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View Full Version : My success overcoming chronic tennis-elbow. (longish)


hifi heretic
04-15-2004, 10:03 AM
let me preface the following by pointing out that I am not a doctor!!! I'm simply relating my experience and knowledge accumulated from reading and discussions with my doctor.

My tennis-elbow saga:

Over the past 6 years I have battled persistent tennis elbow. My left elbow developed T.E. as a result of golf (probably too much hitting off of plastic mats!) and was chronic enough to require surgical repair (after countless cortisone shots, re-hab, etc.). Two years ago (as my left elbow was healing from surgery) I got back into tennis and almost immediately developed TE in my right elbow. After swithching to a heavier "players" racquet, having a pro check my form (no obvious problems discovered), perpetual icing-down, ibuprofen, alleve, and finally a cortisone shot, I still was not getting any relief and was fearful that I was heading for yet more surgery.

Finally, my orthopedic surgeon (the one who fixed my left elbow!) referred me to a new physician in their practice (Bryn Mawr Orthopedic Associates) who was a very strong advocate of something called Prolotherapy.

With my appointment 2 weeks away, I began reading as much as I could on the subject. It's a pretty interesting approach that challenges the time-honored "R.I.C.E." paradigm (stands for Rest, Ice, Compression, Elevation) as the appropriate treatment for tendon injuries. In short, the premise is that tendon and ligament injuries should NOT be treated the same way as muscle injuries are treated (i.e., with swelling-reducing intervention). Attempts to reduce swelling through R.I.C.E. and the taking of N.S.A.I.D.s (ibuprofen, Alleve, Aspirin) are increasingly viewed by many sports medicine docs as quite counterproductive in the case of tendon injuries. Whereas the swelling response of a muscle injury is generally so severe that that the swelling becomes problematic (hence the need for R.I.C.E.), tendons/ligaments swell very little. In fact, because of their very limited blood supply, the body's healing processes simply aren't adequately triggered. In essence, some swelling is good and necessary part of the healing process - while too much of it is a bad thing, so is too little. Tennis elbow (lateral epicondylitis) is a painful condition where small tendon tears persist without healing - it is believed by proponents of this treatment - because the body's own healing-processes are not adequately triggered. It is believed that TE occurs when elbow tendons become lax and some play develops in the joint which allows for destructive rubbing of bone against tendon within the joint. Prolotherapy is a process of injecting an irritant (glucose in my case) directly into the injured tendon with the goal of causing temporary swelling and triggering a more pronounced healing response from the body. Unlike cortisone which only reduces the pain temporarily (and allows the root cause to continue and perhaps worsen), Prolotherapy is intended to help heal the injury AND help prevent reoccurrence by leading to a tightening and thickening of the tendon/ligament. Apparently, it's not altogether new. It used to be the standard treatment for many soft-tissue injuries up until the 60's when cortisone became popular. If you go this route, your doctor will urge you to cease using all anti-inflammatories and ice!

All I can say is that it definitely has made a difference in my case! I was skeptical, but it's clearly working. I've had two treatments (with 4wks b/w) and I'm now about 90% free of all pain. This is far better than what I was able to accomplish through icing, bracing, cortisone shots, etc.. Though the shots are quite painful, they are considered (even by those who are question the treatments effectiveness) to be quite safe and non-invasive. If you have persistent TE, I urge you to ask your doctor what he knows of prolotherapy. If he knows very little, then I urge you to call around to other Sports-medicine practices until you find some who can refer you to a practioner. You can also visit prolotherapy.co(m) to read up and find a listing of practicing physicians in your area.

James Brown
04-15-2004, 11:17 AM
do you know if this works with golfer's elbow as well? Thanks for your story

hifi heretic
04-15-2004, 12:59 PM
James... visit the website. Prolotherapy - according to its advocates - works for a whole host of tendon and ligament related problems.

bee
06-25-2004, 10:19 PM
LONGBODY RACQUETS CAUSE MORE STRESS ON THE ELBOW. AVOID THEM IF YOU HAVE A TENDENCY TOWARDS ELBOW PROBLEMS.

NATURAL GUT STRINGS REALLY MAKE A DIFFERENCE AND SUPPLY ADDED POWER AS WELL! WHAT'S NOT TO LIKE? THE PRICE IS NOT THAT BAD IF YOU CONSIDER INJURY PREVENTION AS PART OF THE BARGAIN. HMMM?

TAKING A HOT SHOWER BEFORE PLAYING CAN HELP. LET THE WATER STREAM MASSAGE THE UPPER BODY AND STRETCH A BIT. OH YEAH!

FOLLOW THROUGH. LOOK AT HOW YOUR SWINGING. DON'T BE NEUROTIC ABOUT IT. FOLLOW ON THROUGH AND HIT THE THING. YEAH, IT MIGHT GO OUT...OR IT JUST MIGHT BE A SCREAMER THAT LANDS IN. REALLY. BEING TENATIVE AND CHECKING THE SWING MIDWAY (AS I'VE BEEN PRONE TO DO) PUTS A LOT OF STRESS ON THE ELBOW.

IF YOU GET THE SORE ELBOW PART OF THE TREATMENT IS TO JUST NOT PLAY FOR SEVERAL WEEKS OR MONTHS AND THEN GO AT IT AGAIN WITH SOME CHANGES MADE. AND, UH...IF NOTHING CHANGES, NOTHING CHANGES.

BEE

arthriticknee
07-16-2010, 03:10 AM
Both tennis and golfers elbow are extremely frustrating conditions that are caused by gripping objects like racquets and clubs. I know plenty of golfers with tennis elbow and vice versa. They are essentially the same condition in a different location. If the wrist extensors are aggravated, the pain is located on the outside of the elbow (if your arm is out straight and palm facing foreward), when the pain is on the inside, it is golfer's elbow and it is the origin of the wrist flexors that is to blame.
This problem has been annoying physical therapists like myself for years. Many treatments (like ultrasound, stretching, massage, cortisone injections) help some people but not all.
Thankfully things have changed. Other parts of the body suffering from tendonitis have always responded well to eccentric exercise. The only problem with the elbow was that no one (myself included) could work out a simple way of doing these.
A smarter physical therapist called Tim Tyler solved the riddle with an ordinary piece of exercise equipment called a flexbar - a rubber bar that lets you build tension through rotation.
It is not great for business but anyone with either golfers or tennis elbow (and this counts for even the most long-term, stubborn cases) I do a single session to show them the eccentric exercise and send them on their way.
There are numerous websites that have detailed instructions including written steps and video examples.
An easy to understand one for Tennis Elbow is www.flexbar.info (http://www.flexbar.info)
For golfer's elbow try:
http://hubpages.com/hub/Golfers-Elbow

NOTE: You need to be 100% sure of which type of tendonitis you have. Doing the golfers elbow exercises when you have tennis elbow will get you nowhere and may exacerbate the problem. If in doubt, see your physical therapist!

mikeler
07-16-2010, 04:14 AM
Ultrasound combined with electrostimulation treatments have worked well for myself and several people down at the club I play at. It took about 12 sessions for my elbow to get better with no playing. The flexbar is great AFTER your elbow is healed to prevent future flareups.