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Nold


Feb 10, 2011, 5:22 AM
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Injured Left Biceps
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       OOOOk So I started climbing seriously last may and was training 3 days a week or so. I was working 11's. I was climbing outside and was pulling hard on an undercling when I felt sharp pain in my left biceps. No pops or anything like that though. I was pretty much done for the day. After resting and not climbing for 2 weeks, I was still having distal biceps pain. On the 3rd week after the injury I made an apt to see an orthopaedic dr where I work. He more or less dismissed me and said it was tendonitis and set me up for therapy and gave me some anti-inflamatorys.

So 2 months of therapy no climbing, and I'm still having almost non stop left biceps pain. I saw my Dr. again after the PT realized I was hyper extending over 20deg and he said again... Keep resting and it'll get better. Sooo another month goes by and I'm still having pain. So this time he set me up for an MRI. The MRI results came back and were all negative for any distal biceps injury. I asked him if I could climb after the MRI came up negative he said sure, but no pullups.

So here I am a few months after an injury and Still in pain. Its funny, when I climb or run I have no pain in my left arm. Its after I climb when the pain kicks in. The Dr. gave me a bottle of anti-inflam cream to rub on. I'm working out body weight exercises to help reinforce my arm, as well as only climbing 5.7's and 5.8's.

I would like to get other people's thoughts on this. He originally thought it was a partial distal biceps tear, but like I said...the MRI didn't show anything. Mabye its just something I need to work though.


(This post was edited by Nold on Feb 10, 2011, 5:27 AM)


Lbrombach


Feb 10, 2011, 5:53 AM
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Re: [Nold] Injured Left Biceps [In reply to]
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I wish more Docs were athletes themselves...I can't seem to find one. when I jacked up my knee and couldn't run to do Train in Jiu Jitsu, My doc basically said .."Well, you're walking OK.." Duh, but I'm not 75yrs old and I don't call it a good day just because I can make it to the bathroom all by myself. Sorry to whine, you just pushed a button there...


Anyway, to this day the doc has no idea. He at first thought MCL and/or LCL might be partially torn, and got me an MRI after much whining. MRI showed nothing. Therapy helped but never made me good as new as promised. My knee works without pain, but the ligaments don't hold things as tightly as they should so there is some slop in my knee that kills me if my running form gets sloppy, so unfortunately I can't run myself to exhaustion anymore. As long as the muscles are fresh I'm fine, so building mileage is happening extremely slowly as I stop at the first hint of discomfort or sloppy form. My point is that MRIs, Cts, and crystal balls are great but don't show all soft tissue damage. If your pain only happens after, it sure sounds like a wicked case of tendonitis tho. Ice after, pay attention during activity and stop as soon as there is nagging, and maybe do what I had to do for running and take a year and a half off..It's sucked ass, but a month or 2 of downtime wasn't helping so I had to forget about it all together and finally I could start to do it again. Bummer in any case. Good luck.


aerili


Feb 10, 2011, 9:16 PM
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Re: [Nold] Injured Left Biceps [In reply to]
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Hey, Nold, here is what I would do: find a new effing doctor!!! This one is clearly content to not think very hard on your behalf.

Find a doc with a sports medicine sub specialty. Maybe even one who treats something called "overhead" athletes (aka athletes whose sports involve a lot of arm-shoulder movement overhead and etc).

As for MRIs not showing anything: this has happened to me more than once. Doesn't mean there's nothing there. An MRI takes cross-sectional slices of your anatomy....think of it like slices of a loaf of bread. If the disruption to your soft tissue is in the middle of the slice, the MRI won't see it. Doesn't mean it's in your head.

Now go kick that doctor to the curb!


shimanilami


Feb 10, 2011, 10:10 PM
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Re: [Nold] Injured Left Biceps [In reply to]
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Listen to Aerilli. You know something is not right, but your current doctor is simply dismissing your complaint. You need a doctor who will take you and your injury seriously.


Nold


Feb 11, 2011, 3:57 AM
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        I'm going to talk to him again in the next few days. I climbed on it last night and it felt fine. Just afterwards it was really sore / painful. In the nook of my elbow on the biceps side I can feel alot of what he thinks is scar tissue. I mean a whole lot. I'm going to ask him again what he thinks about it.

All the doctors here are sports medicine specialists. The distal biceps tears are pretty rare so I'm told, so maybe he just hasn't seen many. As far as arm strength goes, I feel like its still strong. I haven't done any pullups, but I still feel like I could knock out 10 or so.

I'll keep everyone updated as to my progress. Going to rocktown this weekend, I'm going to stay away from overhangy stuff and stick with slab. Gonna get a send on the scoop!!!


saint_john


Feb 11, 2011, 5:54 AM
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Re: [Nold] Injured Left Biceps [In reply to]
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Nold wrote:
OOOOk So I started climbing seriously last may and was training 3 days a week or so. I was working 11's. I was climbing outside and was pulling hard on an undercling when I felt sharp pain in my left biceps. No pops or anything like that though. I was pretty much done for the day. After resting and not climbing for 2 weeks, I was still having distal biceps pain. On the 3rd week after the injury I made an apt to see an orthopaedic dr where I work. He more or less dismissed me and said it was tendonitis and set me up for therapy and gave me some anti-inflamatorys.

So 2 months of therapy no climbing, and I'm still having almost non stop left biceps pain. I saw my Dr. again after the PT realized I was hyper extending over 20deg and he said again... Keep resting and it'll get better. Sooo another month goes by and I'm still having pain. So this time he set me up for an MRI. The MRI results came back and were all negative for any distal biceps injury. I asked him if I could climb after the MRI came up negative he said sure, but no pullups.

So here I am a few months after an injury and Still in pain. Its funny, when I climb or run I have no pain in my left arm. Its after I climb when the pain kicks in. The Dr. gave me a bottle of anti-inflam cream to rub on. I'm working out body weight exercises to help reinforce my arm, as well as only climbing 5.7's and 5.8's.

I would like to get other people's thoughts on this. He originally thought it was a partial distal biceps tear, but like I said...the MRI didn't show anything. Mabye its just something I need to work though.

sorry to hear that. it sucks being out-of-commision. it really sounds like you need a new Dr!


onceahardman


Feb 11, 2011, 4:00 PM
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Re: [Lbrombach] Injured Left Biceps [In reply to]
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I'm tempted to whine right back at you...

In reply to:
I wish more Docs were athletes themselves...I can't seem to find one.

So...make that situation better! Go to med school, and be a climbing doctor! But you may find you have less time on your hands to climb.

In reply to:
My doc basically said .."Well, you're walking OK.."

What did he ACTUALLY say? (not "basically") Probably a bit more than that, although I wasn't there, so I can't say for sure. The doc cannot treat the pain you had the previous day. He can only treat the symptoms you are presenting with. If you are "walking OK", that is a good thing.

In reply to:
Anyway, to this day the doc has no idea. He at first thought MCL and/or LCL might be partially torn, and got me an MRI after much whining. MRI showed nothing.

So, the doc DOES, in fact have an idea. He knows the MRI is negative.

In reply to:
Therapy helped but never made me good as new as promised.

"as promised"? Did the PT or doctor PROMISE you would be as "good as new"? Really?

Again, I wasn't there, but it does not sound very "doctor-like" to make such a PROMISE.

In reply to:
My knee works without pain, but the ligaments don't hold things as tightly as they should so there is some slop in my knee that kills me if my running form gets sloppy, so unfortunately I can't run myself to exhaustion anymore.

How do you KNOW that the "ligaments don't hold things as tightly as they should?" Did the doctor say that? Or is that your impression? Pain that increases with running could certainly have several other causes. If the doctor said that, how does that square with your complaint that the doctor is essentially clueless?

The non-existence of a way of making you 18 years old again is not a failure of your doctor.

Anyway, I wish you well. I hope you feel better.


dugl33


Feb 11, 2011, 5:14 PM
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Re: [Nold] Injured Left Biceps [In reply to]
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Nold wrote:
I'm working out body weight exercises to help reinforce my arm...

What does that mean ("body weight exercises")? Have you tried some bicep curls and reverse bicep curls? Go easy to start, every other day or every third day, depending on delayed onset muscle soreness. Ice afterwords.

Skip the pull-ups, push-ups, all that BS. Do some modest (i.e. light) bench press, bicep curls, dumbell kickbacks. Ice the elbow and the bicep. Do this about twice a week, 3 max.

Proceed at your own risk if you try this but I'd bet you just need to re-tune the machine a bit. Completely ignore antagonists at your own peril. Pirate


Nold


Feb 11, 2011, 5:22 PM
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Re: [dugl33] Injured Left Biceps [In reply to]
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Body weight = isometric stuff, pushups etc. I'll give some light curls a try. High reps? medium reps? My PT also said I should try working out my back and tris to help support my weak biceps.


dugl33


Feb 11, 2011, 5:53 PM
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Nold wrote:
Body weight = isometric stuff, pushups etc. I'll give some light curls a try. High reps? medium reps? My PT also said I should try working out my back and tris to help support my weak biceps.

Well, isometric means the length of the muscle doesn't change -- not sure if this is what you mean.

To answer your question, I'd say medium. Start with 2 sets of 10 or 12 for the curls and tricep extensions. Maybe 2 sets of 15 on the bench press. Don't go to failure at this point, but you should be feeling it on the last rep.

A simple program would be 2 sets of bench press, 2 sets bicep curls, 2 sets tricep kickbacks, 2 sets dumbell bent rows (lawn-mower pulls) and 2 sets of military press (not behind the head, only in front). Go easy and see what your body tells you regarding soreness, joint pain, etc. Rest 48 to 72 hours before repeating. Ice afterwords. If all is well, and your no longer getting DOMS, bump up to 3 sets of everything.

Meanwhile, stop climbing for a bit or stick to slab as you mentioned. Over a few months add in additional climbing days, from once a week to 2 or 3 times a week.

I'm not a doc or PT, just to be clear, but I have had pretty good success with this approach for my own problems in the past.

You might also look into theraband flexbars and start doing the golfers elbow and tennis elbow exercises.

I wouldn't heap all this onto intensive climbing training. Back off on climbing a bit, strengthen the antagonists, then gradually add the climbing back in.


Nold


Feb 11, 2011, 6:50 PM
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What I meant by isometric stuff, and this is what the PT told me. You do curls with nothing in your hand, but resist yourself. I'll give what you said a try for a few weeks and I'll let you all know how it goes.


Lbrombach


Feb 12, 2011, 6:30 AM
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Re: [onceahardman] Injured Left Biceps [In reply to]
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onceahardman wrote:
I'm tempted to whine right back at you...

In reply to:
I wish more Docs were athletes themselves...I can't seem to find one.

So...make that situation better! Go to med school, and be a climbing doctor! But you may find you have less time on your hands to climb.

In reply to:
My doc basically said .."Well, you're walking OK.."

What did he ACTUALLY say? (not "basically") Probably a bit more than that, although I wasn't there, so I can't say for sure. The doc cannot treat the pain you had the previous day. He can only treat the symptoms you are presenting with. If you are "walking OK", that is a good thing.

In reply to:
Anyway, to this day the doc has no idea. He at first thought MCL and/or LCL might be partially torn, and got me an MRI after much whining. MRI showed nothing.

So, the doc DOES, in fact have an idea. He knows the MRI is negative.

In reply to:
Therapy helped but never made me good as new as promised.

"as promised"? Did the PT or doctor PROMISE you would be as "good as new"? Really?

Again, I wasn't there, but it does not sound very "doctor-like" to make such a PROMISE.

In reply to:
My knee works without pain, but the ligaments don't hold things as tightly as they should so there is some slop in my knee that kills me if my running form gets sloppy, so unfortunately I can't run myself to exhaustion anymore.

How do you KNOW that the "ligaments don't hold things as tightly as they should?" Did the doctor say that? Or is that your impression? Pain that increases with running could certainly have several other causes. If the doctor said that, how does that square with your complaint that the doctor is essentially clueless?

The non-existence of a way of making you 18 years old again is not a failure of your doctor.

Anyway, I wish you well. I hope you feel better.

I don't feel like doing the multi quote thing, but

1. I'm happily done with school, have a good career that lets me finally climb and spend time with my kids. Med School? No thanks.

2. Of course he said more, but he actually did say the words "Well, you're walking ok" and was reluctant to dig in to the problem. He told me to rest and ice it for 6 wks. Then I got an MRI and told to rest it some more. All the while the pain had gone away except for the ovbious feeling of instability and seemingly random buckling episodes where I'd be walking fine then suddenly accelerating toward the floor. He was reluctant to dig in until I pressed. It took me 4 months to get a referral to a specialist out of him, who did some electrical testing and some other stuff, SAW nothing wrong, but still understood what the symtpoms indicated and sent me to PT. It was the PT who promised me "good as new," which I took to mean pre-injury, not 18. Yes, my doc knew not only that the MRI was negative, but also that if I had syrup on my waffles didn't fix the problem either. He was clueless as to what the problem was. Fortunately, he took me more seriously with my more recent shoulder problem. I was hoping for therapy right away, but he sent to a specialist, then HEe sent me to therapy. Which is fine except that it took me a long time to get in to see the specialist - nearly 2 months wasted.

The ligament loose/sloppy theory is my impression and that of my PT and thus the whole aim of my treatment was to strengthen the muscles so they can do a better job holding things. I was making progress and I've little doubt that if I had continued to spend 5-7 hours/week rehabbing my ONE leg that injury would be even better off, but my complaint was never the outcome, it's that every doc I've ever had wants to treat me like one of their geriatric patients.


(This post was edited by Lbrombach on Feb 12, 2011, 11:10 AM)


aerili


Feb 12, 2011, 11:01 AM
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Nold wrote:
What I meant by isometric stuff, and this is what the PT told me. You do curls with nothing in your hand, but resist yourself. I'll give what you said a try for a few weeks and I'll let you all know how it goes.

This is not an isometric exercise. Isometric means the muscle is resisting a force, but the joint isn't moving. As long as the joint is moving, it is (usually) something called isotonic contractions (whether you use body weight or something else is irrelevant).


altelis


Feb 12, 2011, 2:41 PM
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Re: [Lbrombach] Injured Left Biceps [In reply to]
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Lbrombach wrote:
...
I don't feel like doing the multi quote thing, but

1. I'm happily done with school, have a good career that lets me finally climb and spend time with my kids. Med School? No thanks.

I think you missed, at least some, of OAH's point. And this little part is representative of it.

You said you wished there were more docs who were athletes themselves. You bemoaned the fact you couldn't find one.

But what was the reason you gave for not going to med school? Interestingly it wasn't that it doesn't interest you, that you don't think you could make it, etc. You said you wouldn't do it because you found a career that lets you HAVE TIME for climbing & family.

The reason there aren't "a lot" of athlete doctors is partially because, at least for a long time, you have to give up a lot of the family/athletic time to train and get into your practice.

I also think it really depends on where you are. If you are in a place with lots of opportunities for athletes, there seems to be a lot of athletic doctors. You can't shake a stick in a hospital in Denver, SLC, Missoula, Vail, etc without hitting a climbing/biking/running/kayaking/skiing/etc doctor (and prob a few IV's to boot).

If you aren't really willing to give up lots and lots of free time and years in which to climb and be with family to be a doctor then you really can't deride others for making the same decision, eh?


enigma


Feb 13, 2011, 12:47 AM
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aerili wrote:
Hey, Nold, here is what I would do: find a new effing doctor!!! This one is clearly content to not think very hard on your behalf.

Find a doc with a sports medicine sub specialty. Maybe even one who treats something called "overhead" athletes (aka athletes whose sports involve a lot of arm-shoulder movement overhead and etc).

As for MRIs not showing anything: this has happened to me more than once. Doesn't mean there's nothing there. An MRI takes cross-sectional slices of your anatomy....think of it like slices of a loaf of bread. If the disruption to your soft tissue is in the middle of the slice, the MRI won't see it. Doesn't mean it's in your head.

Now go kick that doctor to the curb!

Get a good doctor in New York City. They have many specialized hospitals and are excellent.
Smile


onceahardman


Feb 13, 2011, 6:34 AM
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Re: [Lbrombach] Injured Left Biceps [In reply to]
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In reply to:
1. I'm happily done with school, have a good career that lets me finally climb and spend time with my kids. Med School? No thanks.

Thats fine, and it's also what I figured. You care enough to whine, but not enough to improve the situation.

In reply to:
2. Of course he said more, but he actually did say the words "Well, you're walking ok" and was reluctant to dig in to the problem. He told me to rest and ice it for 6 wks. Then I got an MRI and told to rest it some more. All the while the pain had gone away

So the rest prescribed by the doc seems to have addressed your chief complaint? Hmm, that's odd. The rest of your whiny-ness doesn't indicate you are very thankful for his effective treatment.

In reply to:
The ligament loose/sloppy theory is my impression and that of my PT and thus the whole aim of my treatment was to strengthen the muscles so they can do a better job holding things. I was making progress and I've little doubt that if I had continued to spend 5-7 hours/week rehabbing my ONE leg that injury would be even better off, but my complaint was never the outcome, it's that every doc I've ever had wants to treat me like one of their geriatric patients.

With all due respect, you have no idea what your doc, even your orthopedic surgeon, does for a living. He may have just finished telling his previous patient that his hip pain is being caused by a pathological pelvic fracture from metastatic prostate cancer (like a patient I have now). You whine because you can only run for 5 miles, and your aging body can no longer run for 10.

Go ahead and find another doctor. Like anybody else, they are all different.


Lbrombach


Feb 13, 2011, 8:13 PM
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onceahardman wrote:
In reply to:
1. I'm happily done with school, have a good career that lets me finally climb and spend time with my kids. Med School? No thanks.

Thats fine, and it's also what I figured. You care enough to whine, but not enough to improve the situation.

In reply to:
2. Of course he said more, but he actually did say the words "Well, you're walking ok" and was reluctant to dig in to the problem. He told me to rest and ice it for 6 wks. Then I got an MRI and told to rest it some more. All the while the pain had gone away

So the rest prescribed by the doc seems to have addressed your chief complaint? Hmm, that's odd. The rest of your whiny-ness doesn't indicate you are very thankful for his effective treatment.

In reply to:
The ligament loose/sloppy theory is my impression and that of my PT and thus the whole aim of my treatment was to strengthen the muscles so they can do a better job holding things. I was making progress and I've little doubt that if I had continued to spend 5-7 hours/week rehabbing my ONE leg that injury would be even better off, but my complaint was never the outcome, it's that every doc I've ever had wants to treat me like one of their geriatric patients.

With all due respect, you have no idea what your doc, even your orthopedic surgeon, does for a living. He may have just finished telling his previous patient that his hip pain is being caused by a pathological pelvic fracture from metastatic prostate cancer (like a patient I have now). You whine because you can only run for 5 miles, and your aging body can no longer run for 10.

Go ahead and find another doctor. Like anybody else, they are all different.

Way to cut and snip out half of my words so you can make a completely erroneous point. Yeah, I'd have periods of no pain , and I'll repeat - followed by a buckling episode that would leave me in significant pain for several days. Are you telling me that most healthy 32 year olds frequently find themselves on the ground when walking across a parking lot? What 32 year old shouldn't be able to run 10 -15 miles?

With all due respect, you have no idea what my understandings of medicine or the human body are. True, I've moved to a different field at this point. And quite frankly, I chose to veer off the medical field for a number of reasons - one of which is that my current profession allows me to have a greater effect on my planet than most people can ever possibly hope to. I get some satisfaction from that, and if I was a doctor, I'd be whining about the people who do my current job. I'm awesome, but I can't do them all.

You were right in your first post when you said you weren't there. Best of luck with your health issues.


Nold


Feb 13, 2011, 8:56 PM
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So for the last 4 days I have rested. Ran 4 miles everyday, but that's it. Arm felt great today. Tomorrow I am going to do some light weight high rep curls and rows, followed by some hardcore icing. Gonna keep everyone updated!


onceahardman


Feb 14, 2011, 5:00 AM
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Mr Brombach, there is a reason I snipped where I snipped.

The doctor did exactly the right thing. He prescribed a course of treatment (rest) which successfully brought the inflammatory component of the injury under control. The evidence for this is, you no longer had pain at rest. Pain at rest is one of the hallmarks of inflammation.

Assuming everything else you have said is accurate (which I do), you now have a case of apparent laxity with a negative MRI. An MRI taken six weeks earlier would almost certainly also been negative.

Laxity without ligament damage? You have not mentioned meniscus, which often causes the "buckling" or "giving way" symptom you described.

If your meniscus is perfect, you are pretty much left with the unpleasant notion that your connective tissue might be of poor quality. There are several conditions which cause this symptom, and none of them bode well for a really good outcome, such as allowing you to run 15 miles at age 32. If that is your problem, learning to accept the condition, and moderating your activity might well be the best option for mangement. There is no surgeon I know (and I know some who operate on professional sports teams), who would compromise your intact ACL, and instead do an ACL repair.

I honestly do wish you well. It's easy to be upset with what you perceive as incompetence in others, but I don't think that is the case here.


(This post was edited by onceahardman on Feb 14, 2011, 5:01 AM)


Lbrombach


Feb 14, 2011, 6:21 AM
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I sincerely wish you well also, but don't quite understand why you need to make assumptions based on terribly little information. I'm not sure why I'm bothering, but let me clarify that I won't even bother a doc with a problem of this nature until I've done 6-8wks of RICE and ibuprofen myself. I went to see him for the buckling episodes, not pain that came with the initial injury. My insurance requires I declare a primary care physician from a list, and finding what I want from the list has proven difficult. My Doc is an internist and has been fantastic at other issues, but is not a whiz in this particular area as evidenced by more than just this issue. That's just how it goes. Neither Myself, my PT, or my physiatrist think that my meniscus is the issue - neither the mechanism of injury nor the majority of signs/symptoms point to it. I never thought surgery was a good idea and never asked for it, believing that therapy was going to be the best course of treatment... but you'll not convince me that it was good for me to take over 4 months from onset of injury to begin PT - all the while suffering bucking episodes that can cause further injury on their own. I can accept the outcome just fine and again, the result was never the complaint. If my truck with 120k miles on it suddenly won't go 70mph, I'd be po'd if my mechanic simply said "Well, she gets you to the grocery store" and made me return several times before he'd even pop the hood. Again, I'm much more familiar with medicine than you seen to accept and if at the end of the day it turns out I'll never run a mile again the so be it (fortunately not the case), but saying I should accept not running is absurd without looking for the problem first. - whether or not I'm a teenager any more.

Cheers,

Lloyd out.


Nold


Mar 23, 2011, 5:13 AM
Post #21 of 21 (4173 views)
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Registered: Feb 10, 2011
Posts: 42

Re: [Lbrombach] Injured Left Biceps [In reply to]
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           Well its been another month or so and I've been climbing on my arm. I'm climbing 11's again, but I still have biceps pain. The pain however is no longer localized to my elbow region. Its more of my actual bicpes now. It doesn't really bother me when I climb. Underclings are the only thing that I'm weary about.

I'm going to swing by the Dr. again and see if he can give me anything. He gave me anti inflammatory cream last time and it worked wonders.


Forums : Climbing Information : Injury Treatment and Prevention

 


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