeks (you know like when you ‘forget’ to mention anything to your coach?) through a good amount of pain, you probably need to double that and give the problematic area at least four weeks. Don’t fret, there is still plenty you can do!
Step 2 – Build Static Strength: Static meaning no movement. This gives your tendons a chance to catch up in strength to your muscles. It also allows for the development of the small intrinsic muscles that are responsible for stability. Since we are talking about elbow injuries, we’re looking at holds and carries. Think farmers carries, waiters walks, single and double arm, holds on the pull-up bar, etc. These are things that you can do every day, squeezed into your warm-ups, in between sets of weightlifting movements, or as part of your cool-down. As with anything, you want to start with something that is easy – not just from a weight standpoint, but also a time domain. Over time, you can increase the duration of movement and loading.
Step 3 – Build Dynamic Strength: Dynamic meaning movement. This is where you’ll start to rebuild the correct movement patterning for your body, so take time to move correctly – make sure that your good reps far outweigh any bad reps you may perform. Movements here include strict pull-ups, push-ups, strict dips (start with parallel bars, not rings). Change your grip between supinated (palms facing you) and pronated (palms facing away) to insert some variety and give your tendons different workloads. I would also recommend staying away from kipping movements for at least another 3-5 weeks after you have resumed normal movement. Why? Go back to part 1 and read the ways people get this movement wrong and cause themselves a problem in the first place. If you want to up the intensity of your pull-ups, do them weighted! I think its fairly obvious, but I feel the need to say it anyway – if a lack of technical ability is cause for you getting hurt in the first place, then be sure to shore that up too!
Step 4 – Take care of the gristle: When something is injured, scar tissue forms as part of the healing process. When you begin to reintroduce movement, there will be pain as the scar tissue breaks apart. This is normal. Taking some extra time to warm-up the recovering area, perform some self-massage, and compression band “flossing” (with the voodoo band) will go a long way toward furthering the recovery process. There are a TON of great resources on how to perform these things, but there is probably none better than Kelly Starrett’s “MobilityWOD” books (which we have on our coffee tables) and his website. Here’s a great example video of the voodoo band flossing:
Taking time to stretch out the area after a workout is a good idea too. Just be sure you don’t do too much. I know, I know, I’ve said that a lot. How do you know how much to do? If you’re spending more time doing this type of stuff than you are on an actual workout, its too much!
One final note about this step – this part of the process can really go anywhere and probably should be introduced as soon as you begin introducing movement.
Going to get some good soft tissue work can also be massively helpful.
My final general rule of thumb – when you feel like you are ready to go and have no pain, take another week or two. The mind is usually a couple of impatient steps ahead of the body. The healing process takes two things in pretty massive quantities: time and patience. The more you have, the better off you’ll be! Finally, the better your nutrition is, the quicker you’ll heal…just saying! Looking for a specific plan to help you? Talk to one of your coaches!