I have tennis elbow that only hurts when I pick up something heavy. I tried climbing, felt pain, rested a week, and then climbed again. My elbow hurt after that session and I stopped climbing for two weeks. Should I wait until there is no pain at all before climbing again or starting rehab? 

Andrewski | Forum

A few months ago I, for the first time, started to suffer from tennis elbow. More precisely known as lateral epichondylosis, it is one of the few injuries I had managed to avoid.

Though Jesus certainly built my hammer drill, he was remiss not to include a remote. After some fervent bolting on a local cliff, I could barely lift the kettle, let alone the drill.

One evening while cooking for my brood, I started to lift the frying pan from the stove and all but dropped a mass of sizzling flesh onto my bare tootsies. Oh, it hurt like I was breast-feeding a piranha. Surely this can’t be good, I heard myself mutter, playing the part of so many of my patients. Note to self, don’t pick up the frying pan. On second thought, do it a lot.

After a week of frying-pan therapy, my elbow was 90 percent better. So I stopped. I tell everyone not to stop, but for some reason I did, and had to start all over again a couple of weeks later.

Select a heavy frying pan from the kitchen. Flatten your arm across the table so that your wrist hangs off the end, with your elbow at roughly 130 degrees (almost straight), and your shoulder slightly higher than the table surface. This is typically the most aggravating angle, but you will need to refine it to find the most painful position for you.

Grip the handle of the pan and lower it until it is hanging. Use your other hand to lift the pan back to its starting point, keeping the optimal angle in the elbow, then take five to seven seconds to lower it again. You may need to change pans to get the weight right. Start at two to three sets of 10 repetitions once a day, and build it up to twice a day depending on results.

I have tried this on several other patients in recent months, and the frying pan seems to isolate the issue with more accuracy than the usual dumbbell.

In the last couple of weeks I have experienced numbness in the fingers of my right hand (index and middle) when I wake. It usually lasts about one minute. I get rid of the sensation by opening and closing my hand. The numbness sometimes occurs during the day, but not while I’m climbing. I am 27, working in IT but not typing much.

Alex | Forum

Does the numbness extend to the surface on the ring finger next to the middle finger, but not the surface next to the little finger? Sounds like carpal tunnel syndrome (CTS), or at least that is the likely diagnosis. There are lots of causes of CTS (compression of some nerves that pass through an anatomical structure called the carpal tunnel).

Any nerve-conductance issue in the arm, or for that matter anywhere, is potentially a serious condition. If my advice does not help, seek a face-toface medical opinion that does not involve tarot cards.

If you are a girl, and pregnant, you have left out some rather important details. Pregnancy is associated with CTS by way of increasing fluid within the body and elevating interstitial pressure in general. As an aside, it will be a girl and you will call her Princess Alex because you always wanted to be a princess.

Try this: Place your forearm on a table. Put the back of your hand (palm facing you) in the palm of your good hand. Curl the fingers of your good hand around so that the index finger is above the lines of your wrist. Twist your bad wrist further out, in the direction it doesn’t want to go, until it is quite uncomfortable, but no more. Hold for 30 seconds.

Turn your bad wrist over and place the palm of your good hand over the back of your other hand with the little finger above the wrist lines. Again, twist your wrist as though you are trying to face the palm of your bad hand outward. Hold for 30 seconds and repeat each stretch a few times once or twice a day.

After refusing to rest on a recent road trip, I started having mild soreness and pain in my brachioradialis (BR). I took two weeks off, and stretched it as you suggest [Ask Dr. J, No. 197 ]. The pain went away and I went back to the gym … the pain came right back. Do I just need more rest? Are the exercises in that column helpful for the BR as well, or just golf/tennis elbow? I could climb through the pain, but I assume that this would be dumb?

Rpevnick | Forum

Blind obsession is like wearing stilettos—you go places you would not have thought possible. But tragedy is the crack in the pavement, small and innocuous, waiting to bring you down. Injury is inevitable. The first rule for avoiding injury is NOT to avoid rest. Strategic resting is when you get stronger. Without it, you will get weaker.

Rest as a sole therapeutic tool, however, is often overrated, especially if you consider your body a performance vehicle—as virtually every climber should. Climbing is not like taking the dog for a walk. If you “only” climb 5.10, that still puts you in one of the upper echelons of activity levels. Get a regular tune up, and treat issues when they are just a rattle.

The second rule for avoiding injury is: If you see it coming, initiate evasive action.

Several different injuries can cause pain in the vicinity of brachioradialis, so don’t be fooled into thinking that your pain is emanating from the BR just because you know the name of that muscle, or because that’s what pops up on the Internet. Recovery starts with the proper diagnosis.