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View Full Version : Oh no ... tennis elbow - it's back with a vengeance!


MCN
09-09-2008, 03:28 AM
I developed really bad TE 3 years ago and had to stop playing for 18 months. Had MRI scans, cortisone, acupuncture, physio but none of these things seemed to really work (the cortisone injections were marginally OK for temporary relief, but became less effective as I had more of them). I was on the brink of surgery when it seemed to ease up and I changed racquets and startd playing again (not quite 100% right) but managed to get through playing 2 or 3 times a week without significant pain. A few weeks ago I was doing some painting and decorating round the house and also using a screwdriver for DIY jobs - and the blasted thing has come back again - BIG TIME! I'm now really fed up. So I have two questions: Has anyone had re-occuring TE and if so, is it usually worse 2nd time around? Also - something interesting has happened. I rested the elbow for a couple of weeks and it seemed to get worse - so I said 'stuff it' and played tennis through the pain - and the next day it got better (not great, but better). Why is this? It seems to me as if there's a level of tennis you can do with TE that may actually improve the condition - BUT if you overdo this (as I have) it all gets worse again. I'm really depressed -- it's a really horrible affliction and I'm so jealous of the people who have got rid of it in just a couple of months - mine lasted for years. Doh!

superstition
09-09-2008, 03:55 AM
Get some Pacific Tough Gut 16. It has a stiffness rating of just 88 lb/in (http://www.racquetsportsindustry.com/issues/200609/200609stringselector.html).

Try to find the Prince Woodie on the auction site. It's an oversized wood racquet with graphite reinforcement. I doubt you'll find anything softer. Make sure your grip is the correct size. Not only is it soft, it's handle heavy.

String the racquet at 45 lbs.

Use regular duty Penn ATP tennis balls. Light tennis balls are essential for keeping pain down. Always use fresh balls. There are some Prince balls that are very light and bouncy also.

Don't use a lot of spin on your shots, especially the serve. Keep it flat.

Take fish oil pills (not cod liver). They're a natural mild anti-inflammatory and have other positive effects.

Zeppy
09-09-2008, 04:16 AM
I feel that I don't have a right to give you any advice since I'm not a doctor or a kinesiologist, but I would recommend you to go see a doctor, not that you already haven't, from what you told us (MRIs, cortisone, and the like). I would rest and ice it. Like what superstition said, take some fish oil pills. From what I can tell, Superstition is also trying to help you build up strengthen up your tendons. I would recommend this too, but by stretching it and lifting light weights and gradually build up.

Maybe the reason why it felt better after you played tennis was because your elbow was getting strengthen? I wouldn't overdo it though.

Moz
09-09-2008, 04:27 AM
I'm really depressed -- it's a really horrible affliction and I'm so jealous of the people who have got rid of it in just a couple of months - mine lasted for years. Doh!

I saw a specialist yesterday about my golfers elbow. He described a relatively recently developed treatment for tennis and golfers elbow which involves reinjecting your own blood into the tendon. Apparently as the tendon has such poor blood flow it has trouble healing and this is a way to circumvent it.

He stated that of 30 times he has performed this procedure none of the patients have returned with the problem. The healing time is about 6 weeks.

MCN
09-09-2008, 04:59 AM
I've been to loads of doctors over the last 3 or 4 years - some advocate more cortisone, some physio, some complete rest and the most interesting one of all was "play through the pain - but don't overdo it" - (this was from a specialist sports doctor). Another recommendation/prescription is to put an angina patch on the elbow - this is designed to open up the blood vessels a bit and get more blood and oxygen into the area which should aid rehabilitation. It's been reported that these angina patches have been successful in some TE cases - but I've only used these for a short while so can't comment on whether they're improving things or not. I am also trying to strengthen the elbow by ongoing gentle exercises and do ice regularly if it feels inflamed. I've change racquets to a Pro Kennex Ki5 recently which is reasonably flexible and reputed to be good for TE sufferers (I quite like it as a playing racquet as well). I'm too old to move to a double-handed backhand - but this would help I think as I feel as if someone has shot me in the elbow every time I hit a backhand. I just think TE is different for different people - ie there's no 'best cure' for everyone. I just hate having the short straw in this as I've tried pretty much everything bar surgery.

TheJRK
09-10-2008, 05:24 AM
Sorry to hear about the setback. I too started to get the pain again. I had pretty bad TE about 5 months ago... to the point I couldn't even hold my racket in my hand. Went to the doc, got some NSAIDs, took off for 2 months. Not only did I not play tennis for 2 months, I tried not to use my right arm for anything (brushing teeth, washing hair, using a mouse, etc.) for those two months. Then I slowly started lifting weights again, started hitting again (for about 20 min only), then finally I began to play matches.

I also switched out my gear... I was using ALU at 62 lbs in my sticks and I switched to VS gut at 57 lbs. I was able to play all-out for about two months with absolutely no pain. Then one match (about 3 weeks ago) I was just warming up and my TE hit me like a punch in the face. Once again I couldn't even hold the racket and I had to forfeit my match.

I was really frusturated because I thought I was over my TE, but alas, it has returned. So I scheduled an appointment with another doc. I'm actually going to see a sport medicine doc this afternoon (he's the doc that oversees the Legg Mason Tennis Classic here in DC). Hopefully I'll have some good news when I return.

***Interesting note*** I thought it was my serve that was causing the TE since I tend to serve on the faster side, but obviously when I was warming up for my match, I hadn't hit any serves yet and I felt the TE. So I did a little experiment. One day I played a match with a friend and just hit flat forehands... I still hit topspin on my 2HBH and I still served. I was able to play the entire match with no pain. A few day later I was hitting with a friend and proceeded to hit topspin forehands <BAM> I felt the pain immediately! So at least I have narrowed down the cause of my TE.

MCN
09-10-2008, 06:33 AM
Hey TheJRK - sorry you've had a setback as well - it's really weird how or why these things come back. In my case it was doing home improvements (I blame the wife!). Funnily enough I played for 2 hrs last night and played a really good, aggressive match. I did feel the TE on some framed shots (usually backhand) but I've learned to play through the pain using a softer racquet and an elbow brace. I thought I'd really suffer overnight (my TE usually wakes me up about 10 times per night, feels as if I've broken my arm) but it was actually a bit better than usual and I got a reasonable night's sleep. I can feel it today but it's not as bad as it sometimes is when I rest completely. That's what I mean in this post, my experience is that complete rest for a few weeks and exercises might not totally cure it at all. When I was doing gentle exercises during my first bout, it seemed to make things worse sometimes! I don't think there's been enough medical research into TE to get a good view of what a suitable course of treatment might be. I guess my decision is to keep playing (within reason) and see what happens - I can't have 2 years off again - I turned into a big grump and felt miserable all the time (- it's easy for others to say take up something else that doesn't involve your arm - but when you love and breathe the sport it's not so easy, is it?). I'll carry on with a mixture of things - pills, ice, exercise, stretches, patches - just in case some of these 'work'. But boy, is this condition an awful thing to try and get rid of!

MTChong
09-10-2008, 11:13 AM
***Interesting note*** I thought it was my serve that was causing the TE since I tend to serve on the faster side, but obviously when I was warming up for my match, I hadn't hit any serves yet and I felt the TE. So I did a little experiment. One day I played a match with a friend and just hit flat forehands... I still hit topspin on my 2HBH and I still served. I was able to play the entire match with no pain. A few day later I was hitting with a friend and proceeded to hit topspin forehands <BAM> I felt the pain immediately! So at least I have narrowed down the cause of my TE.


For me, it's primarily my serve. I can hit groundstrokes 3-4 days a week without any problems, but if I'm playing matches 3-4 days a week, my elbow will start to flare up. Additionally, I noticed that my forehand can aggravate it sometimes. I use a western grip and when I catch the ball late, it hurts my arm.

Is it the same for you?

blakesq
09-10-2008, 12:18 PM
How much does your racquet weigh? If it is a light racquet, change to a heavier, at least 12 oz racquet, or at least add lead tape to get the weight up. I switched from a light raquet to a heavier one, 12.1 oz strung, and my tennis elbow is much much better. Light raquets are horrible for tennis elbow. Good luck.


I developed really bad TE 3 years ago and had to stop playing for 18 months. Had MRI scans, cortisone, acupuncture, physio but none of these things seemed to really work (the cortisone injections were marginally OK for temporary relief, but became less effective as I had more of them). I was on the brink of surgery when it seemed to ease up and I changed racquets and startd playing again (not quite 100% right) but managed to get through playing 2 or 3 times a week without significant pain. A few weeks ago I was doing some painting and decorating round the house and also using a screwdriver for DIY jobs - and the blasted thing has come back again - BIG TIME! I'm now really fed up. So I have two questions: Has anyone had re-occuring TE and if so, is it usually worse 2nd time around? Also - something interesting has happened. I rested the elbow for a couple of weeks and it seemed to get worse - so I said 'stuff it' and played tennis through the pain - and the next day it got better (not great, but better). Why is this? It seems to me as if there's a level of tennis you can do with TE that may actually improve the condition - BUT if you overdo this (as I have) it all gets worse again. I'm really depressed -- it's a really horrible affliction and I'm so jealous of the people who have got rid of it in just a couple of months - mine lasted for years. Doh!

tennisdad65
09-10-2008, 12:39 PM
I agree with Superstition above:
1) use natural gut
2) switch to a very flexible racquet (RA ~ 55 ) about 12-12.5 oz weight
3) use lower tensions in the 40s
4) use light balls
5) do not pronate excessively on serves
6) slice your backhand more rather than using topspin/flat backhand
7) switch your grip to a cushioned gel grip

I had to do all this to get rid of my TE in about 3 months. Completely gone now :).

TheJRK
09-10-2008, 01:38 PM
For me, it's primarily my serve. I can hit groundstrokes 3-4 days a week without any problems, but if I'm playing matches 3-4 days a week, my elbow will start to flare up. Additionally, I noticed that my forehand can aggravate it sometimes. I use a western grip and when I catch the ball late, it hurts my arm.

Is it the same for you?

Yes, I use a western grip (maybe even an extreme western) as well and I have a tendency to catch the ball late. I'm almost 100% sure that this the cause of my pain. Serving fast and pronating obviously doesn't help either but I can still get away with serving flat bombs for the most part.

Try it one day, just hit flat forehands and see how your arm feels.

MCN
09-11-2008, 01:44 AM
It's mostly my 1HBH that causes me problems - especially a mis-hit BH volley - ouch! (that's why I said earlier that I should switch to 2HBH, but I'm too old to learn and prob don't play enough in any case). And no, I don't play with light racquets (used to use a Yonex RDS002 Tour SL at 12.5 oz (but this made my shoulder a bit sore and in any case I generally found it tiring to swing after a couple of sets). I now use a Pro Kennex Ki5 which still comes in at just over 12oz but feels easier to swing and is quite soft. As I posted earlier - it's not so much the tennis that makes the TE bad as I can be sensible and adjust my shots according to how I feel (although it does make it worse a bit) - it's other stuff such as decorating/painting using a screwdriver etc.. I'm trying to play more doubles on the forehand side to cut down on backhands. I also use a computer mouse for several hrs a day - it's part of my job - some have said this makes things worse - but it's difficult to change as I do lots of graphics etc... Trying to sleep is the worst - I wake up in agony when my arm is bent and I need to slowly stretch it out. I'm going to try the angina patches on the arm to get the blood flowing a bit better - there have been some positive things said about this and the doc seems to think that it may help. The blood plasma injection into the elbow is not at all common here in the UK but I might try and find someone who will do this if things don't settle down in the next few months.

Robbnc
09-11-2008, 08:43 AM
You can search for my posts on this forum about PRP (blood injection),
it works. I don't know about the UK but it is being done in many parts
of Europe.

Martingale
09-13-2008, 02:10 PM
The PRP is also done in the UK, as is prolotherapy (injection not of your own blood, but of one of a series of irritants, meant to stimulate healing). These options have been proposed to me in the UK, but I have been getting gradually better without them. I would consider either of them, though, if it was to worsen, as they seem to work for many people and they do not seem overly harsh or invasive, as a cortisone injection or surgery would.

scotus
09-13-2008, 03:06 PM
The PRP is also done in the UK, as is prolotherapy (injection not of your own blood, but of one of a series of irritants, meant to stimulate healing). These options have been proposed to me in the UK, but I have been getting gradually better without them. I would consider either of them, though, if it was to worsen, as they seem to work for many people and they do not seem overly harsh or invasive, as a cortisone injection or surgery would.

----------------

Bud
09-13-2008, 06:14 PM
Sorry to hear about the setback. I too started to get the pain again. I had pretty bad TE about 5 months ago... to the point I couldn't even hold my racket in my hand. Went to the doc, got some NSAIDs, took off for 2 months. Not only did I not play tennis for 2 months, I tried not to use my right arm for anything (brushing teeth, washing hair, using a mouse, etc.) for those two months. Then I slowly started lifting weights again, started hitting again (for about 20 min only), then finally I began to play matches.

I also switched out my gear... I was using ALU at 62 lbs in my sticks and I switched to VS gut at 57 lbs. I was able to play all-out for about two months with absolutely no pain. Then one match (about 3 weeks ago) I was just warming up and my TE hit me like a punch in the face. Once again I couldn't even hold the racket and I had to forfeit my match.

I was really frusturated because I thought I was over my TE, but alas, it has returned. So I scheduled an appointment with another doc. I'm actually going to see a sport medicine doc this afternoon (he's the doc that oversees the Legg Mason Tennis Classic here in DC). Hopefully I'll have some good news when I return.

***Interesting note*** I thought it was my serve that was causing the TE since I tend to serve on the faster side, but obviously when I was warming up for my match, I hadn't hit any serves yet and I felt the TE. So I did a little experiment. One day I played a match with a friend and just hit flat forehands... I still hit topspin on my 2HBH and I still served. I was able to play the entire match with no pain. A few day later I was hitting with a friend and proceeded to hit topspin forehands <BAM> I felt the pain immediately! So at least I have narrowed down the cause of my TE.

Serving, overheads and the one-handed BH are the shots that really aggravate TE.

MTChong
09-13-2008, 06:56 PM
Serving, overheads and the one-handed BH are the shots that really aggravate TE.

Specifically Bud, what about the serve is it? For me, that tends to aggravate it, but I wasn't sure why. Is it the pronation?

onehandbh
09-13-2008, 11:13 PM
Give Active Release Technique physical therapy a try. It hurts but works
for soft tissue injuries.

It may also be that there is something going on technique-wise in your
game that is causing the stress on your elbow. I've seen people with poor
one hand backhand technique get tennis elbow. Usually they are hitting it
with their elbow pointing at the ball at contact. Sort of an arm straightening
at contact kind of stroke. What happens is that when they are early they
are getting a bit of a mild hyperextension. Another thing I've seen is that
people that use their arm to generate topspin on the forehand side and not
enough of their body sometimes get tennis elbow. Especially when they really
windshield wipe with a very short backswing without their body behind
the shot. On the serve, sometimes using a forehand grip can be hard
on your elbow as well.

Whatever the cause, try to find the cause and fix it instead of just
trying to cope with the pain.

tlm
09-14-2008, 05:00 PM
I would suggest to anyone who gets te, after it heals do some weight lifting. I had te bad 10 years ago+ i now play tennis almost everyday, with no problems. Once in a while i will feel a little pain but it never goes any further.

I think that once you get te, you are definitely more prone to it. Also i dont think it is ever completely gone, in other words there is some damage that will always be there.

The key to not getting te again is working out, which is the key to avoiding + preventing most injurys. I do a complete forearm workout 2-3 times a week.

The whole workout take about 8 minutes, so it is pretty easy. I do 2 sets of wrist curls, 2 sets of reverse curls, 2 sets of 1 arm forearm curls+ 2-3 sets of wrist roll ups. Which is the exercize were you roll a rope around a wood handle with a weight hanging on 1 end.

If you have te it is almost impossible to do a forearm workout. You can do some stretching, but you would be in intense pain if you tried this workout while having te.

Sometimes when i do my first set of reverse curls i will feel a little discomfort in my arm, but by the 2nd set the pain is gone. I believe the reason is after pumping blood into the area it relieves the tightness.

Anyone that really wants to play tennis for a long time+ avoid injurys as much as possible needs to workout.This is especially true for te, you have to strengthen the forearm if you dont want it to come back.

I use a k95 strung at 62lbs. with full poly, use western grip with windshield wiper forehand, one handed backhand. Which i know is a little dangerous, but with strong forearms+regular workouts i have no problems.

Also i dont agree that serving causes te, it can cause golfers elbow though. The one handed backhand, gripping the racquet to tight, backhand overheads, and of course stiff light racquets with stiff strings dont help.

Martingale
09-15-2008, 02:17 PM
Agree with tlm on most points. Very important to not aggravate, or even do exercises, until it gets better and the pain is gone to a large extent. Then start muscle exercises, such as weight lifting, to get the muscles to absorb shocks better, as well as to get more blood and healing chemicals into the injured area where collagen and elastin are damaged. Th low blood supply in the tendons implies that repairs are of poor quality and very slow. This can be established by the fact that lymphocites can be shown to be absent during "healing", leading to second rate reconstruction, called tendinosis. As tlm said, a weakness seems to remain for a very long time, even if the causation for the micro tears has stopped.

It can be compared a bit to the wear of a car tyre when the driver sits in the car. The driver does not really notice the fact that the tyres wear down and the rubber becomes thin. Suddenly a small cause, such as a bit of broken glass, can deflate the tyre. The driver will blame the piece of glass, although the weakness has always been present, and any other little roughness could have deflated the tyre as well. In reverse, the rubber gets patched up a bit here and there, but will not be as durable as when new. Bad tennis technique is akin to reckless driving, such as repeated overaccelerating and excessively brusque breaking.