# cyclists' elbow



## gbs (14 Apr 2011)

Currently I am suffering from what, for the moment, I can only describe as cyclists' elbow - very sore tendons/ligaments in the R arm induced I believe by 3 rides in 10 days on the bumpy lanes of Surrey and Hampshire in hilly/rolling terrain that requires frequent braking. 

As we all know these lanes are in poor shape and the vibration at speed is not comfortable. I have a conventional setup so the R hand/arm take most of the strain when braking. Also relevant perhaps is that I broke the R ulna and thumb in October. Whilst the arm is/was perfectly seviceable for every day use and tennis (cue for Aperitif) I know from a sports trainer that I have lost muscle mass around the right shoulder. I will be seeing a generalist sports physio this evening.

Are there any fellow sufferers out there or medics who might have an informed opinion?


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## Aperitif (14 Apr 2011)

Youch! I know that feeling Geoffrrey. Previously I have used 'Voltarol', which is a diclofenac-based ointment, available over the counter from Boots (although in France it is possible to get its big daddy 'Voltarene, which is 'stronger'.) Also, I have used a 'compression type' / neoprene etc sports support - although my arm always seemed to be fighting to get out! Much more control can be gained by using a cohesive bandage - tension and grip on affected area etc - and it is self-gripping. It really did help. I rode through the painful bits, in the knowledge that it is going to get better. Up the Omega 3-6-9 tablets to three a day with meals, and also try investing some time in eating loads of cherries, in whatever form you like, fresh, tinned (but not in cherry ice-cream too much eh?!  ) or taking a cherry capsule. A cherry taster is here.

It is always a sure sign that one has a tender elbow. Corners of walls and doors queue up to exuberantly rap the affected spot, so promoting the favoured "aggh!" or "ouch" (Definitely not words like "F*** it" or "bollards!" though - that would be unbecoming ) 

gbs gws

(Oh, and increase the vin rouge intake to unreasonable levels. That works from time to time also.)


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## Fiona N (14 Apr 2011)

I found when I started riding uprights again after 5 years or so on recumbents (for anything more than shopping trips and the odd mtb ride), I also got sore elbow joints - a feeling a bit like tennis elbow. 

I found that more general arm and shoulder strengthening, and for triceps in particular, sorted the problem over about 2 months and this year, despite the sudden jump to longer distances, I've had no problems at all.


P.S> I'd avoid NSAIDs if at all possible as the evidence is growing that although they do reduce pain and inflammation, they also inhibit healing.


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## MacB (14 Apr 2011)

Elbows and wrists, tricky to sort and it really is a case of what works for you and experimenting, also be aware of over compensation. I've had ongoing issues having now broken my left elbow twice, left lower arm once and left wrist 3 times, I've also had an operation to remove some bone from the end of the radius to leave a 'floating' joint, ie bone no longer reaches elbow. A complicating factor is that things can be in constant flux as your fitness and strength varies, as well as length and bumpiness of rides, even one pothole strike, in the wrong place at the wrong time, can be enough to set you back. What I've found:-

painkillers are good, never leave home without them and hoard stronger ones, just be aware of side effects and cycling not mixing too well

core and upper body strenth - matters a lot for me and allows me to spread the load far better, my favourite is doing chinups but this isn't always possible, so plenty of situps as the next option

bike setup - tricky as I'm not always sure what is just general wear and tear and what is an ache brought on by the setup needing tweaking - this is the real trial and error bit, I've found that tiny differences in bars can give me real elbow problems

over compensation - I don't actually know but suspect I tried to do too much to soon after the last wrist break, it was only a cracked bone and didn't seem too bad, but I managed to pop something in my right wrist. This happened during the last night ride I did and was evidenced by the appearance of a knobbly protrusion on the inside of the wrist below the pad of my right thumb. This has only returned to normal in the last month or so and was, I believe, a direct result of trying to ride with too much reliance on one side.

maximise ride positions - I've gradually moved over to drop bars, from butterfly bars, and set them up with an additional crosstop brake lever for the front brake only. I have a fairly upright setup anyway, with shallow drops, and this allows me to comfortably brake from the drops, hoods and flats. I did have a pair of crosstops initially but found that just the one was enough for my purposes. It's only really there to allow modulation, from the flats, without having to move hands to hoods or drops. This may not sound like much but I found, on a long ride, I'd often be on the flats having to move a hand/s to brake. My natural way of doing this would be to move the right hand first thus putting the load on the left. The crosstop lever option has greatly reduced the amount of times I need to do this.

padding - again this is personal but I've gone to using less padded mitts/gloves and I have foam tubing underneath the bar tape all round. I tried some of the gel strips etc but found the foam tubing easier and gave results I preferred. It does make for much chunkier grips though so size of hands would be a big influence on this.

brake levers - no reason you couldn't reverse front and rear brakes to let the left hand take the strain

grip strengthening - I have those squeezy spring loaded hand grips from my golfing days and, just like improving core strength, they really do help improve grip strength. You could also consider something like a Powerball which would work on wrists and forearms more.


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## Becs (14 Apr 2011)

I get elbow pain too (fracture into the joint when I was a kid and now the left one's a bit wonky). I find taking ibuprofen about 30 mins before I start riding and again 4 hours later really helps. By taking it before the ride it is working when I start aggravating it. NSAIDs do mildly impair healing (as inflammation is a natural part of the healing process) but I see them as a management strategy for a chronic condition. If you do this just make sure you stay well hydrated. I also wear elbow supports but I have a feeling it is the extra warmth that's helping rather than the mechanical action of some stretchy cloth!


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## gbs (15 Apr 2011)

@Aperitif, Fiona, MacB, Becs, thankyou for the prompt and helpful suggestions. I can adopt many of these immediately. Some of the ideas had not occurred to me - more vin rouge, cherries and supporting the elbow(s). I think I will hold back on reversing F and R brakes for the moment and I will leave painkillers in the backpocket as long as posible - I have the strange notion that pain tells one something useful.

Last night the physio diagnosed golfers' elbow and suggested selfhelp massage and streching exercises; he seems quite confident that the problem is curable and did not suggest lots of his treatment. He has a contract with one of the premier league clubs, with a tennis club (where he is well regarded) and Wimbledon/LTA. So he has a good CV but he does not have cycling speciality experience. Any thoughts/reccommendations for someone near Fulham?


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## Aperitif (15 Apr 2011)

Oddly enough, all my bikes are set up continental style... apart from the s/s which is a nuisance,(I'm left-handed also, for what it's worth) but not insurmountable. With your decent brakes gb, I don't think that makes much difference, unless you have major grip problems. . Regarding the NSAIDs - the intake is greatly reduced via topical application compared to swallowing Naproxin / Naprosyn etc... unless of course you 'butter' your tostados with it (unlikely ).

gwsgbs (Part II)


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## gbs (18 Apr 2011)

One week on and I can report great progress

Xray has confirmed that the ulna break has healed v cleanly and that no bone has been detached by the affected tendons/ligaments - that was frankly my big fear
80% reduction in soreness after significant amounts of massage and exercises
able to ride 100k in Surry heathland area on Sunday - no pain worth mentioning
contributing to the more comfortable ride 1) self adhesive compression strapping - thanks Apero! 2) delibarately soft elbows and hands at all times.
I feel sufficiently confident to play tennis tomorrow.

I still await cherry capsules from H&B so no comment.

Someone suggested that I may have been subconsciously tensing the previously broken arm and that, given the road vibration, would be enough to trigger the stiffness.


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## Munchkin100 (25 Apr 2011)

Im glad its not just me. I am suffering, my right elbow is always sore after my ride, usually around 20 miles. I put it down to the road surface, Bucks CC are not good at maintaining them. So glad I signed up on this website its great for finding out about every aspect of cycling :}


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## NorthernSky (5 May 2011)

i get soreness on the inside of my elbow. i need to do a 'no hands' and stretch my arms out and when i bend them in, thats when it hurts.

i'm an upright rider and think i'm overstretched. i'm looking into getting a steeper stem so i'm not stretching as far forward

i have gel gloves but may look at some gel bar tape too


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## gbs (5 May 2011)

addendum to post #8

Playing tennis was a big mistake. Back to the accupuncturist and, after a week, back on the bikes with swapped over brakes to reduce stress on the dominant R arm and gel tape to cushion vibration.


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