When climbers encounter persistent elbow pain, it’s often more than simple soreness it may be a condition so common that it’s earned its own nickname in the climbing world dodgy elbows. The phrase draws attention to elbow injuries among climbers that can derail performance and become chronic nuisances. One of the most cited guides on this topic is the work of Dr. Julian Saunders, who in his topic Dodgy Elbows laid out key ideas about how these injuries develop, how to understand them, and how to manage them. In this topic we explore what dodgy elbows means in a climbing context, Dr Saunders’s insights, the underlying anatomy and causes, signs and symptoms, prevention strategies, and rehabilitation practices for climbers looking to keep their elbows healthy.
Defining Dodgy Elbows in Climbing
In climbing circles the term dodgy elbows refers loosely to elbow conditions stemming from overuse, repetitive strain and biomechanical imbalance in climbers’ elbows. Dr Saunders points out in his original topic that elbow pain in climbing is the most common and debilitating of chronic climbing injuries. He distinguishes the problem from casual, acute pain by emphasising conditions such as tendinosis (degenerative tendon changes) rather than mere tendonitis (acute inflammation). The scope is wider than just tennis elbow or golfer’s elbow. For climbers using intense fingerholds, crimping, dynamic moves and high load volumes, the stress accumulates in the tendons and joints of the forearm and elbow, producing this dodgy state.
Why the Term Dodgy Matters
Using the word dodgy captures something informal yet accurate about the condition it’s unreliable, it can flare up unexpectedly, and it often persists despite rest. It signals that the elbow is behaving in a risky way for a climber one that may require targeted attention, not just more climbing and hoping for the best. Dr Saunders’s choice to call his guide Dodgy Elbows reflects his practical, candid approach to climbing injuries and sets the tone for the rest of his advice.
Anatomy and Common Injuries in Climbing Elbows
Understanding what’s going on under the skin helps climbers appreciate why their elbows become dodgy. The elbow joint itself is complex, but in the context of climbing the two tendons attaching at the medial and lateral epicondyles (the bony bumps on either side of the elbow) often bear the brunt of overuse. Dr Saunders explains that most elbow pathologies in climbers fall into two broad categories tendonitis (acute inflammation) and tendonosis (degenerative changes).
Key Tendons and Vulnerable Points
- The common flexor tendon, which attaches at the medial epicondyle, is often implicated when climbers use aggressive grips and pronationflexion movements.
- The common extensor tendon, attaching at the lateral epicondyle, is less common but still relevant with repeated wrist extension or supination under load.
- Muscletendon imbalance is a major factor if your forearm muscles strengthen faster than the tendons can adapt, the tendon can degenerate and become dodgy.
Causes and Risk Factors for Dodgy Elbows
The development of an elbow condition that qualifies as dodgy is typically multifactorial. Climbers often inadvertently set themselves up for trouble through training habits, technique, and load progression. Dr Saunders highlights that one trigger is a sudden increase in training intensity or volume, giving the muscles a head start on strengthening while the tendons lag behind.
Common Risk Scenarios
- Accelerated training moving from moderate climbing to highvolume or highintensity loads without gradual adaptation.
- Excessive crimping and high finger loads these put extra strain on the flexor carpi ulnaris (FCU) and pronator teres muscles, which originate around the medial epicondyle.
- Poor forearm or wrist positioning biomechanical inefficiencies can shift load to elbow tendons instead of distributing it properly.
- Inadequate recovery or ignored early symptoms what starts as a mild ache becomes chronic degeneration when climbing continues unmodified.
Signs, Symptoms and Diagnosis
For climbers wondering if their elbow is dodgy, Dr Saunders offers practical guidance on how symptoms manifest, how to differentiate them, and when to seek professional help.
Typical Symptoms
- Sharp pain around one of the epicondyles shortly after aggravating activity may indicate tendonitis.
- Dull aching pain that appears when warming up and temporarily eases during the session but returns after cooling down is indicative of tendonosis.
- Soreness or sensitivity when you tap the bony bump (epicondyle) on the inside or outside of the elbow.
- Loss of strength, especially in grip, forearm flexion or wrist motions, and a sense of weakness that lingers beyond pain.
Prevention and Efficient Training Habits
Preventing a dodgy elbow is far preferable to treating one. Based on Dr Saunders’s advice and broader climbing rehab literature, a thoughtful training and recovery approach is key.
Prevention Strategies
- Gradual progression in training volume and intensity avoid sudden jumps in load or season changeups without rampup.
- Include forearm and elbow specific exercises in your routine especially eccentric loading of the tendons (lowering against resistance) as Dr Saunders recommends.
- Favor openhand grips over full crimping when possible, since crimping increases load on the FCU tendon around the medial epicondyle.
- Ensure adequate rest, warmup and cooldown. If mild pain appears, modify activity before it escalates into chronic degeneration.
Rehabilitation Managing and Recovering from Dodgy Elbows
If the elbow has already become dodgy, Dr Saunders offers a clear framework, emphasising that healing takes time and must include targeted rehabilitation. His topic Dodgy Elbows Revisited updates his original program with refined load, angles and frequency details.
Key Rehab Principles
- Eccentric loading of tendon focusing on the lowering phase of movement to stimulate tendon adaptation and remodelling.
- Correct load balancing avoid increasing muscle strength without simultaneous tendon adaptation. The muscletendon imbalance is central to injury.
- Manual therapy adjuncts in his revisited topic Dr Saunders emphasises that soft tissue work (e.g., deeptissue massage) substantially improves outcomes when combined with exercise.
- Technical and behavioural correction examining climbing technique and grip habits, and reducing repetitive highstress moves until tendon recovers.
When Things Get More Complicated
While many elbow issues among climbers can be managed conservatively, Dr Saunders warns that surgery and other invasive interventions should remain lastresort options. He notes that many dodgy elbows result not from acute tears but from cumulative degeneration, which responds best to rehabilitation, not injection or immediate surgery.
Red Flags and Further Investigation
- Pain that does not improve despite six to twelve weeks of proper rehab and load management.
- Signs of nerve involvement, joint instability or previous trauma requiring imaging (MRI, ultrasound) to assess more than tendonopathy.
- Persistent loss of function (e.g., grip weakness lasting beyond pain) that may signal tendon tear or joint degeneration.
Dodgy elbows constitutes a familiar yet serious issue in the climbing community one that requires more than just rest and hope. Thanks to the guidance of Dr Julian Saunders and others, climbers now have clearer insight into what causes these elbow problems, how they develop, how to prevent them and how to rehabilitate them. Recognising the signs early, adopting training practices that protect tendons, and applying a rehab program that emphasises eccentric loading, soft tissue care and technique adjustment can make the difference between a long dodgy elbow saga and a swift return to strong, healthy climbing. If you’re encountering persistent elbow pain, taking action with a targeted approach may prevent your climb from being sidelined by a dodgy joint.