TE anatomy question (TE without pain on backhand)

I have always suspected my TE in 2016 wasn't typical TE. Serves and FHs hurt, but backhands never did. I had lateral elbow pain, hurt to grab plates off the shelf, hurt bad to press down on an aerosol can with index finger, etc. Not so much with the door knob turning, that seemed fine. Supination with green flexbar was bad pain.

After looking at lateral elbow anatomy, maybe I figured out why mine was not typical. I am suspecting it was tricep injury at connection of elbow (different connection point than typical TE injury).

I have marked in red in the first pic where my pain was:



The tricep connects to the Olecrannon, typical TE is at the Lateral epicondyle. I had mild discomfort at the TE location (Lateral epicondyle) in the pic above, and seemed to respond to flexbar and forearm massage. Now, I am starting to wonder if it was ever Lateral epicondyle related, and the flexbar stuff really didn't do anything (I did find knots and sore spots, but I suspect all tennis players have them in the forearm if they poke around). I do remember responding well to adding tricep massage later in the rehab.

Anyway, thought maybe someone here might know more about the arm/elbow anatomy, and match that to the symptoms I had. It always seemed odd that I never had any backhand pain. It does seem like anyone with TE might as well massage the tricep also, don't see how that could hurt.

The following shows the tricep connection point:




Edit:

Just noticed when I do flexbar eccentric TE exercise, you also work the tricep. Maybe the flexbar TE eccentric exercise also works the tricep tendon connected at the elbow. ???

It's all connected. Your back and shoulders can also cause tennis elbow. If your muscles can't slow your arm adequately and safely then the force will be absorbed by the elbow.

srwaldr said:

It's all connected. Your back and shoulders can also cause tennis elbow. If your muscles can't slow your arm adequately and safely then the force will be absorbed by the elbow.

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Yes, I understood a muscle imbalance can cause an injury, but I am trying figure out what tendon I actually injured. From the diagrams and the the location of where I felt pain, it doesn't appear to be the extensor tendons at the Lateral epicondyle. That is probably why BHs never hurt, and the TE elbow strap never seemed to help. My pain was in the gap between the lateral epicondyle and the Olecrannon. The only tendon that seems to match is the tricep. I never had tricep pain above/behind the elbow, but it was very tight when I started massaging it.

My first experience with tendonitis involved the triceps. It hurt a little on serve between the triceps and elbow but nothing too bad. Eventually, it turned into a bad case of golfer's elbow where it became too painful to hit serves and forehands so I had to take a break from the game. As stated above, one time I solved tennis elbow by massaging out a knot (trigger point) in the back of my shoulder. I tried cortisone but it came back worse than ever when it wore off. It's always best to talk to a doctor and get a professional diagnosis.

mikeler said:

My first experience with tendonitis involved the triceps. It hurt a little on serve between the triceps and elbow but nothing too bad. Eventually, it turned into a bad case of golfer's elbow where it became too painful to hit serves and forehands so I had to take a break from the game. As stated above, one time I solved tennis elbow by massaging out a knot (trigger point) in the back of my shoulder. I tried cortisone but it came back worse than ever when it wore off. It's always best to talk to a doctor and get a professional diagnosis.

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How is the knee rehabbing?

Yes, it would have been a more obvious tricep issue if I had pain above the elbow, but never did. The one time I felt some slight pain this spring trying fb hdx tour, it was at that exact spot I marked in the pic above. I always get immediate release/relief with roller bar massaging, but I always massage the forearm and tricep.

I doubt my primary doc would have identified the tendon injured. I guess that would have required a trip to the primary, than specialist. It would have been nice to rehab the right tendon.

There's lots of connective tissue in that area that connects together, don't get so caught up in identifying what's what. More important is to work on what you find is tender or hard, like what you've been doing.

Plenty of things can give referred pain into other areas of the body that don't at first seem connected.

RogueFLIP said:

There's lots of connective tissue in that area that connects together, don't get so caught up in identifying what's what. More important is to work on what you find is tender or hard, like what you've been doing.

Plenty of things can give referred pain into other areas of the body that don't at first seem connected.

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I just assumed it must have been a tendon injury since it took eight months to play matches again. Would a ligament injury in the elbow area mimic TE?

I'm going to have to slowly read up on TE.

I was hitting with my son last Saturday and I had a framer and there was an electric shock that started from my elbow and radiated out toward my wrist and tricep. When I was hitting on Tuesday, the pain was still there.

I'm not sure if I had banged my arm on anything around that time. But I found a big bruise just above my elbow along my tricep. Not sure if it's related.

Part of the reason I'm trying out gut/velocity. Just so I have a softer setup to play. No poly.

ByeByePoly said:

I just assumed it must have been a tendon injury since it took eight months to play matches again. Would a ligament injury in the elbow area mimic TE?

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I'm not saying it couldn't be a tendon injury, but perhaps it took 8 months bc you weren't treating the right area to begin with.

Do you think you would have been been able to get back to playing sooner if you had started treating your triceps area right away instead of the other stuff you were doing?

In terms of pain, a ligament injury could certainly mimic TE.

Traffic said:

I'm going to have to slowly read up on TE.

I was hitting with my son last Saturday and I had a framer and there was an electric shock that started from my elbow and radiated out toward my wrist and tricep. When I was hitting on Tuesday, the pain was still there.

I'm not sure if I had banged my arm on anything around that time. But I found a big bruise just above my elbow along my tricep. Not sure if it's related.

Part of the reason I'm trying out gut/velocity. Just so I have a softer setup to play. No poly.

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I refuse to "like" that ... we just got you past the ankle cr@p. We should replace our racquets with cane poles, bobbers and minnows.

Your elbow sounds like a nerve thing to me.

RogueFLIP said:

I'm not saying it couldn't be a tendon injury, but perhaps it took 8 months bc you weren't treating the right area to begin with.

Do you think you would have been been able to get back to playing sooner if you had started treating your triceps area right away instead of the other stuff you were doing?

In terms of pain, a ligament injury could certainly mimic TE.

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Absolutely ... although I can't really remember how long it was until I started doing tricep massage. I could probably figure it out by searching my old posts.

Do you think the flexbar eccentric TE exercise also works the tricep? When I put my hand in extension and move it to flexion ?, I can feel the tricep muscle working when holding left hand on right tricep. I'm not sure that necessarily means it would also be a tricep eccentric exercise. If it was, maybe I got lucky and got some early help, even if I was missing the massage.

Thanks ... appreciate the input. Doesn't @Traffic 's radiating pain above sound like nerve?

Traffic said:

I'm going to have to slowly read up on TE.

I was hitting with my son last Saturday and I had a framer and there was an electric shock that started from my elbow and radiated out toward my wrist and tricep. When I was hitting on Tuesday, the pain was still there.

I'm not sure if I had banged my arm on anything around that time. But I found a big bruise just above my elbow along my tricep. Not sure if it's related.

Part of the reason I'm trying out gut/velocity. Just so I have a softer setup to play. No poly.

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Maybe just TE ... did not know the radiating thing could happen from TE.

Symptoms of Tennis Elbow
The symptoms of tennis elbow include pain and tenderness in the bony knob on the outside of your elbow. This knob is where the injured tendons connect to the bone. The pain may also radiate into the upper or lower arm.

ByeByePoly said:

Absolutely ... although I can't really remember how long it was until I started doing tricep massage. I could probably figure it out by searching my old posts.

Do you think the flexbar eccentric TE exercise also works the tricep? When I put my hand in extension and move it to flexion ?, I can feel the tricep muscle working when holding left hand on right tricep. I'm not sure that necessarily means it would also be a tricep eccentric exercise. If it was, maybe I got lucky and got some early help, even if I was missing the massage.

Thanks ... appreciate the input. Doesn't @Traffic 's radiating pain above sound like nerve?

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The flexbar will pull on the distal end of the triceps tendon via the connective tissue, but not enough to "work it" in a traditional sense. You're not going to get stronger triceps doing eccentric TE exercise. But if you felt like it helped you then by all means do it.

Yes Traffic's description of "electric shock" sounds like a nerve irritation.

RogueFLIP said:

The flexbar will pull on the distal end of the triceps tendon via the connective tissue, but not enough to "work it" in a traditional sense. You're not going to get stronger triceps doing eccentric TE exercise. But if you felt like it helped you then by all means do it.

Yes Traffic's description of "electric shock" sounds like a nerve irritation.

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Isn't the point of the flexbar eccentric loading healing a tendon and not strength building?

ByeByePoly said:

How is the knee rehabbing?

Yes, it would have been a more obvious tricep issue if I had pain above the elbow, but never did. The one time I felt some slight pain this spring trying fb hdx tour, it was at that exact spot I marked in the pic above. I always get immediate release/relief with roller bar massaging, but I always massage the forearm and tricep.

I doubt my primary doc would have identified the tendon injured. I guess that would have required a trip to the primary, than specialist. It would have been nice to rehab the right tendon.

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Knee is almost there. If you don't trust your primary doc, see an orthopaedic or physical therapist.

mikeler said:

Knee is almost there. If you don't trust your primary doc, see an orthopaedic or physical therapist.

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Great news on knee. Break out the sweat gutter ... mine has already been used.

My TE questions were out of curiosity, no current TE issues other than warning signs if I get near poly. I trust my primary, I just figure most primary docs couldn't drill down on exact TE injury. Maybe that is a false assumption. I had contacted my primary and he had the MRI approved if I decided to get one. I was going to get one if I didn't improve in 3 months ... but I improved. The main thing that caused the long time off from matches was the serve. Perhaps that is also a indicator of the actual injury.

ByeByePoly said:

Isn't the point of the flexbar eccentric loading healing a tendon and not strength building?

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I get that's what it was designed to do. However can't involved a tendon without involving the muscle its attached to. Whether or not you contract concentrically or eccentrically, when you put a load on a muscle more than it's used to, con't loading will cause adaption and the muscle should will get stronger.

I thought you were asking if your triceps would get stronger by doing the flexbar. My answer is no.

RogueFLIP said:

I get that's what it was designed to do. However can't involved a tendon without involving the muscle its attached to. Whether or not you contract concentrically or eccentrically, when you put a load on a muscle more than it's used to, con't loading will cause adaption and the muscle should will get stronger.

I thought you were asking if your triceps would get stronger by doing the flexbar. My answer is no.

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Interesting ... I know others here have thought of flexbar as building the forearm. I always viewed it as tendon rehab ... there was reference to collagen fibers building back up in the right way. In fact, in hindsight I would have probably bought the red flexbar and the green one, and started with red. If it's for tendon repair, then it's not matching to forearm strength ... or even the goal of increasing forearm strength. You have an injured tendon you are about to put under eccentric load. I don't do the flexbar anymore as standard maintenance, just the roller bar massage.

ByeByePoly said:

Maybe just TE ... did not know the radiating thing could happen from TE.

Symptoms of Tennis Elbow
The symptoms of tennis elbow include pain and tenderness in the bony knob on the outside of your elbow. This knob is where the injured tendons connect to the bone. The pain may also radiate into the upper or lower arm.

Click to expand...

The pain radiating was sort of there. But if I rub on the elbow bone, no pain. I did experience some discomfort about a month or two ago when I played a bunch.

Played last night. It was a bit sore (like climbing up stairs after doing a bunch of squats and lunges the previous day) during warm up. But didn't feel too bad playing. I feel better today than I have all week. So symptoms are calming down.

I think you had TE.
My TE didn't hurt much on the BH either and it was definitely TE. Serves were the worst for it.

The triceps tendon is less commonly involved in tendinopathy because it's got a broad attachment and is rarely under much load. It's mostly seen in weightlifters. In tennis, the triceps is only activated when serving (and OH's I guess) and just enough to lift a racket over your head. The power in the serve mostly comes from the pectorals and core. I had a pinched C7 this winter with virtually 0 power in my triceps and could still serve over head reasonably well until the muscle fatigued so much I couldn't lift the racket over my head.

Tennis player tendinopathies are TE, GE, Achilles, patellar, biceps, rotator cuff for the most part.

Dartagnan64 said:

I think you had TE.
My TE didn't hurt much on the BH either and it was definitely TE. Serves were the worst for it.

The triceps tendon is less commonly involved in tendinopathy because it's got a broad attachment and is rarely under much load. It's mostly seen in weightlifters. In tennis, the triceps is only activated when serving (and OH's I guess) and just enough to lift a racket over your head. The power in the serve mostly comes from the pectorals and core. I had a pinched C7 this winter with virtually 0 power in my triceps and could still serve over head reasonably well until the muscle fatigued so much I couldn't lift the racket over my head.

Tennis player tendinopathies are TE, GE, Achilles, patellar, biceps, rotator cuff for the most part.

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If TE, what would be the reason why the bh hurts for some and not others? Degree of injury? Different extensor muscles? Different rsi (extension, supination, ?). Unless I am missing something, there is one common extensor tendon, and then different extensor muscles. The variation in injury could be which extensor muscle offending.

My guess is unknown at this point, otherwise we would all be talking about "which extension muscle TE did you have?"