Yesterday’s elbow dysfunction clinic with Josh Bellingham of West Coast SCI was of particular interest to me because, despite the ridiculous things you’ll hear in the media about CrossFit injury, Tennis Elbow, Golpher’s Elbow and bicep tendon irritation are by far the most common ailments that we see with our athletes.  We’re not sending our CrossFit Empower members to orthopedic surgeons or ER with the kinds of calamitous injuries you see associated with skiing, cycling or even basketball, our problems are more of the over-use variety, chronic and nagging.  Professionals like Josh can help us prevent and cure these problems with proper joint care.

The biggest take away for me from yesterday’s clinic was the important tie-in to proper shoulder function.  It turns out that a lot of bicep tendon irritation does not originate from problems in the elbow joint but because of restrictions in the shoulder joint that create downstream problems.  Second big surprise was that poor rack position is as likely a culprit as the pull up in aggravating the elbow/bicep tendon.

It certainly gave me a lot to think about as a coach.  What follows are Josh’s notes from yesterday’s clinic:

“How to identify and resolve common Elbow movement dysfunction”

Exploring different elbow movement and applying them to the front rack position

Elbow Dysfunction related to the Front Rack position

  • Requires end range elbow supination and flexion
  • ote: Also requires shoulder flexion and external Rotation to achieve proper position without common faults. If your elbow feels good with all of the above movements but you can’t get into a front rack position it’s important to explore the shoulder.

    Did you miss the shoulder clinic?  Check it out here.

    Common Front Rack Position Faults:

    • Elbows Out (Keep wrists inline with elbows, may be missing shoulder flexion/external rotation)
    • Bar coming forward off of torso (may be missing elbow flexion or wrist extension)

    These faults, along with most movement limitations can be caused by:

    • Articular Movement Limitation (Movement at the joint level. Unable to roll or glide in it’s desired direction due to capsule limitation)
    • Physiological Movement Limitation (Soft tissue layer, dynamic movers)
    • Poor Motor Control (Neurological connection, coordination and activation)

    We need to address these issues to improve shoulder flexion range of motion. Also, none of the following techniques should hurt. Pain is never a normal reaction and you likely need to have a healthcare provider such as a Physio, Chiro, Osteopath, RMT investigate further (I’m a bit biased to physio 😉 )

    Progression from the following joint level mobilization to soft tissue release to activation will prime your elbows for a workout requiring the above elbow movements and is a great warm up before a front rack heavy workout.

    If you are really limited it should be done daily.

    Whole Elbow Capsule Mobilization with Supination + Pronation (Arm Hang)

    1-3 minutes within tolerance

    Whole Elbow Capsule Mobilization with Flexion (Banded Distraction)

    1-3 minutes within tolerance

    Soft Tissue Mobilisation for Triceps (Using barbell, lacrosse ball or foam roller)

    Soft Tissue Mobilisation for Biceps (Using barbell, lacrosse ball or foam roller)

    3 minute minimum, but build up to this within tolerance. Remember to explore the entire area of the lats

    Elbow Controller Articular Rotations

    Choose at least one of the above motions for a minimum of 10-15 slow and controlled repetitions splitting the set between clockwise and counter clockwise directions