Tennis elbow.

[chris watton]

Hoofy said:

Well, put him down then. NOOOOOO not like that, put the gun down now!

Ah, you probably ramped up the weights too quickly - the muscles were happy to accommodate but the ligaments and tendons take a lot longer to strengthen.

When I say rest, I mean don't do any exercises that aggravate. However, you could experiment with a lighter load... well, lighter than your sausage dog.

Great advice! Thrice thank you.

What you say makes perfect sense - I know that I had to throttle back the weight when doing leg extensions - I discovered that, although my leg muscles could take the weight, my knees were less happy, so I used a little less weight and all's been well since.

I shall try the same with the curls and use less weight.

[m3sye]

Buster73 said:

Tried acupuncture , relieved it a bit but not cured.

Time for the injection ?

Do you work in an office?

I thought mine was from the gym but more I thought about it the more I realised it was from working at my desk... ?

[Digger]

Wasn't sure whether to PM you Ross, but will ask here for the possible benefit for all!

Would you recommend sessions of slow front crawl swimming as an exercise that shouldn't exacerbate tennis elbow symptons? My only concern is that it is a repetitive movement for a nearly straight elbow, so may not be ideal.

Also, is 'thumb' active massage release on the tender tendon area actually a good idea whilst the 'injury' is still present?! I fully understand the theory of trigger point massage for muscle groups, but not for dodgy tendons



Feel free to send me an invoice should you reply or feel free to PM if preferred.

[E65Ross]

Digger said:

Wasn't sure whether to PM you Ross, but will ask here for the possible benefit for all!

Would you recommend sessions of slow front crawl swimming as an exercise that shouldn't exacerbate tennis elbow symptons? My only concern is that it is a repetitive movement for a nearly straight elbow, so may not be ideal.

Also, is 'thumb' active massage release on the tender tendon area actually a good idea whilst the 'injury' is still present?! I fully understand the theory of trigger point massage for muscle groups, but not for dodgy tendons

Feel free to send me an invoice should you reply or feel free to PM if preferred.

If it is proper tennis elbow, and not something else it shouldn't be a problem.

Tennis elbow (lateral epicondylitis) can be 1 of 4 main categories according to where exactly the problem is, but by far the most common (something like 90% if my memory serves me correctly) is the point at which the tendon joins the bone (something called the enthesis) for a muscle called extensor carpi radialis brevis. Now, this muscle is a wrist extensor (hence the extensor and carpi part of its name) and abducts the wrist. The reason I'm saying all of this is because whilst pain is felt at the elbow, the main contributory factor in developing the lesion in non-traumatic cases are repeated movements of predominantly wrist extension(e.g. at a keyboard a lot, typing) and not necessarily elbow extension. So, in answer to your question there are 2 main things to say....

1 - swimming shouldn't be a problem for it
2 - if, however, swimming does make it HURT, don't do it. If it can make it a little achy etc, that's generally OK.

WRT thumb active massage and trigger point therapy you may be getting 2 different treatment modalities mixed up (or potentially 3).

There is something called active release technique which is number 1 "go to" treatment method for this problem (followed by cross friction massage). It involves shortening the muscle (ie bringing the wrist back and slightly deviated towards the direction of the thumb), clamping down over a tight/tender spot of the ECRB muscle and getting the patient to actively go in the opposite direction (flexing the wrist and taking it towards the little finger.....if this is too painful I'll do the movement for them, but it's slightly less effective in my experience).

Secondly, you have trigger point therapy, which is simply sustaining pressure on a muscle to help it relax.

Thirdly, there is general massage which helps it relax, increase blood supply etc etc etc

All of the above will help. Whilst you probably won't be able to do a massive amount of direct work to/for the enthesis/tendon-bone insertion, by relaxing the tight muscle down you will, in theory, take some of the pressure off of that tissue.

Rest alone will help, but it's a fker to get better by itself because of the poor blood supply. You should also try to regularly stretch out your wrist extensor muscles.....15-20secs hold each time, repeat 3-5x all in one go (short breaks in between....or do the other side as the break), and do that 2-3x per day.

Hope that helps and sorry it's a bit long winded. Any more questions just ask.

[Digger]

That's invaluable advice Ross. Many many thanks for taking the time to post that up. Much appreciated.

[Digger]

Just to update . . .

I reckon the elbow is at least 50% improved, so quite happy about that.

Helped by completely stopping all pull movements with weights and machines, BUT as I missed them so much, back to doing intervals on the cross-trainer which does involve putting the elbow under a fair bit of strain as I grip the machine to keep my upper body still under acceleration ie I don't use the machine's arms when doing intervals!

Also been doing the active release technique and wrist stretching as described by Ross, twice a day in the shower directly under hot hot water. Seems to have helped a large amount methinks.

Decided not to do any swimming as I feel it might be too repetitive, and would prefer to rest the elbow as much as possible.

Will keep doing all this until the end of October and see where it's at then. It would be nice to get back to training back and arms properly, but will have to remain patient, frustrating!!

[Digger]

chris watton said:

Hoofy said:

Yes, it is. Go lighter for a bit (unless you're already using the pink dumbbells, in which case, just rest).

Cheers. I shall lay off the preacher curls for a couple of weeks, then (got up to 12 reps a set using 40kg and curling bar)

How are you getting on Chris? I'd forgotten that preacher curls were causing you pain. I only mention that, as when I trained arms once a week, (stopped for a month so far) using the EZ curl bar I'd do a set standing with a wide or close grip, then seated do preacher curls with the opposite grip to standing, add 2.5kg each side, another couple of sets, rinse and repeat, continue adding weight, and then do some drop sets. Some days would end up doing 14-16 sets in total.

So hopefully that was the cause of the issue, although overtraining and taking very few days off to rest certainly didn't help!

[chris watton]

Digger said:

How are you getting on Chris? I'd forgotten that preacher curls were causing you pain. I only mention that, as when I trained arms once a week, (stopped for a month so far) using the EZ curl bar I'd do a set standing with a wide or close grip, then seated do preacher curls with the opposite grip to standing, add 2.5kg each side, another couple of sets, rinse and repeat, continue adding weight, and then do some drop sets. Some days would end up doing 14-16 sets in total.

So hopefully that was the cause of the issue, although overtraining and taking very few days off to rest certainly didn't help!

Not so bad now, thanks. I throttled back on the amount of weight I was using for a while, but am now training normally again. I still have a bit of pain, but not as bad as before. I have just ordered some elbow, knee and wrist supports to see if they help take the pressure off the joints a little.

Hurt my right shoulder now, though (one ache clears up only to be replaced by another in a different part of the body! ). Didn't realise how much the shoulder hurt until I tried to wash my car earlier!

[E65Ross]

Digger said:

Just to update . . .

I reckon the elbow is at least 50% improved, so quite happy about that.

Helped by completely stopping all pull movements with weights and machines, BUT as I missed them so much, back to doing intervals on the cross-trainer which does involve putting the elbow under a fair bit of strain as I grip the machine to keep my upper body still under acceleration ie I don't use the machine's arms when doing intervals!

Also been doing the active release technique and wrist stretching as described by Ross, twice a day in the shower directly under hot hot water. Seems to have helped a large amount methinks.

Decided not to do any swimming as I feel it might be too repetitive, and would prefer to rest the elbow as much as possible.

Will keep doing all this until the end of October and see where it's at then. It would be nice to get back to training back and arms properly, but will have to remain patient, frustrating!!

Glad to hear it's feeling better. Stretching that frequently is fine, but I wouldn't recommend the active release technique that often.

Buster73 said:

Tried acupuncture , relieved it a bit but not cured.

Time for the injection ?

Funny this topic was resurrected today, because I've just been on an acupuncture course and it's something I will be adding to my treatment for patients with various problems if they do not respond to my traditional methods.

The fact you got some relief is positive. Effects tend to be cumulative with treatment (not just acupuncture, but other modalities too), meaning that 1 day of relief can become 2 days, 5 days, a week and so on. I suspect that you didn't have enough treatments, or the time lapse between treatments were too long.

[Foppo]

I've had tennis elbow for a weeks irritating but the pain is slowly going.

To much gardening.>

[YankeePorker]

Go to Boots and buy a copper bracelet. It was recommended to my tennis crazy dad by an American friend many years ago, and it worked. My Father was a cynical scientific type person, so not really the standard prey for placebo/faith healing remedies.

Ok, you get a green mark on your wrist when you sweat, but if it does the trick then that's a small price to pay.

[Digger]

I'm not normally one to believe and accept leftfield suggestions, but they're not too expensive so may try and source a nice manly copper bracelet!

[The Beaver King]

Just found this thread after a quick search and, after reading through, this sounds like my issue.

I started back at the gym 2/3 months ago with a lot of focus on bulking up.

I was doing 3 sets of incline chest flies 2 weeks ago and felt a twinge in my left elbow; being a bloke I ignored it and powered through. Big mistake. After a shower and getting back to the car, my left elbow being extremely painful (meaning driving home one handed).

It hurt no matter what position I put it in and only seemed to stop after some Ibuprofen and Deep Heat. Back to the gym 2 days later and no issues at all.

Yesterday it started hurting while doing some bag work and worsened while doing curls (although subsided if I switched to Hammer curls). Wrecked again by the time I finished in the gym.

Ibuprofen and Deep Heat have patched it again, but I'm concerned this is going to be a reoccuring issue. I've order an elbow support in the meantime, but really don't want any downtime from the gym (I'm bulking for a specific reason).

Does this sound like Tennis Elbow or have I just pulled something? The pain is located on the outside of my left elbow and seems to be located inside. Touching the area causes no additional pain, so I'm leaning towards tendons.

Any advice guys or could it be something less severe (fingers crossed).

Not sure if it has any bearing, but I'm 28 so not exactly 'falling apart'. Not really 'overweight'; 6ft 1" and just up to 16 stone (up nearly a stone in 2 months).