In a recent TrainingBeta Podcast episode, Neely spoke with climber and physical therapist Esther Smith specifically about elbow pain.  In their talk, they covered exactly what can cause elbow pain, what climbers can do to treat their conditions, and what we can do to avoid elbow problems all together.  Anyone who trains or climbs consistently should do themselves a favor and give this episode a listen.  Elbow pain is one of the most common climbing ailments and while it may seem minor at first it can quickly become highly debilitating.

Although Neely and Esther’s discussion focused on the elbow pain in particular, anyone listening will quickly realize that while the pain may present itself locally in the elbow this doesn’t necessarily mean the underlying issues are only located only in the elbow joint.  To expand on the discussion in the podcast, as well as give you some really helpful visuals, here’s an article Esther wrote for the Black Diamond blog.  It talks about the underlying causes of elbow pain and also shows you some upstream, local, and downstream solutions to help you treat any existing elbow pain you may be suffering from.

“Successful treatment of painful elbows (especially among climbers) should involve the chest, trunk and arms instead of an exclusive focus on localized pain. This is especially important when it comes to larger groups of muscles that are organized through a structure called fascia. Let’s use fascial systems to consider two common conditions among climbers: tennis elbow and golfer’s elbow.” – Esther Smith

Underlying Causes of Elbow Pain:

To explain how pain at the elbow can be caused by interconnected issues elsewhere in the body, Esther first describes and illustrates how fascia connects the elbow to all of the muscles along the chest, trunk, and arms.

While this may seem fairly obvious, it has some major implications for how we should go about treating any elbow pain.  For example, if our golfer’s elbow is actually being caused by chronic tightness in biceps and pectoral muscles, then treatment shouldn’t be focused on the elbow joint itself, but on releasing this built up and addressing any movement pattern issues that are causing it.

Upstream Solutions:

When Esther mentions “upstream solutions,” she is referencing exercises and mobility work that we can do to address tightness or weakness in the fascial and muscle networks further up the arm and in the trunk from the elbow.  Here’s a list of the upstream exercises she recommends:

  • Floor Angles on a Foam Roller
  • Backside Shoulder Stretch with Block
  • Prone I’s, Y’s and T’s
  • Serratus Push Up in Quadruped

All of these exercises have photos and a link to video that show you exactly how to perform them.

Local Solutions:

As Esther’s fascia explanation and the above upstream solutions illustrate, elbow pain is not always caused by issues in the elbow itself.  However, this doesn’t mean this is never the case.  For local solutions to treating elbow pain, here’s what Esther recommends:

  • Tennis Elbow Remodeling Exercises:
    • Tyler Twist
    • Hammer Drill
  • Golfers Elbow Remodeling Exercises:
    • Reverse Tyler Twist
    • Reverse Hammer Drill

Clearly, elbow issues are very complicated and if you are suffering any major pain or discomfort, it probably pays to seek out professional advice.  However, before you do, click through below to read about all these treatments in greater detail.  All the injury prevention work and remodeling exercises in the world won’t help if you aren’t targeting the right problem!

Full Article: Hang Right – Part II: Elbow Pain in Climbers

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(photo courtesy of

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