TennisCanada1
Professional
^ Yes! I'm so glad I avoided surgery. It's a good thing I didn't settle for that.
My physio said it was where the red region is in this picture, like between the shoulder and neck
http://www.hughston.com/hha/b_12_2_1a.jpg
He said it was because since I'm chronically slouching from my leg length disrespency, the shoulder is being pulled down chronically so it was ocnstant pressure on the nervous system. He did a lot of different techniques including the techniques that I mentioned in my previous posts but also this silicone thing that he rubbed on the are, and he massaged a part of my upper back (where it is supposed to have nerve supply).
Almost 4 months now.
I am mostly fine, and do normal activities without consciously thinking about it.
However, healing has leveled off in a big way. And the inner elbow is still not close to 100%.
It is weak, and could easily be damaged by sharp acute use.
I played tennis (just hitting balls for 20 mins) about 2 weeks ago.
Arm was generally weaker, but the elbow held up.
But, there is no chance I can serve. One real serve and the elbow would reset back to day 1.
I tried doing a few pullups this last month also.
While I didn't reinjure, I could feel this was putting overdue strain on the elbow.
It's not ready for that yet.
This is most certainly a 1 year injury. I have no plays on playing tennis this year.
It takes a long time for tennis elbow to heal.
This seems really puzzling to most.
That is because in their experience, most other conditions they have had get better much faster.
But most have not had tendon injuries before.
While tendons are strong, they heal very slowly.
The way they heal is for the body to lay down protein strands into the areas that have the small tendon tears that comprise tennis elbow.
Those protein strands look a lot like the similar flimsy strands that make up a spider's web.
Like a spiders web, those strands are easy to break with any movement.
It is only over many weeks that those strands are bound together - just like the many strands in a rope or cable are bound together to form one strong rope or cable.
The problem is that with early movement, the ends of the tendon pull apart again, tearing the fragile protein strands.
The body has to start over again.
So stick with the red Flexbar for a fairly long time.
Indeed, if it hurts to use the red Flexbar, you should hold on even using this for now.
The idea of using the Flexbar is to do just enough movement that the new healing tissue won't "stick" to adjacent muscles or tendons - but instead glide smoothly past one another.
The place for the green flexbar is for when you can easily work with the red one and have no pain.
So pain will be your guide to whether the inflammation is subsiding enough to move on to the next step.
Don't go back to tennis too soon and disrupt all the healing that has already started until you have done the exercises with the green flexbar for a few weeks and the arm has been actually strengthened.
The above is a best case scenario. Often, progress is more of a two steps forward, one step backward kind of progression.
Therefore, many do better with the guidance of a therapist.
I do hope you are better "soon" - but realize with this process that soon is still likely many weeks away.
It sounds like you love tennis too much to hurry back and then have have to miss even more.
It took me 14 health professionals to even figure out my issue after 15 months so I have no regrets about not taking time off; throughout the entire process I was trying to find out what was wrong with me and I could still hit groundstrokes without any pain so for all I knew it was a nervous system issue or something of that nature that didn't interfere with normal play. Now that I know, I have an action plan, but I don't think you can generalize and say a year.In other words, if you had just taken one year off, you would have allowed it to heal properly.
That's my plan. I am currently on 7 months, and I can tell I am not even close to 100%.
It feels fine, but if I lift something heavy, I can sense it flaring up.
In fact, I don't even think one year is enough. This might be multi-year, or it may simply NEVER get back to 100% ever again.
What is the diagnosis of your injury?In other words, if you had just taken one year off, you would have allowed it to heal properly.
That's my plan. I am currently on 7 months, and I can tell I am not even close to 100%.
It feels fine, but if I lift something heavy, I can sense it flaring up.
In fact, I don't even think one year is enough. This might be multi-year, or it may simply NEVER get back to 100% ever again.
UPDATE: It's a miracle....
after 10 months of going through this terrible time of trying to figure out what my elbow issue was, going to 3 elbow specialists in two different countries, 5 physios, a myofascial release expert and other healthcare professionals, I finally figured out what is wrong with me.
I basically gave up hope and was ready to quit tennis for good. I was developing my lefty side, but didn't have much motivation. I decided to give one last physio a try that I randomly looked up. I went to the physio for an initial assessment, and after an hour he told me that "I have a relatively apparent leg length discrepancy, and so everything on my left side is a little bit higher (hip bone, etc) Since my right side is lower, my nervous system was chronically stressed and a nerve got caught that caused deferred pain to my elbow. I went to him last week for treatment and by the time the treatment was done, the pain was GONE. 100% gone. Just like that. After 10 months of trauma to my elbow, it was just gone. We did nerve flossing techniques, rotational techniques, and a lot of different things, but I can't even mentally process how much of a relief it is to just have my problem vanish like that." My tissue in my elbow needs another week to recover after being trapped for so long, but I have taken light serves and I have absolutely no pain whatsoever..
Thanks to everyone who has helped. I really do appreciate it...
I was just reading this thread and I am very interested in the details here.
I have been battling golfers elbow for 2 years and have had percutaneous tenotomy procedure that didnt take.
I have the EXACT same symptoms. I can swing 100% on forehands, backhands, slices, etc. But serving causes pain.
UPDATE: Despite my prior belief that the nervous system theory was accurate and that it healed me, it did not. I've been to several doctors at this point, and I ended up at Anthony Galea's place. Recall I did an MRI last year and the only thing it said was minor edema of the ulnar nerve. Well, nobody thought to do an ultrasound on me because of the MRI results, but Galea did one and found a microtear in my forearm flexor. It was 7mm in length and he said that pain I felt in June 2014 when it first happened was me tearing the muscle on a serve. He said it was too small to show up on the MRI. It makes sense now why it hurt on serves but not groundstrokes, and I thought the nervous system exercises were helping because I would take a few weeks off and then my physio would tell me to serve and I would keep opening up the tear when I attempted to serve, but at first it felt relatively ok. I ended up doing PRP a little over a month ago. I went for my 4 week checkup, and the ultrasound showed that the tear went from 7mm to 4mm. I have another appointment in a month and hopefully it will be closed in 6 weeks time. No tennis at all, I'm going nuts but it's the sacrifice that we make for the game that we are so passionate about. 15 month journey hopefully coming to an end....
No need to overthink this.
Just take 6 months off, and it will solve itself.
End thread.
I disagree completely. You can't generalize and prescribe rest for everyone. Especially with tendon injuries, where in several cases, rest is rust. You MAY need rest, you MAY need to condition and work the tendon, or you MAY need both. Best course of action is to seek various professional opinions and then reflect and come to your own conclusion and action plan.No need to overthink this.
Just take 6 months off, and it will solve itself.
End thread.
Here is a later update -
I have not read this whole thread (since 2015 when I posted on it.) but injuries can be difficult to diagnose especially if they are not the common diagnosis It is not unusual to have false diagnoses.
See the thread Tendon Injury Nuthouse for some publications on tendinitis (with inflammation) , tendinosis (with defective healing).
There is likely to be some tendinosis in a very short time if the joint is stressed.
I’ve been studying this matter lately.
There is indeed clinical evidence of excess fibrosis (scar tissue buildup) when injury is very severe or chronic. This is why rest is recommended and works when there is an injury.
This is all part of the inflammation / immune response by the body. Common signs of inflammation include pain, redness, swelling, heat in the affected area. After four days it should resolve mostly, and then completely 1-2 months hence, if healing is proceeding normally. If there is reinjury during that time, it’s more likely to form a scar. If reinjury within the four days of initial, then almost for sure. In kids it’s all accelerated, in adults the resolution phase is slower.
This mechanism explains a lot of why playing once a week (at a certain age) is quite sustainable, but a jump to 2-3 times per week can often lead to injury. Advice to rest for 3+ months also makes sense, especially considering that many of us also carry heavy objects or work at a keyboard, which repetitively stresses the forearm.
I disagree completely. You can't generalize and prescribe rest for everyone. Especially with tendon injuries, where in several cases, rest is rust. You MAY need rest, you MAY need to condition and work the tendon, or you MAY need both. Best course of action is to seek various professional opinions and then reflect and come to your own conclusion and action plan.
Very interesting. I have severe GE in my right arm that i am beginning to suspect originates at the neck area and is referred. I also have/had a leg length issue which i never knew about, look up lateral pelvic tilt. It is what I am in the process of correcting.UPDATE: It's a miracle....
after 10 months of going through this terrible time of trying to figure out what my elbow issue was, going to 3 elbow specialists in two different countries, 5 physios, a myofascial release expert and other healthcare professionals, I finally figured out what is wrong with me.
I basically gave up hope and was ready to quit tennis for good. I was developing my lefty side, but didn't have much motivation. I decided to give one last physio a try that I randomly looked up. I went to the physio for an initial assessment, and after an hour he told me that "I have a relatively apparent leg length discrepancy, and so everything on my left side is a little bit higher (hip bone, etc) Since my right side is lower, my nervous system was chronically stressed and a nerve got caught that caused deferred pain to my elbow. I went to him last week for treatment and by the time the treatment was done, the pain was GONE. 100% gone. Just like that. After 10 months of trauma to my elbow, it was just gone. We did nerve flossing techniques, rotational techniques, and a lot of different things, but I can't even mentally process how much of a relief it is to just have my problem vanish like that." My tissue in my elbow needs another week to recover after being trapped for so long, but I have taken light serves and I have absolutely no pain whatsoever..
Thanks to everyone who has helped. I really do appreciate it...
Very interesting. I have severe GE in my right arm that i am beginning to suspect originates at the neck area and is referred. I also have/had a leg length issue which i never knew about, look up lateral pelvic tilt. It is what I am in the process of correcting.
UPDATE: Despite my prior belief that the nervous system theory was accurate and that it healed me, it did not. I've been to several doctors at this point, and I ended up at Anthony Galea's place. Recall I did an MRI last year and the only thing it said was minor edema of the ulnar nerve. Well, nobody thought to do an ultrasound on me because of the MRI results, but Galea did one and found a microtear in my forearm flexor. It was 7mm in length and he said that pain I felt in June 2014 when it first happened was me tearing the muscle on a serve. He said it was too small to show up on the MRI. It makes sense now why it hurt on serves but not groundstrokes, and I thought the nervous system exercises were helping because I would take a few weeks off and then my physio would tell me to serve and I would keep opening up the tear when I attempted to serve, but at first it felt relatively ok. I ended up doing PRP a little over a month ago. I went for my 4 week checkup, and the ultrasound showed that the tear went from 7mm to 4mm. I have another appointment in a month and hopefully it will be closed in 6 weeks time. No tennis at all, I'm going nuts but it's the sacrifice that we make for the game that we are so passionate about. 15 month journey hopefully coming to an end....
I was just reading this thread and I am very interested in the details here.
I have been battling golfers elbow for 2 years and have had percutaneous tenotomy procedure that didnt take.
I have the EXACT same symptoms. I can swing 100% on forehands, backhands, slices, etc. But serving causes pain.
I was just doing some internet searching to see if my pullups and chinups were possibly aggravating my GE as I suspected. Of course they were.
Anyway, I came across this link below. I'll let it speak for itself since I've only run across it, but my arm does feel relieved after just doing it.
Worth a shot!
http://tomrandallclimbing.wordpress.com/2012/11/23/golfers-elbow-a-possible-solution/
Are you saying the pain is 100% gone?
Or are you just saying it's more manageable?
If you are playing tennis with even 1% of discomfort, your tendons are injured and need rest.
No magical stretch will repair damaged tissue.
I had golfer’s elbow caused by doing pull-ups. It was diagnosed by a very respected doctor just the other day but without an MRI. He’d like me to do PT for a month before ordering an MRI to see if it can be cured without surgery or extended time off.Ok, so you have 0% discomfort in your elbow now?
You feel nothing during and after playing tennis?
You did not have tennis elbow.
You must have had some kind of acute injury
Damaged tendons take a 6-12 months to heal, not 4 days.
Be careful spreading bogus cures on an internet forum.
Other people can inflict a lot of damage on themselves thinking they are curing a different injury.
TE is an overuse injury.
If it were degen, millions of non-tennis people would have it.
They don't.
REST
TE is an overuse injury.
If it were degen, millions of non-tennis people would have it.
They don't.
May be anecdotal but I'm certainly willing to try that stretch routine a try. It's a simple and common yoga stretch so its likely harmless at worst and at best it helps the problem. I wouldn't be so critical of other folks solution to a problem.
As they say, there is more than one way to skin a cat. Some of us like to view TE/GE as a degenerative condition rather than a chronic injury. If you view the tendons as degenerating, your mindset changes from one of "I've got to rest this tendon" to one of "I've got to strengthen and build up this tendon". I've had tendinopathies in both Achilles, wrist, patellar and TE, which have all healed best with eccentric exercise and stretching regimens than with rest.
Now I've got GE and I've been looking for good exercises and stretches to help strengthen this tendon as well.
@Dartagnan64
What is the story with your TE or GE? Let's hear the back story.
It wasn’t until the third day for me that I felt flexible enough that it wasn’t just painful. I’ve probably done it now for the last 6 days and 2-3 times per day.Tried this exercise and I have to say it's far more difficult than it looks. At least for a moderately inflexible 55 year old man who's never done a stitch of yoga in his life. I had to modify it so only my right arm was under my body as both arms under the body was killing my neck.
Anyways I can see the value since it really does stretch out the forearm and in particular gives a great stretch on the pronator teres where a lot of the problem likely originates.
Not sure its going to help but I'll try it some more over the next week and report back. Will combine it with my usual massage and flexbar routine.
It wasn’t until the third day for me that I felt flexible enough that it wasn’t just painful. I’ve probably done it now for the last 6 days and 2-3 times per day.
I have a yoga routine that I do designed for runners. When I’m doing it regularly I can easily touch my toes. When I’m not doing it, I can barely get to my shins.
Stretching is so important for me.
I did something similar with a frying pan.
Rotate it from noon to 9am and 3pm
Nothing works better than rest, however