Weird Elbow "Twang" Pain

smrvl

Hey all,

So the past few months I've had this weird pain on the inside of my right elbow, only occurring at the top of a pull up or the bottom of an overhead press (which are of course basically the same position). I don't really know how to describe it other than that it feels like something is "twanging" right in the elbow pit. It doesn't happen every time I press or do a pull up, but when it does, it's severe enough that I can't just keep going. 

Anyone have any idea what causes this and how I can fix it?

-Ben

iron_tiger

Hey Ben,

Do you get the same twang or whatever if you do a pull-up with an underhand grip?

smrvl

I think I have felt it happen once or twice with an underhand grip, but definitely much less often.

Philip White

Ben, as with every issue at a joint, start looking upstream and downstream for issues and soft tissue restriction. 

Go after the forearms: 

The triceps: http://www.mobilitywod.com/2013/01/triceps-smash/

Open the front of your shoulders, chest and biceps with this bad boy (2 minutes in): 

And even hit the elbow itself: 

and: 

and 

Once you've hit all these areas, it should feed slack to your problem area. Good luck!

Phil 

SJMckay27

Do some neural flossing too. Your Ulnar nerve runs through the medial aspect of your elbow and could be getting constricted. Doing neural flossing will put some tension on the nerve and glide it around hopefully creating some space. I'll attach a video that explains it a lot better than I just did! I had this problem during rugby in the spring and these exercises helped a lot.

https://www.youtube.com/watch?v=d85QKyWvrbI

iron_tiger

Just some quick words of caution regarding the neural flossing:

1) It's not really meant to tension the nerve (those are called neural tensioners). The idea is to simultaneously tension the nerve from one end and slacken it from the other end, so you pull it back and forth slightly through the tissue tunnel, which can help reduce restrictions if the nerve's coating is getting stuck and preventing it from sliding properly.

2) If you have a lot of muscle tension along the neural pathway, this can cause compression of the nerve at key sites. Don't be too eager to floss the nerve until you've resolved those compressing factors.

3) The ulnar nerve passes the elbow on the inside, not in the elbow pit, so that's probably not what you're experiencing. The median nerve does run along that area, but if you're not experiencing pain or nerve symptoms (downstream numbness and tingling, etc) I would look elsewhere for the issue.

I think it's more likely that you experiencing some sort of twangy tendon snapping over bone, which could be caused either by your mechanics, overtension issues in the arm and forearm, or (most likely) some combination of both (mechanical issues create stiffness which creates mechanical issues, etc). David gave you a pretty comprehensive list of mobilizations to try, but make sure you test/retest the twangy position so you can tell if you made change, and what mobs made it happen.

Also, if you're not 100% confident in your mechanics, post a video and we can see if that is a contributing factor.

Good luck!