How do climbers prevent tricep tendinitis?

Question

For the past year or so, I've been really into sport climbing. I climb 3-4 times a week, and it's been amazing for my grip strength and my pulling strength.

One thing that limits how often I can climb is the creeping sensation of tendinitis in the tendon between the tricep and elbow joint.

I've tried to find out how climbers in general deal with tendinitis, as it's a pretty common thing, but every damn thing I find deals with bicep tendinitis, and not tricep tendinitis. Oddly enough, my biceps haven't had a single issue.

So my question is; how would you go about actively preventing getting tricep tendinitis in the first place? Naturally, any onset of tendinitis is treated with cutbacks in the activity that causes it. But active prevention could be of more use.

Note that I'm not asking for how to treat an active case of tendinitis. I'll be consulting other professionals for that.

Similar threads

I found this excellent Q&A from a few years back: Avoiding Tendinopathy (suggested rest interval to prevent chronic pain)

My question differs in that the answer suggests methods for someone "coming straight off the couch", whereas compared to that, I'd like to think of myself as more intermediate. In other words, I'm not asking about the general "take it easy in the beginning" answer, but more so how climbers who train 6 times a week manage to avoid it. In other words, active prevention rather than passive prevention.

Follow-up

To answer the question of where I'm feeling the tendinitis, I have placed green markers on this figure.

Answer 1

I had tricep tendonitis (tendonosis in my case, to be more specific) for years and have only recently got over it.

Whilst you're looking to prevent it in the first place, I imagine you could do the same as what I did to cure it.

I found the best ways of treating it was with a combination of eccentric exercise and 'heavy slow resistance' training in order to strengthen / repair my tendons.

Eccentrics are better for when it's really bad, simply do an exercise like cable tricep extensions and use your good arm to bring the cable down, and then use your bad arm to slowly bring the cable back up again.

HSR is what I did after a few weeks of eccentrics, which involves really slow-tempo reps... 3 seconds up and 3 seconds down. Start off with a light weight of 15 reps and over the course of a few weeks, increase weight to heavier sets of 6–8 reps.

Which method you choose will depend on how bad your tendonitis is. But if you're simply looking to prevent it, I'd just do a few sets of the above each week to keep your tendons strong.

Answer 2

Are you sure that it's triceps tendonitis that you're experiencing? Medial epicondylitis ("golfer's elbow") is much more common among climbers, which makes sense, as this is where the origin of the finger flexor muscles attaches, whereas the triceps really don't get used much in climbing.

If you hold your arm out in front of you, with elbow bent to 90° such that your forearm is horizontal, then the medial epicondyle is the lump at the bottom of your elbow. Is this where you feel pain? It's pretty much right next to the triceps insertion point, so they're easy to confuse.

In any case, the usual active prevention for tendinitis is workload management, either formally though logging all your climbing activities and applying limits on the basis of tools like acute:chronic workload ratio, or just informally trying to avoid sudden big increases in the frequency or intensity with which you are climbing. A person can become accustomed to climbing 6 days per week, but if a 3 day/week climber decides that they're suddenly going to start climbing twice as often, then they're risking injuries like this. The key is slow and gradual increases in volume, and backing off and working your way back up if symptoms appear.