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View Full Version : Absolutely NO PAIN before returning? (Golfer's elbow)


yemenmocha
12-10-2009, 01:15 PM
Re: Golfer's Elbow

I'm 10 months into my current rest from a failed attempt to return to hitting. I've made a lot of progress with PT exercises, weightlifting in general, and especially the eccentric exercises for my forearms.

I have no pain during or after any of the above weight exercises. I'm able to do bicep curls with normal dumbell weights, chin ups with some weight assistance (I'm overweight), as well as push-ups and dips. All with no pain.

I have zero pain when swinging racquet in the air at home, and even after 2 very light & very short hitting sessions (I demoed and purchased the Pro Kennex kinetic racquet & strung it loose with multifilament).

However, about once every other day something triggers a minor shock of pain to my elbow such as using my index finger as a shoehorn to get my sneakers on, or maybe shampooing hair, or even rubbing my eyes out of tiredness at the end of the evening. Pain is no more than a 1 on a 1 to 10 scale of pain.

Would you slowly return to hitting or wait a few more months until there is zero pain?

:cry::cry::cry:

mikeler
12-10-2009, 02:11 PM
Granted it has only been 1 month for me, but I'm in the same boat. No pain when I take a racket out and serve into the air. Last weekend serving hitting an actual ball was painful but hitting was fine except mishits. Every now and then I do some unknown motion where I feel that 1 out of 10 pain. I'm going to hit again this weekend and hit a few serves to see if I've made any progress.

bad_call
12-10-2009, 05:41 PM
...Would you slowly return to hitting or wait a few more months until there is zero pain?

definitely return if the pain level is that low. get used to a little pain ...especially as one ages. :( :) :shock:

yemenmocha
12-10-2009, 06:26 PM
But what about the general rule of thumb that if it hurts, you should stop doing it... or that if it hurts, then it isn't fully healed?

bad_call
12-10-2009, 06:33 PM
if i could alter my technique enough that the pain wasn't distracting when playing, then off to the courts. after play, ice and maybe aspirin or whatever. in fact still do that on occasion when necessary.

larry10s
12-11-2009, 04:01 AM
definitely return if the pain level is that low. get used to a little pain ...especially as one ages. :( :) :shock:

look at the name of this poster. i mean no disrespect. but that is a bad call.imho. the op aready has failed before from coming back too soon . if you (the op) can still wait, WAIT. i read somewhere and it was not referenced but the advice given was dont think about hitting a ball untill you can do wrist flection extension exercises with 5 lbs. and no pain. when i was recovering from te i had to start with a tomato paste can !!!! because i could not do them with a 1 lb weight.

bad_call
12-11-2009, 06:33 AM
look at the name of this poster. i mean no disrespect. but that is a bad call.imho. the op aready has failed before from coming back too soon . if you (the op) can still wait, WAIT. i read somewhere and it was not referenced but the advice given was dont think about hitting a ball untill you can do wrist flection extension exercises with 5 lbs. and no pain. when i was recovering from te i had to start with a tomato paste can !!!! because i could not do them with a 1 lb weight.

someone call me? :) use common sense or hawkeye if available or read my post regarding technique larry. btw - it's just above your post. :rolleyes:

if u can't pick up a 1 lb weight and try to play tennis = complete denial / bad judgment.

mikeler
12-11-2009, 06:55 AM
It's a good question. I've been playing with pain for a year, so I'm trying to nip this in the bud for good. My thinking is I don't want my arm to get so out of shape that I hurt something else resting this injury. So I still want to get out there and hit some.

yemenmocha
12-11-2009, 07:34 AM
look at the name of this poster. i mean no disrespect. but that is a bad call.imho. the op aready has failed before from coming back too soon . if you (the op) can still wait, WAIT. i read somewhere and it was not referenced but the advice given was dont think about hitting a ball untill you can do wrist flection extension exercises with 5 lbs. and no pain. when i was recovering from te i had to start with a tomato paste can !!!! because i could not do them with a 1 lb weight.

I do 3 sets of 15-18 reps, eccentric range of motion only. I'm up to 12.5 lbs. with no pain during or after the exercise.

Only pain is the random weird shock from little things, like cutting my Belgian waffle this morning with too much enthusiasm (I was hungry and needed food in mouth, fast).

charliefedererer
12-11-2009, 07:56 AM
You may want to try a very limited hit, like 5 minutes of easy groundstrokes on a backboard. Icing the area after playing is probably the best way of limiting the inflammatory reaction.
If pain occurs on tasks of daily living, then you need to hold off.
Even if pain doesn't occur, proceed cautiously by adding only a few more minutes per hitting session, and just using a very easy swing motion. Remember that even with your exercises, these muscles have not moved in unison hitting a ball, or absobing the shock of hitting a ball, for a long time. Therefore very gradually increase the length of time and the force you use in hitting over many weeks. Volleys involve more of a blocking motion, and maybe you can work on these to help develop your timing. Serving invovles the most violent motion and should be held for last. But even with serves, start with just an easy motion and at first no first serves. All along the way you are doing an experiment to see how much your arm will tolerate. If there is pain (not just a little muscle soreness) you will have to rest and then start again. There is no way of telling right now how fast your progress will be. There is no way of telling at any point in time whether the next progression will result in your needing to hold off for a time.

But I wish you good luck on your comeback, and hope the progress is faster than slower.

larry10s
12-11-2009, 09:29 AM
You may want to try a very limited hit, like 5 minutes of easy groundstrokes on a backboard. Icing the area after playing is probably the best way of limiting the inflammatory reaction.
If pain occurs on tasks of daily living, then you need to hold off.
Even if pain doesn't occur, proceed cautiously by adding only a few more minutes per hitting session, and just using a very easy swing motion. Remember that even with your exercises, these muscles have not moved in unison hitting a ball, or absobing the shock of hitting a ball, for a long time. Therefore very gradually increase the length of time and the force you use in hitting over many weeks. Volleys involve more of a blocking motion, and maybe you can work on these to help develop your timing. Serving invovles the most violent motion and should be held for last. But even with serves, start with just an easy motion and at first no first serves. All along the way you are doing an experiment to see how much your arm will tolerate. If there is pain (not just a little muscle soreness) you will have to rest and then start again. There is no way of telling right now how fast your progress will be. There is no way of telling at any point in time whether the next progression will result in your needing to hold off for a time.

But I wish you good luck on your comeback, and hope the progress is faster than slower.

excellent post. good advice

larry10s
12-11-2009, 09:30 AM
I do 3 sets of 15-18 reps, eccentric range of motion only. I'm up to 12.5 lbs. with no pain during or after the exercise.

Only pain is the random weird shock from little things, like cutting my Belgian waffle this morning with too much enthusiasm (I was hungry and needed food in mouth, fast).

everyone whose had te or ge gets "twinges" and/or soreness from time to time. if its random and minimal try the advice above by charliefederer

Shangri La
12-11-2009, 10:06 AM
If the original injury was severe enough to stop you from playing, then it's hard to return to the sport with absolutely ZERO pain. Of course you'd return with caution, but you'll have to learn to control the pain, deal with some discomfort/soreness at least, ice and stretch a lot, for as long as you want to play. Sorry if I sound negative, but this is from other injuries I had, not too sure about GE/TE though.

larry10s
12-11-2009, 10:18 AM
bad call technique improvement was not the question the question was if still having symptoms is it time to return to tennis. get" used to a little pain" to me was not the best advice.i could be wrong.

larry10s
12-11-2009, 10:23 AM
If the original injury was severe enough to stop you from playing, then it's hard to return to the sport with absolutely ZERO pain. Of course you'd return with caution, but you'll have to learn to control the pain, deal with some discomfort/soreness at least, ice and stretch a lot, for as long as you want to play. Sorry if I sound negative, but this is from other injuries I had, not too sure about GE/TE though.

from my own experience yes you will have soreness/discomfort from time to time after in my case te but its not disabling and ice, antiinflammatories, and rest usually quiet it down. this is AFTER you have recovered. the issue now is at what level of symptoms should you come back.

larry10s
12-11-2009, 10:45 AM
http://www.nismat.org/ptcor/tennis_elbow theres a table showing a progression of how much hitting to do when you get there. got this from mikeler from another thread .

mikeler
12-11-2009, 10:52 AM
http://www.nismat.org/ptcor/tennis_elbow theres a table showing a progression of how much hitting to do when you get there. got this from mikeler from another thread .


That table seems pretty reasonable to me. charliefedererer's approach is more conservative but could be better depending on the person.

DANMAN
12-11-2009, 10:55 AM
EDIT: OP can disregard below as I saw in another thread he has been to the doctor (though another visit if possible may still be best); however, this goes for those that always have health and fitness questions and never go to a physician:

There is a very easy answer: go to the doctor. Let him/her tell you if the pain is ok to play through with NSAIDs or a cortisone shot. Everyone here always has advice about what to do, but most people on this forum are not doctors. If you are worried about tendon inflammation, go get it checked out by someone who studies tendons and healing and inflammation and everything else that can go wrong with your body for a minimum of 7 years. Injuries that can be nagging like lateral/medial epicondylitis (TE/GE respectively) should be dealt with appropriately.

I really wish you the best, and this is the best advice I can give you. Hope you make it back to the courts soon.

mikeler
12-11-2009, 11:15 AM
I've already been to an orthopedic surgeon and tried the cortisone route once. :(

larry10s
12-11-2009, 04:30 PM
I've already been to an orthopedic surgeon and tried the cortisone route once. :(

look into platelet rich plasma therapy if other traditional therapy did not help

mikeler
12-11-2009, 05:46 PM
look into platelet rich plasma therapy if other traditional therapy did not help


What type of professional do you see for this?

bad_call
12-13-2009, 04:05 PM
What type of professional do you see for this?

quite possible that it's not offered in your current health plan. :-?

larry10s
12-14-2009, 05:02 AM
What type of professional do you see for this?

orthopedist but not all do it. still not mainstrem. relatively new.
http://www.nytimes.com/2009/02/17/sports/17blood.html?_r=1
http://www.orthohealing.com/plateletrichplasmatherapy-prp/
the comprehensive review link in that article might be more than you want to read

bad_call
12-14-2009, 06:33 AM
orthopedist but not all do it. still not mainstrem. relatively new.
http://www.nytimes.com/2009/02/17/sports/17blood.html?_r=1
http://www.orthohealing.com/plateletrichplasmatherapy-prp/
the comprehensive review link in that article might be more than you want to read

PRP has been around for 20 years. why "relatively new" and not mainstream?

Blade0324
12-17-2009, 07:22 AM
I am one that is going to be on the opposite end of the spectrum on this. I had a bit of GE a little over a year ago and instead of stopping hitting I made a point to note when I had pain from hitting. I worked with my coach and we were able to make minor tweaks in certain mechanics to get to a point where playing did not cause me pain. I have also started using resistance bands regularly. I have very little pain in the joint now but after long matches sometimes still a little bit, maybe 3 out of 10. I just take advil before and after playing and it works out well.

IMO if you play any sport with intensity and at a pretty high level there is a degree of pain in various areas of the body that is to be expected. Either you learn to live with it or you don't.

charliefedererer
12-17-2009, 11:54 AM
PRP has been around for 20 years. why "relatively new" and not mainstream?

Golfer's and tennis elbow include a wide spectrum of degree and anatomical extent of inflammation, and most who have it are actually neither golfer's or tennis players. And those that arrive for platelet rich plasma therapy usually only do so after other other therapies have failed, and all too often in a subgroup of patients who continued to work/exercise/train even in the face of pain and continued inflammation. Yes, this does seem to help people, but it is hard to predict exactly who it will help, how much to inject, how diffuse the injection needs to be and what is really happening at the tissue level - it seems like a stimulation of a more acute inflammation with the result that normal feedback mechanisms against chronic inflammation finally kick in. Again, a relatively murky overall procedure. But hey, if it works for you, great. If not, was it worth a shot?

bad_call
12-17-2009, 12:17 PM
Golfer's and tennis elbow include a wide spectrum of degree and anatomical extent of inflammation, and most who have it are actually neither golfer's or tennis players. And those that arrive for platelet rich plasma therapy usually only do so after other other therapies have failed, and all too often in a subgroup of patients who continued to work/exercise/train even in the face of pain and continued inflammation. Yes, this does seem to help people, but it is hard to predict exactly who it will help, how much to inject, how diffuse the injection needs to be and what is really happening at the tissue level - it seems like a stimulation of a more acute inflammation with the result that normal feedback mechanisms against chronic inflammation finally kick in. Again, a relatively murky overall procedure. But hey, if it works for you, great. If not, was it worth a shot?

that sums it up.

will pass on this one but then i've accepted a certain level of pain ... like Blade.