Ease Tennis Elbow with Eccentric Twists

[chess9]

http://www.medpagetoday.com/Orthope...tm_campaign=DailyHeadlines&utm_content=Group1

"After seven weeks of physical therapy in both groups, pain scores improved to an average of about 5 on the 10-point Visual Analog Scale in the standard treatment group -- but dropped all the way to about 1 point in the isolated eccentric exercise group.


The mean improvement in pain was 81% in the group that used the bar compared with 22% in the control group (P=0.002 for difference in improvement over time by group and P<0.0001 for post-treatment score by group).


Tenderness in the affected elbow also decreased in the experimental group, though not in the standard group (P=0.003 between groups)."

-Robert

 

[Noisy Ninja]

Very interesting findings. Thanks for posting.

 

[chess9]

No problem, mate! I've never had tennis elbow, but two of my 5.0 buddies DO HAVE IT! They are both young and DO NOT LIFT. I've been lifting my whole life. I think some sort of strength training, whether weights, plyometrics, or something that stretches and strengthens tendons is preventative and palliative. But, that's just a wild guess.

-Robert

 

[chess9]

I have golfer's elbow! LOL!

In the second set of a friendly match against one of my friends, I framed a very hard topspin forehand and felt a slight twinge, but when I went to serve the pain went off the charts.

I play with Big Banger Ace or Rough at 58-60 lbs. So, that's going to have to change. I'll keep my EXO3 93 racquets as I don't think that's the problem.

I'm resting, icing, and taking one Advil a day (I'm asthmatic, and am mildly allergic to them.) No tennis for at least three days, but I have a big tournament this weekend.

I've never had tennis elbow or golfer's elbow, so this caught me by suprise. It might have been the 6 hours I played yesterday?

Has anyone seen anything new since I posted this article? This article is about tennis elbow, not golfer's elbow, but I suspect the eccentric exercises would be as helpful.

-Robert

 

[bad_call]

thanks for the post. one could wring out wet laundry and possibly achieve similar results.

mentioned was eccentric exercises for leg rehab. do you know of a link to that topic?

 

[larry10s]

http://well.blogs.nytimes.com/2009/08/25/phys-ed-an-easy-fix-for-tennis-elbow/
http://www.sportsinjurybulletin.com/archive/achilles-tendonitis-1.html
two links bottom one for achilles tendon (need to scroll thru to get to the info)
eccentric strengthening seems to be beneficial for these type of tendon issues. robert check out platelet rich plasma therapy for your golfers elbow. see what the doc says

 

[larry10s]

i had achilles tendiditis and bad tennis elbow. i do the eccentric exercises for my calves. do wrist extesions and curls with 5 lbs . i recently bought the least resistance flexbar to try it out. my forearms get sore like when i do the calf exercises. learned about both here on the tw message boards. go guys keep sharing info

 

[Xenakis]

There is a golfers elbow twist exercise too, the 'tyler twist' is the normal TE one, the 'reverse tyler twist' is the GE one.

http://www.youtube.com/watch?v=oHrDtRtLmFg

Re using laundry instead of a proper flexbar, the physio I saw (about my knee as it happens) said you can use something like a towel instead but it's not quite as good/effective arguably.

I don't actually have TE or GE but do the 'twist' exercise to avoid getting either of them (hopefully.)

Also I like the term 'isolated eccentrics', sounds like a target group in a mental health outreach program.

 

[charliefedererer]

I have golfer's elbow! LOL!

In the second set of a friendly match against one of my friends, I framed a very hard topspin forehand and felt a slight twinge, but when I went to serve the pain went off the charts.

I play with Big Banger Ace or Rough at 58-60 lbs. So, that's going to have to change. I'll keep my EXO3 93 racquets as I don't think that's the problem.

I'm resting, icing, and taking one Advil a day (I'm asthmatic, and am mildly allergic to them.) No tennis for at least three days, but I have a big tournament this weekend.

I've never had tennis elbow or golfer's elbow, so this caught me by suprise. It might have been the 6 hours I played yesterday?

Has anyone seen anything new since I posted this article? This article is about tennis elbow, not golfer's elbow, but I suspect the eccentric exercises would be as helpful.

-Robert

Sorry to hear of your difficulties.
I've been keeping an eye out for more information on the Thera-Band Flexbar since your post, but have no direct experience with it. I just did another quick google search and didn't come up with anything new of real significance, atlothough this review by someone on A*az*n.com may be of interest to you: "I purchased this brand and model to compare against the Cando twist-n-bend, which is a very similar product. The Thera-Band Company makes quality products and some of them are designed for very fit individuals. However, the Flexbar heavy model is not a product for a person of even moderate strength. It is far to easy to twist and bend this model to get a decent workout. The Flexbar heavy, medium, and light models are better suited for people going through rehabilitation, those that lack upper body strength, and teenagers whose muscles have not fully developed. Although the material ingredients are a little bit better quality than the Cando twist-n-bend, the Cando extra heavy model, which Thera-band does not have a similar model, is designed for strong athletes, martial artists, boxer, wrestlers, bouncers and many others. The Cando model is also cheaper.
I should have spent my money on another Cando twist-n-bend instead of the Flexbar."

As for the benefits of the Flexbar, I'm sure it would be good for anyone playing tennis who previously was out of shape to help develop stronger forearm muscles to resist the abnormal bending of the muscles and tendons that occurs on striking the ball, and to resist the wristy follow through seen in many beginners.
But it sounds like you are in great shape, and don't suffer from flawed technique. This was a fluke injury. I'm sure your forearm muscles are already in much better shape than the control group in the study reported in the Times. It is probably less likely the Flexbar will help you, or that it has specific benefits over excises you are doing.
On the other hand, I too am interested to hear if there are any users of the Flexbar that will report in. Even if they don't, I would love to hear if you get the Flexbar, or Cando equivalent, and what your experience is.

 

[chess9]

http://well.blogs.nytimes.com/2009/08/25/phys-ed-an-easy-fix-for-tennis-elbow/
http://www.sportsinjurybulletin.com/archive/achilles-tendonitis-1.html
two links bottom one for achilles tendon (need to scroll thru to get to the info)
eccentric strengthening seems to be beneficial for these type of tendon issues. robert check out platelet rich plasma therapy for your golfers elbow. see what the doc says

I just called her office and left a message about it, but I hope it doesn't go that far! I'm still icing....

-Robert

 

[chess9]

Sorry to hear of your difficulties.
I've been keeping an eye out for more information on the Thera-Band Flexbar since your post, but have no direct experience with it. I just did another quick google search and didn't come up with anything new of real significance, atlothough this review by someone on A*az*n.com may be of interest to you: "I purchased this brand and model to compare against the Cando twist-n-bend, which is a very similar product. The Thera-Band Company makes quality products and some of them are designed for very fit individuals. However, the Flexbar heavy model is not a product for a person of even moderate strength. It is far to easy to twist and bend this model to get a decent workout. The Flexbar heavy, medium, and light models are better suited for people going through rehabilitation, those that lack upper body strength, and teenagers whose muscles have not fully developed. Although the material ingredients are a little bit better quality than the Cando twist-n-bend, the Cando extra heavy model, which Thera-band does not have a similar model, is designed for strong athletes, martial artists, boxer, wrestlers, bouncers and many others. The Cando model is also cheaper.
I should have spent my money on another Cando twist-n-bend instead of the Flexbar."

As for the benefits of the Flexbar, I'm sure it would be good for anyone playing tennis who previously was out of shape to help develop stronger forearm muscles to resist the abnormal bending of the muscles and tendons that occurs on striking the ball, and to resist the wristy follow through seen in many beginners.
But it sounds like you are in great shape, and don't suffer from flawed technique. This was a fluke injury. I'm sure your forearm muscles are already in much better shape than the control group in the study reported in the Times. It is probably less likely the Flexbar will help you, or that it has specific benefits over excises you are doing.
On the other hand, I too am interested to hear if there are any users of the Flexbar that will report in. Even if they don't, I would love to hear if you get the Flexbar, or Cando equivalent, and what your experience is.

I lift two and sometimes 3 days a week. I can do bicep curls with 45 pounds. Hmm...I mean I COULD. LOL! I could barely pick up my coffee awhile ago. OUCHEE'.

I'm off tennis for a few days to see how it does.

-Robert

 

[chess9]

There is a golfers elbow twist exercise too, the 'tyler twist' is the normal TE one, the 'reverse tyler twist' is the GE one.

http://www.youtube.com/watch?v=oHrDtRtLmFg

Re using laundry instead of a proper flexbar, the physio I saw (about my knee as it happens) said you can use something like a towel instead but it's not quite as good/effective arguably.

I don't actually have TE or GE but do the 'twist' exercise to avoid getting either of them (hopefully.)

Also I like the term 'isolated eccentrics', sounds like a target group in a mental health outreach program.

Ooh, great find, mate! Many thanks for that. Just another reason why Tennis Warehouse is the best tennis site in the world, eh?

-Robert

 

[chess9]

I wonder how long I should wait before I start some re-hab? I'm icing and taking advil today, and no tennis. If it's feeling better tomorrow I'll start re-hab.

-Robert

 

[larry10s]

I wonder how long I should wait before I start some re-hab? I'm icing and taking advil today, and no tennis. If it's feeling better tomorrow I'll start re-hab.

-Robert

robert friendly advice talk to your doc but you may have to stop tennis for longer than you want to to get well and not have a chronic problem.(like no tournament this weekend )

 

[chess9]

robert friendly advice talk to your doc but you may have to stop tennis for longer than you want to to get well and not have a chronic problem.(like no tournament this weekend )

Yes, that's my fear. I have an appointment on Friday with my doctor.

-Robert

 

[larry10s]

Yes, that's my fear. I have an appointment on Friday with my doctor.

-Robert

good luck and let us know how it goes. from someone who could not play for almost a year with tennis elbow there is life during rehab

 

[chess9]

Oddly, my arm is much better today after just two days off. I did the following the last two days:

1. Lots of icing of the elbow. Probably spent 3 hours total icing;
2. Took three meloxicam in two days, even though I'm allergic to it;
3. I took 5 grams of creatine both days, a bit more than my 3 gram typical. My thinking is that creatine tends to aid recovery, so it might help.
4. No tennis of course.
5. Elevated my elbow for extensive periods.
6. Gentle eccentric stretching yesterday.
7. Massage of the Ulnar Tendon near the Medial Epicondyl.
8. Lots of sex.

-Robert

 

[larry10s]

Oddly, my arm is much better yesterday after just two days off. I did the following the last two days:
Lots of sex.

-Robert

when you let someone else do the work of course your arm and you feel beller

 

[kslick]

What kind of eccentric stretching did you do and Ulnar nerve massage. I spent the summer mending my golfers elbow and all is pretty much back to normal but not 100%. I ordered the Flex-bar so we'll see how that works out.

 

[eagle]

Oddly, my arm is much better today after just two days off. I did the following the last two days:

8. Lots of sex.

-Robert

Are you suggesting self-love made your tennis elbow better? LOL!

r,
eagle

 

[chess9]

Are you suggesting self-love made your tennis elbow better? LOL!

r,
eagle

Actually, I wasn't saying that, but the motion might have some therapeutic value!

-Robert

 

[chess9]

What kind of eccentric stretching did you do and Ulnar nerve massage. I spent the summer mending my golfers elbow and all is pretty much back to normal but not 100%. I ordered the Flex-bar so we'll see how that works out.

1. Palm up. Elbow in at your side. Press the palm down gently with your left hand (if you have the problem with the right arm) and then press UP with your right fingers while you press down gently with your left hand. You will feel it a lot if your GE is really bad, so go easy at first.

2. Palm down. Elbow at side. Do the same thing, but press UP. You can do this harder usually.

I like doing it this way, rather than with weights because I can vary the pressure depending on the pain.

Good luck with the Flexbar. Let us know how that turns out. I've been thinking about getting one just in case I get this again some time in the next 66 years.

For the massaging, I simply start at the epicondyle and work back pressing with about 5 lbs of force. You don't have to go back far. (also, if you feel that ulnar tendon, it might be a bit tight, so the stretching and massaging might loosen it a small amount.) I use my thumb and grip my other fingers around my right forearm. Works for me so far.
-Robert

 

[kslick]

Thanks! Lets us know how the Dr appt went.

 

[chess9]

Thanks! Lets us know how the Dr appt went.

Slick: I cancelled the appointment today because my arm was feeling so good! When I first got this GE I couldn't lift my laptop with my right hand in the waiter's pose. This morning I could lift my laptop. So, I went to the gym and did a group of wrist curls and reverse curls and hammer curls with 20 lbs. I had no problem. I've been icing still all day, plus using the heating pad some. I took two Advil as well. No more Meloxicam because it reduces my aerobic capacity too significantly.

I have a tournament tomorrow. So....I'm going to wear an elbow brace for the first time in my life and try to get through it. If I have any significant pain, however, I'm going to retire and give it another full week of rest and rehab before I start back again.

I'll post tomorrow on the tourney result.

Researching this issue on the web I've found that everyone is different in terms of how long they take to heal. Some guys never heal, but most are healed in 3 months. Some can go back to tennis in a few days with a brace.

My racquet with Luxilon Rough is in the shop being restrung with synthetic gut at 50 lbs. I pick it up before I play tomorrow. I have a backup racquet strung with gut at 58 lbs, just in case.

I've never had elbow problems before, but, I must say I now really can sympathize with Cal with TE and all the other sufferers. GE was very very painful. I got shooting pains picking up an emtpy coffee cup the day it happened. Sheezh.

-Robert

 

[ace0001a]

I have a buddy who somehow managed to strain the tendons in his elbow. His one handed backhand seems to agitate it. But when he uses tries a two hand backhand, it seems ok. He said his elbow clicks when he pronates it. Anyone know if taking anti-inflamatory medication helps with tennis elbow or tendonitus? He was told to rest it for a few months, but he's always itching to get back on the tennis court and we've been taking 1 to 2 week breaks in between court sessions. I also told him to get one of those heavy duty elbow braces (the ones that hold the top and bottom areas), but he's too cheap. Any ideas how he can still be on the courts every other week without agitating it more or having much pain?

 

[chess9]

Anti-inflammatories, like ibuprofen do help.

The arm bands help Golfer's Elbow and Tennis Elbow.

Rest is a good idea. If it keeps flaring up, he's probably not resting long enough.

He should check his form with a pro, as he's probably aggravating it with his backhand. If he leads with his elbow, he's asking for trouble.

-Robert

 

[charliefedererer]

Slick: I cancelled the appointment today because my arm was feeling so good! When I first got this GE I couldn't lift my laptop with my right hand in the waiter's pose. This morning I could lift my laptop. So, I went to the gym and did a group of wrist curls and reverse curls and hammer curls with 20 lbs. I had no problem. I've been icing still all day, plus using the heating pad some. I took two Advil as well. No more Meloxicam because it reduces my aerobic capacity too significantly.

I have a tournament tomorrow. So....I'm going to wear an elbow brace for the first time in my life and try to get through it. If I have any significant pain, however, I'm going to retire and give it another full week of rest and rehab before I start back again.

I'll post tomorrow on the tourney result.

Researching this issue on the web I've found that everyone is different in terms of how long they take to heal. Some guys never heal, but most are healed in 3 months. Some can go back to tennis in a few days with a brace.

My racquet with Luxilon Rough is in the shop being restrung with synthetic gut at 50 lbs. I pick it up before I play tomorrow. I have a backup racquet strung with gut at 58 lbs, just in case.

I've never had elbow problems before, but, I must say I now really can sympathize with Cal with TE and all the other sufferers. GE was very very painful. I got shooting pains picking up an emtpy coffee cup the day it happened. Sheezh.

-Robert

Glad to hear you are feeling so much better so fast.
I think your case of golfer's elbow is different than the majority who develop a slowly worsening inflammatory response over time as an overuse injury.
It sounded like you had a freak mishit resulting in your problem, and your forearm muscles are overall in great shape. As such, I was optimistic you would have just an acute inflammatory response that would fairly quickly abate.
Good luck in your tournament.

 

[chess9]

Had to withdraw from the tournament. I hit some balls against the wall for 10 minutes and could feel the sharp pains in my elbow. I'm definitely better, but not ready to play. I can see why this injury could become chronic, because one is tempted play even though you have twinges in the elbow. That's a prescription for disaster, IMHO. No play for me for another 3 days. I'll try to hit against the wall again then.

Bummer....

And to add insult to injury, I just bought a new pair of RF Nike shoes from TW. Black and Red too!
-Robert

 

[chess9]

Glad to hear you are feeling so much better so fast.
I think your case of golfer's elbow is different than the majority who develop a slowly worsening inflammatory response over time as an overuse injury.
It sounded like you had a freak mishit resulting in your problem, and your forearm muscles are overall in great shape. As such, I was optimistic you would have just an acute inflammatory response that would fairly quickly abate.
Good luck in your tournament.

Thanks, CF. I am better, but not ready. I'll spend the week running hills and cycling, mostly.

-Robert

 

[ace0001a]

Thanks for the info chess9. I will let my buddy know.

Just one last thing though: Should he be taking the Ibuprofen before or after playing?

 

[chess9]

Thanks for the info chess9. I will let my buddy know.

Just one last thing though: Should he be taking the Ibuprofen before or after playing?

Did you read the thread below this one citing a NY Times article on the disadvantages of taking ibuprofen? With that caveat, NSAIDS when not playing, and to reduce inflammation, might still be ok. Frankly, though, I'm now confused!

-Robert

 

[ace0001a]

Did you read the thread below this one citing a NY Times article on the disadvantages of taking ibuprofen? With that caveat, NSAIDS when not playing, and to reduce inflammation, might still be ok. Frankly, though, I'm now confused!

-Robert

Yeah I looked up some articles about it. I guess my buddy will have to rest his elbow longer. Thanks for the info!

 

[larry10s]

. I'm definitely better, but not ready to play. I can see why this injury could become chronic, because one is tempted play even though you have twinges in the elbow. That's a prescription for disaster, IMHO. No play for me for another 3 days. I'll try to hit against the wall again then.

Bummer....


-Robert

robert do me a favor (and yourself). take at least 2 weeks off and see the doctor. i am very proactive when i get an injury. you may have read my thread on scapular bursitis. once i realised this wasnt a mild muscle strain i went to the otrthopod and got a cortisone shot. i did not want to wait 2-4 weeks to see if rest ice and mobic would do it and THEN get the shot.3 days rest is NOT going to be enough imho. see if a cortisone shot is indicated and check out platelet rich plasma therapy. im not saying to rush into "invasive intervention" but you do want to get healed as quickly as possible. get medical advice especially at this time of year if you have met your deductible my 2 cents to help someone who has helped so many others with his advice. larry

 

[larry10s]

also check out the flexbar not just for rehab but to use for pervention after you are healed. would get advice as to how much you should be doing now (20 lb wrist curls to see if you are ok?????)

 

[chess9]

Actually, I did 25 lb wrist curls yesterday with no problem. The issue for my GE is the sudden load of a forehand hit. At the point of contact, I'm guessing the forces must be well over 100 psi. In other words, unlike a curl, where the forces are spread out over several muscles, and are not instantaneous, a forehand generates focused forces on the medial epicondyle. When I first got this, I couldn't hold a coffee cup, but that quickly subsided. Now, I can twist jar lids off, and hold my laptop like a waiter's tray. BUT, even though my elbow is better today than it was yesterday, I tried hitting some forehands against the big stuffed chair in my living room, and I could feel slight twinges. My thinking is that one must be COMPLETELY free of those twinges for a few days at least before one should attempt to hit balls GENTLY.

With these small tendons, re-injury can and will occur if full healing hasn't occurred, I'm sure.

-Robert

 

[larry10s]

My thinking is that one must be COMPLETELY free of those twinges for a few days at least before one should attempt to hit balls GENTLY.

With these small tendons, re-injury can and will occur if full healing hasn't occurred, I'm sure.

-Robert

my thinking is it takes more than 3 days for full healing to take place".With these small tendons, re-injury can and will occur if full healing hasn't occurred, I'm sure"

 

[chess9]

my thinking is it takes more than 3 days for full healing to take place".With these small tendons, re-injury can and will occur if full healing hasn't occurred, I'm sure"

Yes, initially I was over-optimistic about healing time. Given my age and the intractable nature of this injury per my reading here and on the web, one needs to be very conservative.

I've purchased two ProKennex Ki5 pse racquets to use during rehab.

-Robert

 

[larry10s]

good luck robert and as speedy a recovery as is possible

 

[yemenmocha]

Why aren't there inboxes and PM's with this vbulletin? It would be great to stay in touch with other people with the same injury besides the posts here which can be easily overlooked sometimes.

 

[chess9]

I'll try to post regularly on my progress. I haven't tried the bands yet or the twisters. I suspect my elbow is not as bad as most, though. If rest doesn't do it, with the few re-hab exercises, meloxicam, and ice, then I'll try cortisone and the commercially available rehab products.

-Robert

 

[yemenmocha]

I'll try to post regularly on my progress. I haven't tried the bands yet or the twisters. I suspect my elbow is not as bad as most, though. If rest doesn't do it, with the few re-hab exercises, meloxicam, and ice, then I'll try cortisone and the commercially available rehab products.

-Robert

How old are you guys? That can matter a lot for recovery times, so I'm told. I'm mid 30's but feel mid 50's re: my arm.

 

[chess9]

How old are you guys? That can matter a lot for recovery times, so I'm told. I'm mid 30's but feel mid 50's re: my arm.

I'm coming up to 67, but I've never had elbow problems before.

I took my old ProKennex Black Ace woodie out this afternoon and tried to hit a few forehands. It's strung with very old nylon at about 35 lbs. No way! Still sore as hell!!

-Robert

 

[arthriticknee]

My physical therapist is making a killing selling flexbars now. She says both interest in the exercise and results are good.
Here are the full instructions and video on the eccentric exercises that i am using. I wasn't sure I was doing it right just watching the video but with the instructions as well its not that hard.
I am hoping the New York study is correct and this can help chronic cases like mine.
i will report if i am successful.

 

[chess9]

My physical therapist is making a killing selling flexbars now. She says both interest in the exercise and results are good.
Here are the full instructions and video on the eccentric exercises that i am using. I wasn't sure I was doing it right just watching the video but with the instructions as well its not that hard.
I am hoping the New York study is correct and this can help chronic cases like mine.
i will report if i am successful.

You have TE? Yes, let us know how you do. Thanx!

-Robert

 

[MayDay]

What's the difference of using the flexbars and doing wrist curls (standard and reverse) with lighter weights? (5-15lb weights)

I watched the eccentric exercises link and as described, and most of the action is "preparation":

"3) Both arms are brought straight out in front of the body, again, the wrist should remain cocked backwards and stationary. This is the starting position for the exercise. Everything up to this point has been preparation."

Then in step 4, the lady in the video is basically doing a standard wrist curl with straight arms using the flexbar instead of good ol'gravity and weights.

Your thoughts?