Ultrasound and Tennis Elbow

[Edberg_Fan]

I've had TE for about a month now and am doing bi-weekly PT. It seemed to help but as of recently, my therapist did some ultrasound, which aggrevated my TE. I am thinking about ditching the PT and just resting. Any advice?
What did you do to recover? If you don't have TE anymore, what was your road to recovery and how long? Thanks.

[Edberg_Fan]

I suppose the ultrasound aggrivation must just be me considering no responses. Seems like a long process to healing. I want to be TE free before starting back up.

At what point did you guys start back up? Did you still have some pain at that point. Right now it still hurts to hold a medium sized frying pan.

[andreh]

Hi,

I've had TE now for 3 months. Still have it.

Sadly, it seems there is only one thing that helps against TE and that is prolonged rest.

I've tried a combo of cortisone injections - it had temporary effect - and NSAIDs (mostly Arcoxia, but also Diclofenac and Naproxen). No lasting effects, alas. I'm also wearing an elbow brace, but I can't really say it has any clear effect.

I apply ice a few times a day, but the effect is also only temporary pain relief.

Just rest.

[Marius_Hancu]

>Sadly, it seems there is only one thing that helps against TE and that is prolonged rest.

Yes, followed by gradual conditioning after the pain has totally disappeared.
Also, changing the equipment (both racquet and strings) may be a must.

Check my signature:

Great fitness sites
http://tt.tennis-warehouse.com/showthread.php?t=15571

esp the Elbow section

FWIW
check my posting here:

Best arm friendly racquets?
http://tt.tennis-warehouse.com/showthread.php?t=58089

[Edberg_Fan]

Thanks for the responses. I assume there are varying degrees of TE and everyone's ability to heal also varies. It would be nice if folks that had TE could post how much long the prolonged rest they took. I'm curious if there is an average duration that could be established???

I do plan to change equipment and also my backhand technique issue (leading with elbow on contact).

Thanks!

[scotus]

I don't think ultrasound is a good idea while you still have pain, mainly because it is designed to promote healing by causing an inflammation first.

I have tried it religiously for about a month, but it hurt the day after each time I did it, and ultimately I gave up on it without seeing results. But I think it may have its place, perhaps after the pain has completely subsided.

[Oxford]

stay off the anti inflamitories in my opinion...see my thread on the topic here.

new research says it has a harmful affect on healing.

ox

[morten]

over 2 years, still not 100 %. Nothing worked, TE travels its own path IMO

[kevint]

I have tried ultrasound a few times, and it did not work at all.
My GE is close to 2 years now, 95% gone, hopefully will be gone by Spring.

just rest, avoid NSAIDs, don't try to exercise your elbow too soon, not until it's almost completely healed, IMHO.

[mhldex]

Originally Posted by morten

over 2 years, still not 100 %. Nothing worked, TE travels its own path IMO

Hi

I'm in the same predicament as you are...already with TE for almost 2 and a half years.

My elbow still hurts especially after I over-stretch my arm for e.g. carrying items of considerable weight over a prolonged period. So I am still fearful of going back to the tennis court at the moment.

Would like to know how you cope with the intermittent pain and also have you started playing tennis? I just feel like it's been such a long time that the pain will never go away completely.....so what the heck.....should I start playing again?

[Mister G]

Man..

On occasion I would get TE, but not even close to what you guys are talking about. I would rest a couple days and I would be ok even though the pain can be excruciating at times.

I wish you all the best of luck - hope you get rested/healed soon.

[volusiano]

How is the ultrasound supposed to heal TE? What's the idea behind it?

And what's NSAIDS?

[Edberg_Fan]

Thanks for the repsonses. I was hoping to see if there is a magic number. So far it seems that most of the folks here have TE for 2 years and still not gone. Among other factors, I presume you were playing through some level of TE which is probably why it has taken longer to go away 100%.

I was hoping to see this number be more in the few months to get to 100% recovery with full-time rest.

So far it seems the data only reflects two people with TE for a couple years.


1 - 3 months - (none)
6m - 1 year - (none)
1 - 2 years - (2) mhldex, kevint
2+ years - (none)

[Edberg_Fan]

I forgot to add 3m - 6m (none).

[volusiano]

My TE lasted me in the 1-3 month range. I would say I recovered 90% and not 100%. I rested for about a month, then started playing again slowly with a heavier, headlight, less stiff, arm-friendly racket, and kept improving my techniques.

Now about a year later, I play about 3 times a week. I may have a little mild TE discomfort after a 2-hour session, but it goes away the next day or so. That's why I say I recover 90% but not 100%. But the minor/short TE discomfort I have now is probably more attributed to the physical demand of the game and not because of doing something wrong.

[andreh]

Originally Posted by volusiano

How is the ultrasound supposed to heal TE? What's the idea behind it?

And what's NSAIDS?

Don't know about ultra sound but NSAID = Non-Steroid Anti-Inflammatory Drug, i.e., common pain relief drugs you can buy at your local farmacy. Ibuprofen (Nuprin), naproxen (Aleve), diclofenac (Voltaren) etc etc.

They inhibit the synthesis of something called prostaglandines, which are active in creating pain and inflammation in the body. The anti-inflammatory effect is negliable unless they are taken regularly for several days.

[scotus]

Originally Posted by volusiano

How is the ultrasound supposed to heal TE? What's the idea behind it?

And what's NSAIDS?

Let me take a crack at this, and please understand that I am not a medical professional and might be wrong on many points.

There are some methods of tendonitis/tendonosis treatment that are based on the theory that the injured tendon is deprived of necessary nutrients and needs more blood supply to that region for proper healing.

So in order to get the body to send more blood to that region, the medical professional inflicts a slight "damage" to the region, which causes an inflammation and signals the body to send more blood to that region for healing.

There are several ways of accomplishing this. One is using a surgical needle to poke some microscopic holes into the tendon. Another is using various waves. Ultrasound is, of course, much less invasive than the needle method, and is thought to penetrate the body deep enough for it to reach the tendon and cause disturbances, which leads to inflammation and a subsequent healing.

This, of course, means that ultrasound will most likely cause pain and make the pain worse before making it better. In my case, it was all pain and no gain.

The most recent advance in tennis elbow treatment is taking the patient's own blood, isolating the plasma rich in healing properties, and injecting it directly to the tendon, which has reportedly seen some really positive results.

Chime in if this needs corrections.

[Edberg_Fan]

Scotus, that sounds about right as was explained to me by my PT. Likewise, I had no benefits and after two weeks of ultrasound I decided my problem was getting worse. So now that I've taken a few steps backwards I'm going to just rest. How long, I don't know yet, which is why I was just curious to see what the general rest period is... understanding there are other factors.

But I thought that if you have TE and you stop playing due to the issue, we have some common ground. Sounds like some folks get back into playing as they feel comfortable. So maybe I need to reconsider my question to how much rest before you are 100% or comfortable enough to starting playing relatively frequently (ie. at least 2-3x week).


1 - 3 months - (1) volusiano
3 - 6 months - (none)
6m - 1 year - (none)
1 - 2 years - (2) mhldex, kevint
2+ years - (none)

[scotus]

I have had two bouts with tennis elbow. Each time I had to rest 6 months. I may have had a quicker recovery but I have toddlers who want to be carried all the time.

[Edberg_Fan]

Thanks scotus; looking for more inputs all.

1 - 3 months - (1) volusiano
3 - 6 months - (1) scotus
6m - 1 year - (none)
1 - 2 years - (2) mhldex, kevint
2+ years - (none)