Hello all!

I am going through the process of (finally) getting diagnosed for AS, after many years of SI/back pain.

I have taken up rock climbing over the past year-and-a-half or so, and was wondering if there are any other members here who climb?

Over this time, I have constantly had issues with (something like) tendonitis in my elbow, usually on the bicep side. It has been difficult to control, but I have found ways around it, (usually by not climbing very hard or too often.) Have others experienced this? Anyone in other sports found they had an increased incident of tendon issues because of AS?

Should be seeing the rheumatologist soon, so will be asking them at the same time, but was curious if others had similar experiences.

It could be enthesitis, which is observed in up to 70% of patients with reactive arthritis (spondyloarthropathy), and most often manifests as tenderness and sometimes pain, with or without swelling at the entheses (areas where tendon and other connecting tissues join to bone). Treatment ranges from NSAIDs to steroids.

More info

i don't rock climb, but know all about tendonitis, pulled and even torn tendons and ligaments, always right at the entheses, where the tendons and ligaments attach to the bone, in the joints.

however, since starting low dose naltrexone (LDN) in sept 2009, i have not torn a tendon or ligament! yay!

and that is a big deal for me because from 1998-2009, i tore the following: rotator cuff, bicep tendon, IT/TLF attachment at the trocanter, left ulnar wrist ligament, ligament in one of my fingers. the tendonitis list is far larger; usually i just tell the doctors that my elbows have been pretty good. easier to state what tendons haven't been a problem, vs which ones have been.

and tore these things doing the most mundane every day activities, while in a flare: stretching, turning a key in the door, pulling the covers up in the morning while in bed. stuff like that.

the rheumy that FINALLY dx'ed me said that he thought it took so long for a dx because i had such an unusually severe case of enthesitis that everyone was looking for other more bizarre answers than spondy.

but with all that said, seriously, the LDN has been nothing short of miraculous for the enthesitis.

yeh, i still flare. yeh, i still have rib and SI joint and neck issues. yeh, still have inflammation, bowel issues, etc. but the enthesitis is now only a little bit when i flare or overuse something. nothing like before. like night and day.

so, i recommend trying LDN for enthesitis. i was amazed how effective it was.

if not that, i've always found PT to be quite useful for tendonitis. also ice or contrast ice/heat. and ultrasound, either at the PT or since i needed it so much, i bought a home ultrasound unit. works just as well as the one at the PT's office.

another thing. i had a research student that climbs. she's on the university climbing team. injured a tendon at the elbow, maybe even the exact one you are talking about. she wore some compression thing on it and that helped her a lot. whenever i tried any form of bracing, which is common practice for tendonitis, it always made it a lot worse! even when i tried wearing just those terry wrist things, that was too much "bracing". but you could try that compression thing. PT could help you with that as well.

and resting the tendon is really what helps the absolute most when it comes to tendons, but sometimes that's easier said than done. like not climbing for a few weeks is one thing. not typing or writing or turning pages for my job is another. but if you can rest it........

Thanks, both of you. Enthesitis seems likely. I will talk to my doctor about it.

Also, along the lines of climbing, a pretty cool video someone posted on another web forum:
Climbing as Therapy with Whitney Boland

Hi Kyle,

I've been climbing for over twenty five years, and I've had problems with elbow tendonitis for much of this time, well before developing, or being diagnosed with AS. In my case, they are mostly unrelated. Working with the muscles imbalances created by the movements, allowing adequate recovery and getting enough protein have helped keep the problem at bay.

The exercises I've found most helpful are reverse curls to strengthen the top of the forearms (the most helpful) and push up strengthen the chest (as the back becomes overdeveloped).

Best of luck!

Peter

I've got tendonitis/tendonois in my archilles and no doubt at all it is the most frustrating thing stopping me running at the moment :-(

Hi Kyle,

I am a climber since several years, have had no problems related to AS except for occasional severe pain in SI/back. Arcoxia (Etoricoxib, 100x more specific for cox-2 instead of cox-1) is sofar the only NSAID that I can tolerate, it also has longer halftime of approx 22 hours so you only take one daily.

According to my physiotherapist climbing is a good due to the natural stretchy movements. When on belay you also spend a lot of time straight looking up which I think also is beneficial.

I hope you find a way to manage the tendonitis.

Tendonitis was a major roadblock for me to perform any type of sports. I started with some Yoga and Tai Chi combined with stretching exercizes. Also I improved my eating habits (low starch, low sugar diet). I found myself doing more and more physical activities.
And now I only have tendonitis when I don't prepare for physical activities. But as long as I stretch and prepare my body, I can pretty much do anything now.
With AS you have to be mindful before and after you engage in physical activities. For me, I have found I appreciate it even more because of it.
Good luck and keep moving!