Can't fix my tennis elbow

Discussion in 'Health & Fitness' started by jaybear1909, Oct 23, 2011.

  1. mikeler

    mikeler G.O.A.T.

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    It happened again and I'm glad. Two years ago, I had a severe stomach illness that put the nail in the coffin of my GE. Not sure how being sick heals tendons, but it did for me. Just had another less severe winter bug and my Achilles heels feel terrific and even my minor TE is gone. I pretty much have to poke those areas now with my fingers to feel anything. Of course, a fresh bed of gut helps the old elbow.
     
  2. Posture Guy

    Posture Guy Professional

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    I'll give my two cents on the subject.

    There's been a lot of great advice on this thread and I'm not here to contradict it, but to add to it.

    First, stop playing tennis until the pain is gone. Pain isn't the problem, pain is a message ABOUT the problem, and it's telling you you're inflamming the soft tissue in your elbow. Do what you need to do to get the inflammation to subside. Rest, ice, then go to ice/heat intervals, and maybe some gentle massage. When an area is inflamed you don't want overly aggressive deep tissue work, it can aggravate the inflammation.

    Second, the one thing no one is talking about in this thread is from my perspective one of the most common causes of tennis elbow, and that is the position of the upper (thoracic) back and shoulder complexes. here's a test you can do: stand naturally and just let your arms hang down without exerting any effort to position them. Have someone take a photo of you from in front of you, then another from behind you. If your upper back and shoulders are in a sound position, your palms should be facing your hips so that all you see from a front view is basically your thumb. You should not be able to see any of your fingers' knuckles. From a back view you should not be able to see your palms. If you can, you have a posture problem and that mis-position is absolutely putting your elbows into a dysfunctional position. You can try all the racquets and PRP and manual therapy you want but until you fix the POSITION that your elbow is in when you ask it to play tennis, you're going to have problems. You simply cannot have an upper back and shoulder that is out of position and have an elbow that isn't also out of position. And when a joint is mispositioned, it will incur more friction when it articulates than if it were normally and properly positioned. Also look at the height of your shoulders. Are they the same, or different? You're designed to be symmetrical. If you're not, you have a problem. You can also take side view photos (if you're a guy, take these photos without a shirt on. If a woman, just wear a sports bra). In the side view photos, draw a dot on the center of your shoulder and another at the center of your elbow and connect them. Does that line point straight up, or does it angle forward. My guess with you is it angles forward, which indicates shoulder capsule hinging. Not good, and again it puts a lot of stress on your elbow. If you see issues here and want a basic resource to start working on these things, here's the book I recommend: Pain Free by Pete Egoscue. Disclaimer: I'm the clinic director of The Egoscue Clinic in Austin. I would read the first three chapters, then alternate the exercises for shoulder/elbow issues with the routine for the thoracic back.

    Once you get the joint into a more functional position, THEN strengthening work is indicated. Strengthening a mispositioned joint isn't a great idea, but once the joint is more properly positioned then you want to incorporate this work. A lot of people have great experiences with the FlexBar. I just bought one to check it out, seems like a cool device that can be used in a lot of ways.

    Get a racquet setup that is more arm friendly.

    Then finally, yes, have a professional instructor review your form to ensure your technique isn't putting undue pressure on your elbow. When you finally come back, don't play two days in a row. Give your body time to adapt and process the demands of playing, and ensure the arm is processing that demand soundly.

    Good luck, hope you're pain free and back on the court as soon as possible.
     
  3. drak

    drak Professional

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    I did a ton of my own research on the Internet and prescribed it to myself. There's a guy in this section with a great thread on this as well (eccentrics). I personally use a slant board to do the eccentric drops but started flat as you have to build up slowly.

    Edit: here is the "eccentric" thread by "Chicakojack"

    http://tt.tennis-warehouse.com/showthread.php?t=101633&highlight=chicagojack
     
    Last edited: Jan 8, 2012
  4. jk816

    jk816 Rookie

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    If you look around the internet you will find a number of references for eccentric training in response to tendinopathies. I recently read a paper by James Andrews and Mike Reinold about elbow issues in throwing athletes (tennis has many of the same problems) that indicated both concentric and eccentric strengthening as well as tranverse friction massage as contributing to good outcomes in elbow tendinopathy.

    From what I've seen eccentric training has been associated more with tendinosis than tendinitis therapy. It would appear the reasoning is loading in extension helps in realigning the collagen fibers in ways concentric does not. Misaligned collagen fibers from repeated microtrauma and failed healing is strongly associated with tendinosis.

    I discussed this with my own PT and he agreed, although it is not in the standard by the book treatment which is normally applied toward tendinitis type issues.

    I do both, hopefully one or the other will work, but my medial epicondylapathy has been my longest duration injury since my shoulder surgery. Very frustrating.
     
  5. jimanuel12

    jimanuel12 Semi-Pro

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    me too, made the same exact mistake, a wilson hammer, 9.2 oz, about 71 stiffness, my arm was never the same.
    am trying the deep tissue massage now, tried everything else to no avail, hope this works.:cry:
     
  6. Wuppy

    Wuppy Professional

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    How old are you guys?
     
  7. jimanuel12

    jimanuel12 Semi-Pro

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    i am 63 1/2, only had TE one time when i was young and got over it pretty quickly but this time around - been reoccurring for almost 3 years now.
    started the ASTYM therapy yesterday and will continue for several more sessions to see if this is the "magic" cure. Man, i hope so, i have suffered from this TE for so long and i want to play so bad. i used to be able to hit the ball at 100+ mph but now, i can't play at all with this pain.:cry:
    you must be one of the youngsters here.
     
  8. jeonej

    jeonej New User

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    I'm also struggling for tennis elbow for a while.
    I also live in southern California.
    Could you tell me where your physical therapy office is?
    I'm interested to take ASTYM.
    Thanks
     
  9. jeonej

    jeonej New User

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    I'm also struggling for tennis elbow for a while.
    I also live in southern California.
    Could you tell me where your physical therapy office is?
    I'm interested to take ASTYM.
    Thanks

     
  10. DaveInBradenton

    DaveInBradenton Rookie

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    After a 15 year layoff from the game, I returned at 68 years old and quickly got TE. One day I came home from the courts and could not lift my TV remote without pain.

    A friend told me he took 4 months off, changed rackets, string, and tension and got better. I could not come to grips with taking a long period off; I had just got started again and was full of enthusiasm.

    So, I changed from 1-hand strokes on both sides to 2-hand strokes both sides. Using two hands reduced the shock to my elbow and I was able to practice 2-3 times a week with NO layoff time.

    My TE slowly went away and have been able to gradually regain the use of my 1-hand shots.

    Funny thing, the 2 handers are so good (natural topspin) that I now use 2 hands for proximity shots and 1 hand for wide and short short shots. The best of both worlds!

    Part of the cure was the usual: flexible racket, natural gut string, and low tension.

    Good luck,
    Dave
     
  11. MGK1965

    MGK1965 New User

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    Are you sure it's not your racquet and/or strings? To me, if I use any racquet stiffer than a 63 flex I can feel it pulling on my forearm. Rest, get a new racquet imo sure can't hurt. Do reverse curls and pushups after it heals.
     
  12. MGK1965

    MGK1965 New User

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    Oops I read further. If you haven't gotten a new racquet buy a Wilson BLX tour (2012 model) and string with something very soft mid range. Very arm friendly and great for blocking, mid swings and huge swings. Isospeed classic pro is a great multi if you don't want gut and won't get too mushy. Current model isn't bad but not as solid.
     
  13. mikeler

    mikeler G.O.A.T.

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    While Isospeed Classic is a good soft string, I believe the lack of power in it caused my most recent bout of TE.
     
  14. Thepowerofchoice

    Thepowerofchoice Semi-Pro

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    Thanks for posting this. I fixed many injuries I have had included TE by correcting my posture and training. If you can't properly fire your rear delts muscle from having postural issues as mentioned above^^^, your elbows will suffer.
     
  15. charliefedererer

    charliefedererer Legend

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    ^^^Posture Guy's post was great.

    Thankfully he posts here, and gives a new perspective for the cause of different tennis and non-tennis related problems.
     
  16. bad_call

    bad_call Legend

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    yup but don't agree with "stop playing tennis until the pain is gone". recall having TE decades ago using trusty wooden JK Pro Staff and after much therapy, rest, etc pain was still there. advice from an elderly college tennis coach was to play through it. so grabbed a racquet, locked my elbow and hit a 1hbh. to my surprise the pain didn't appear. thus technique solved that riddle but undoubtedly credit due to rest, etc. contributed to the partial recovery...true story. :)

    now if only this dang GE would be as cooperative but then again that was almost 40 yrs ago.
     
  17. Chas Tennis

    Chas Tennis Hall of Fame

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  18. mikeler

    mikeler G.O.A.T.

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    On tennis channel, they interviewed one of the ATP trainers and their philosophy is if the pain is in the joint, you take time off. If the pain is in the muscle, you play through it.
     
  19. bad_call

    bad_call Legend

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    thanks for that tidbit. what if it's neither...in the tendon? actually can feel pain when pushing on the bone. i'll get shooting pains when doing little or nothing. pain's not crippling, just a reminder.
     
  20. bad_call

    bad_call Legend

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    mikeler - where was your GE pain?
     
  21. Chas Tennis

    Chas Tennis Hall of Fame

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    I have not had shooting pains. I know little about that but would consider pinched nerves a possibility and go see a Dr for a diagnosis.

    My golfer's elbow pain (similar tendon injury to TE) was very localized and sharp, it felt like a small damaged volume of tendon. Using the muscle attached to the tendon was painful with any force. A distinct, recognizable feeling, the GE on my right arm was just like the minor GE on my left arm.
     
    Last edited: Apr 24, 2013
  22. bad_call

    bad_call Legend

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    apologies...meant sharp pain and localized like your description.
     
  23. mikeler

    mikeler G.O.A.T.

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    This is a pretty good description of my GE which started out as triceps tendinitis. Very localized right at the tendon and it hurt like heck if I hit that bony protrusion.
     
  24. donnadev

    donnadev New User

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    I had one treatment of ASTYM and it caused severe bruising and was very painful. 2 doctors saw this and they were appalled. I will never do this again. I'll just wait it out and try strength training and take lessons. I was twisting my wrist on my back hand and have a terrible habit that I want to stop. Good luck if you take the therapy.
     
  25. movdqa

    movdqa Legend

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    Try the Flexbar. I've had medial epicond... on and off for many, many years, mostly related to weight-lifting, some related to tennis, and I started using a Flexbar (gym had one) and I can feel improvement in strength in the forearms. It's an improvement with the golfer's elbow as I can find that I can lift more weight (yeah, not the right way to exploit improvement). It's supposed to have an 80% success rate for tennis and golfers elbow but it is an incredible pain to do.

    You're supposed to do 3 sets of 15 every day for six weeks. I find the rubber tough on my hands and have been doing 1 set of 15 every day for the last two weeks.
     
  26. Fintft

    Fintft Hall of Fame

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    People have probably already told you this but:
    a) Try not to do anything with that arm, ecept maybe playing tennis, if that. I.e. switch the mouse to the other side, don't carry stuff, don't open doors etc.

    b) String your (heavy) racquet with full bed natural gut at around 50 LBs.

    c) Check your technique.
     

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