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Injuries and Medical Advice

Synovial Chips

Typically, debris in the elbow arises from damage to the synovial cartilage surface.

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I recently had elbow surgery to remove some debris in the joint, though I have not had any major elbow injuries. How did the junk get there and, now that it’s gone, what can I expect?

Hayden Johnson / rockandice.com

Well, you’re not suddenly going to become the next Alex Megos because those bits were your personal Kryptonite. One-arm chin-ups will still be prohibitively
hard.

You first need to give that elbow a month to recover from the surgical incision, as the doc will have sliced into the joint itself. If the surgeon has
only irrigated the joint, then recovery and return to climbing should be pretty quick. The real question is why is there shrapnel in your joint? Where
has it come from and how much damage is associated with its origin?

Typically, debris in the elbow arises from damage to the synovial cartilage surface. Acute trauma can lift a chunk out of the shiny surface—known
as synovial cartilage—in the joint much like a wedge to a putting green. That piece of cartilage, bathed in nutritional synovial fluid, lives
on as a vagrant inside the joint. Chronic load can also cause degeneration of the synovial surface, resulting in small pieces breaking away.

If you have had a significant cartilage lesion, then the outcome will be tepid at best. Although your elbow may be less aggravated in the following months—and
any locking of the joint is also likely to be alleviated—those cartilage “scabs” will make themselves known as surely as nepotism in the U.S.
political landscape.

There is certainly something to be said for joint strength and stability when it comes to slowing joint degeneration, but at some point this benefit is
mitigated and the same exercise will accelerate the degenerative process. Anything other than moderate recreational climbing is probably overstepping
your bounds.

You could train and climb hard again. At some point in years to come you might develop arthritis. It’s actually likely, but not a given. Add the factor
of mental health and there is a pretty good argument to resume business as normal. If your elbow becomes aggravated, then you are going too hard and
you need to back off.

This article was published in Rock and Ice No. 227 (July 2015).