Discussion
hi all
I think i know the answer to this already - see a dr. Did phone GP but they said to see A&E but with covid etc prefer not unless no option.
About a month ago i had a pedal strike on my mountain bike, rather awkward dowbhill bend at around 15mph resulting in my going over the handlebars. Before i knew it my head was scraping along the gravel and i was thinking how glad i was to be wearing a helmet. Bike landed on top of me.
Bit sore but no issues till a few days or maybe a week later when my left elbow started twinging. Fast forward 3 weeks and its pretty painful to do certain things like open door handles, pull actions, or put weight on it. My tendon slips over the elbow joint/bone when i do a push-up action. Ive still been riding and its mostly ok unless doing a steep uphill or downhill which pulls or pushes on the handlebars.
Prodding my elbow causes pain on the nobbly bit that sticks out when arm is bent. No swelling, no redness etc.
Does this sound like tennis elbow (which google says cyclists can get), or something more serious like a fracture?
thanks
Mike
I think i know the answer to this already - see a dr. Did phone GP but they said to see A&E but with covid etc prefer not unless no option.
About a month ago i had a pedal strike on my mountain bike, rather awkward dowbhill bend at around 15mph resulting in my going over the handlebars. Before i knew it my head was scraping along the gravel and i was thinking how glad i was to be wearing a helmet. Bike landed on top of me.
Bit sore but no issues till a few days or maybe a week later when my left elbow started twinging. Fast forward 3 weeks and its pretty painful to do certain things like open door handles, pull actions, or put weight on it. My tendon slips over the elbow joint/bone when i do a push-up action. Ive still been riding and its mostly ok unless doing a steep uphill or downhill which pulls or pushes on the handlebars.
Prodding my elbow causes pain on the nobbly bit that sticks out when arm is bent. No swelling, no redness etc.
Does this sound like tennis elbow (which google says cyclists can get), or something more serious like a fracture?
thanks
Mike
This question is completely impossible to answer without an examination as a bare minimum so frankly every reply you get, including this one will at best be pointless and at worst dangerously misleading.
Personally I would examine you before directing you to A&E, since doing so could mean an XR is not necessary - you were presumably directed to A&E to rule out a fracture. All they’d do is an XR and then send you on your way as you’d no longer be their problem, so your pain would still require a diagnosis.
In general terms onset of pain delayed by days would suggest a soft tissue (e.g. tendon, muscle) injury is more likely than a fracture but that’s not inviolable. Tenderness over the olecranon (use Google) is not indicative of tennis elbow, which would typically give you tenderness over the lateral epicondyle (again, Google) and pain in your elbow when you make a fist and extend the wrist.
I would suggest you contact GP again either over the phone or via e-consultation (check the website to see if they have it). Explain exactly what happened and report that the pain has worsened over time and that doing innocuous activities is exacerbating the pain. At least if he/she thinks you need an XR they could give you a form so you can book it and avoid waiting in casualty for hours. If you are given the same answer then bite the bullet and go to A&E. if it’s not a fracture then your GP will need to diagnose and treat you. Don’t worry about Covid; the infection rate in most areas is low single digits per hundred thousand per day. I haven’t so much as spoken to a person with a cough in primary care for three months. You’re more likely to die of boredom in the ED than contract Covid.
Personally I would examine you before directing you to A&E, since doing so could mean an XR is not necessary - you were presumably directed to A&E to rule out a fracture. All they’d do is an XR and then send you on your way as you’d no longer be their problem, so your pain would still require a diagnosis.
In general terms onset of pain delayed by days would suggest a soft tissue (e.g. tendon, muscle) injury is more likely than a fracture but that’s not inviolable. Tenderness over the olecranon (use Google) is not indicative of tennis elbow, which would typically give you tenderness over the lateral epicondyle (again, Google) and pain in your elbow when you make a fist and extend the wrist.
I would suggest you contact GP again either over the phone or via e-consultation (check the website to see if they have it). Explain exactly what happened and report that the pain has worsened over time and that doing innocuous activities is exacerbating the pain. At least if he/she thinks you need an XR they could give you a form so you can book it and avoid waiting in casualty for hours. If you are given the same answer then bite the bullet and go to A&E. if it’s not a fracture then your GP will need to diagnose and treat you. Don’t worry about Covid; the infection rate in most areas is low single digits per hundred thousand per day. I haven’t so much as spoken to a person with a cough in primary care for three months. You’re more likely to die of boredom in the ED than contract Covid.
Edited by DeWar on Wednesday 26th August 11:47
Managed to finally get through to speak to a GP and the advice is to rest for a week and warm treatment on the elbow, something about bursitis. If that doesnt improve then i call back for a face to face. They are saying no mtb for a week, and no opening jars as the two examples i gave of activities that cause pain.
Have a feeling i will be calling back next friday but lets see.
Looking at strava it was six weeks ago, and wife reckons i was complaining about a bad arm from day one. Curse my memory.
Have a feeling i will be calling back next friday but lets see.
Looking at strava it was six weeks ago, and wife reckons i was complaining about a bad arm from day one. Curse my memory.
Edited by bmwmike on Friday 28th August 10:57
I had Achilles bursitis and I’ve also had what we would typically call elbow tendonitis and it sounds more like the latter to me.
Bursitis was really debilitating, I couldn’t comfortably walk for days and it slowly dissipated.
Tendonitis is fine unless you do something to irritate it, and the pain goes quite quickly if you stop.
The best advice for tendonitis is to do high rep low stress exercise to stimulate blood flow to the area without causing the inflammation.
Googling theraband flexbar would be a good place to start. That definitely helped me.
Bursitis was really debilitating, I couldn’t comfortably walk for days and it slowly dissipated.
Tendonitis is fine unless you do something to irritate it, and the pain goes quite quickly if you stop.
The best advice for tendonitis is to do high rep low stress exercise to stimulate blood flow to the area without causing the inflammation.
Googling theraband flexbar would be a good place to start. That definitely helped me.
DeWar said:
This question is completely impossible to answer without an examination as a bare minimum so frankly every reply you get, including this one will at best be pointless and at worst dangerously misleading.
Personally I would examine you before directing you to A&E, since doing so could mean an XR is not necessary - you were presumably directed to A&E to rule out a fracture. All they’d do is an XR and then send you on your way as you’d no longer be their problem, so your pain would still require a diagnosis.
+1Personally I would examine you before directing you to A&E, since doing so could mean an XR is not necessary - you were presumably directed to A&E to rule out a fracture. All they’d do is an XR and then send you on your way as you’d no longer be their problem, so your pain would still require a diagnosis.
definitely keep an eye on it, long story short, fell down the stairs back in feb, tripped over the dog early hours, called ambulance as was screaming in pain the following morning, due to covid, wouldn't take me in, even when i called them back early hours the next dayas i couldnt move without screaming, had various weeks off work. finally spoke to a doctor that looked at my file, osteopenia been diagnosed since 2005, sent for xray finally, saw from the look on their faces wasn't good, have a burst t12 fracture, that has been left for 6 months, very quickly got an mri scan, thankfully no shattered fragments near spinal cord, as have been in absolute agony for months.
saw the trauma clinic and the bone has healed as it had 6 months to do what it wanted, but not in alignment or a good way, so just waiting for appointment to try injections via the spine and ct scan into the nerves.
just glad some one has taken me seriously of how much pain i was in.
good luck with the recovery
saw the trauma clinic and the bone has healed as it had 6 months to do what it wanted, but not in alignment or a good way, so just waiting for appointment to try injections via the spine and ct scan into the nerves.
just glad some one has taken me seriously of how much pain i was in.
good luck with the recovery
Good luck MC with the recovery.
Looking back at my calendar ive done 21 rides since the fall, around 170 miles, and only ride i skipped was the next day because according to whatsapp message to a mate my arm was "aching like f***". Cant believe ive let this go so long.
Will rest it over weekend and call em back next week. Doh.
Looking back at my calendar ive done 21 rides since the fall, around 170 miles, and only ride i skipped was the next day because according to whatsapp message to a mate my arm was "aching like f***". Cant believe ive let this go so long.
Will rest it over weekend and call em back next week. Doh.
Eventually got seen by doc and had the elbow xrayed and they said its golfers elbow brought on by the accident.
Im still riding my bike, just slower and less of anything that causes pain.
Guitar is the worst thing as my elbow aches like buggery after ive played but not during, oddly. Left elbow, so left hand chords etc.
Doc recommended wearing a band which ive been doing, tight around my forearm.
Is it just a case of waiting it out now? I have been told to rest but thats easier said than done. Accident was July 18 and its worse today than it was the day after i did it!
Have private medical, might ask for a referral to see a specialist.
Anyone else got golfers elbow from a mtb accident? Nearest i come to golf is riding through on my mtb.
Im still riding my bike, just slower and less of anything that causes pain.
Guitar is the worst thing as my elbow aches like buggery after ive played but not during, oddly. Left elbow, so left hand chords etc.
Doc recommended wearing a band which ive been doing, tight around my forearm.
Is it just a case of waiting it out now? I have been told to rest but thats easier said than done. Accident was July 18 and its worse today than it was the day after i did it!
Have private medical, might ask for a referral to see a specialist.
Anyone else got golfers elbow from a mtb accident? Nearest i come to golf is riding through on my mtb.
bmwmike said:
Eventually got seen by doc and had the elbow xrayed and they said its golfers elbow brought on by the accident.
Medial epicondylitis can be a swine to get rid of. Try aggressively rubbing the ball of the elbow joint for a couple of minutes - it will hurt like hell for a while then the pain will recede quite quickly. Also those antiinflammatory creams offer some respite. Every time you ride you'll antagonise the elbow though I speak from the perspective of a motorcyclist and sports enthusiast who has suffered the same!bmwmike said:
Is it just a case of waiting it out now? I have been told to rest but thats easier said than done. Accident was July 18 and its worse today than it was the day after i did it!
Hate to say it but you have a simple choice here. Either do what the doc says and rest it up, or live with the pain (which is probably only going to continue to get worse).I've had a few bouts of tennis elbow over the years and whilst supports definitely ease the symptoms, resting and time is the only thing that actually fixes it.
deckster said:
Hate to say it but you have a simple choice here. Either do what the doc says and rest it up, or live with the pain (which is probably only going to continue to get worse).
I've had a few bouts of tennis elbow over the years and whilst supports definitely ease the symptoms, resting and time is the only thing that actually fixes it.
Massaging the (scar) tissue on the ball of the elbow and eccentric wrist curls work for some. But as you say one needs to rest it almost completely.I've had a few bouts of tennis elbow over the years and whilst supports definitely ease the symptoms, resting and time is the only thing that actually fixes it.
deckster said:
Hate to say it but you have a simple choice here. Either do what the doc says and rest it up, or live with the pain (which is probably only going to continue to get worse).
I've had a few bouts of tennis elbow over the years and whilst supports definitely ease the symptoms, resting and time is the only thing that actually fixes it.
I disagree, and actually the medical advice in this area has moved on from rest. If you rest it; it is unlikely to heal properly, because tendons don't get their own blood flow, and will more likely than not become an ongoing cycle of rest, injure, rest, injure.I've had a few bouts of tennis elbow over the years and whilst supports definitely ease the symptoms, resting and time is the only thing that actually fixes it.
The current advice is to work it, and encourage blood flow to the area, it will feel irritated but shouldn't hurt and the irritation subsides quickly.
I think I suggested previously that the OP buy a flex bar, doing reverse Tyler twists will likely see results quickly.
This is a good guide - which the OP might find useful - https://stevenlow.org/overcoming-tendonitis/
To be fair it looks like I might be out of date now as well, although the mechanism for repair is still the same the thinking about blood flow has changed.
In any case, I wouldn't just rest it and hope it goes away.
you must stop the overuse though, and that's acknowledged on that Steven Low page and multiple other researchers.
If Golf/Tennis caused your tendinitis, then you should dial right back on this, and expect to wait 18 months.
Musculoskeletal Science and Therapy is plagued by bad quality research. The most important thing to disregard these weak or poor studies and only accept high quality research, even if this means you have little to go on. As a researcher and therapist I try to stick only to strongly proven results and thus you often get a list like this one below which is a bit depressing.
The real gold for these painful tendons and tendon origins is on that page at the bottom:
Source: https://stevenlow.org/overcoming-tendonitis/
If Golf/Tennis caused your tendinitis, then you should dial right back on this, and expect to wait 18 months.
Musculoskeletal Science and Therapy is plagued by bad quality research. The most important thing to disregard these weak or poor studies and only accept high quality research, even if this means you have little to go on. As a researcher and therapist I try to stick only to strongly proven results and thus you often get a list like this one below which is a bit depressing.
The real gold for these painful tendons and tendon origins is on that page at the bottom:
StevenLow said:
High quality evidence = eccentrics. This is likely the best study explaining why eccentrics work.
Moderate quality evidence = ECST knee and achilles (moderate to weak),ECST for calcific tendonitis. Surgery (variable from low to moderate, and depends which surgery. Some have high satisfaction)
Weak evidence / No evidence / Conflicting evidence { IE don't bother with these they are snake oil } = PRP (platelet rich plasma), PRP for knee (moderate to weak but need to be in conjunction with eccentrics, overall mixed results), LLLT (low level laser therapy — weak helpful, mainly for pain), ECST (covered above), prolotherapy and other sclerosing injections (probably helps, but still limited evidence), stretching and balance training (no evidence or make it worse — hence why I only use stretching for range of motion deficits), massage/manual therapy (case studies weak evidence in support, systematic reviews helpful in conjunction with eccentrics), acupuncture (might help lower body), dry needling (little to no evidence), possible improvement with nitroglycerin, ergonomics (useful for pain management, but doesn’t solve the problem), supplements like fish oil, gelatin, vitamin C, L-lysine, glucosamine and chondroitin, (See bottom of this article for supplements section), etc.
No evidence = Ultrasound (doesn’t work), NSAIDs (no evidence as tendinopathy is generally not inflammatory)
Can help, but too much makes it worse and possible long term issues = corticosteroids/cortisone (short term better pain and function, long term worse)
Remember, all the guys that sell you the unproven therapies are just keen to make a buck and then move quickly onto the next fad. They don't actually care if it works for you.Moderate quality evidence = ECST knee and achilles (moderate to weak),ECST for calcific tendonitis. Surgery (variable from low to moderate, and depends which surgery. Some have high satisfaction)
Weak evidence / No evidence / Conflicting evidence { IE don't bother with these they are snake oil } = PRP (platelet rich plasma), PRP for knee (moderate to weak but need to be in conjunction with eccentrics, overall mixed results), LLLT (low level laser therapy — weak helpful, mainly for pain), ECST (covered above), prolotherapy and other sclerosing injections (probably helps, but still limited evidence), stretching and balance training (no evidence or make it worse — hence why I only use stretching for range of motion deficits), massage/manual therapy (case studies weak evidence in support, systematic reviews helpful in conjunction with eccentrics), acupuncture (might help lower body), dry needling (little to no evidence), possible improvement with nitroglycerin, ergonomics (useful for pain management, but doesn’t solve the problem), supplements like fish oil, gelatin, vitamin C, L-lysine, glucosamine and chondroitin, (See bottom of this article for supplements section), etc.
No evidence = Ultrasound (doesn’t work), NSAIDs (no evidence as tendinopathy is generally not inflammatory)
Can help, but too much makes it worse and possible long term issues = corticosteroids/cortisone (short term better pain and function, long term worse)
Source: https://stevenlow.org/overcoming-tendonitis/
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