Golfer's Elbow

TennisCanada1

Professional
Can't run more than 5k because hip labral tear starts to hurt (I don't feel it when I play tennis for some reason, more lateral movement over a long period of time I guess) I've been playing with my left hand... any other suggestions for cardio? (Swimming is boring, and I can't do bike or anything that involves lunging or squatting because of my hip.)
 

Bobo96

Semi-Pro
Or you might consider that if groundstrokes don't affect the elbow but overhead serving does, there might be some connection to your elbow from your shoulder region.

Like pulling a rope, you can pull from one end but feel it at the other end. You can treat the end where you feel it all you want, but until you release the pull from the other end, you'll never get satisfactory results.

Something to think about.
Hey rogue! I was reading through and I found your comment interesting. I was dealing with Te and a little GE for 3 months, after it pretty much healed up I started playing and gut rotator cuff tendinintis. After reading your post I'm wondering if my shoulder could have caused both. I could hit groundstrokes as hard as I wanted as long as I had a motrin or two, but serving was excruciating. I am pretty sure my shoulder issue was caused by the repetitive movement of tennis causing my shoulders to roll forward due to imbalance.
 

Royce

Semi-Pro
Hey OP, I'm 22 years old and got what I was pretty sure was either golfer's elbow or tennis elbow. Either way, there was definitely inflammation in my elbow which also extended into my forearm and made everything painful.

IMO, the trick when dealing with these injuries is to acknowledge that you injured yourself. When you injure yourself you have to heal. That means you stop doing what injured you for a good amount of time.

When it happened to me, I stopped what I was doing, acknowledged that I had improper form (for you it may be a different reason obviously) practiced correct form while resting by just swinging the racquet in my house and not hitting anything, then went back when I was all healed.

If you don't let it heal and try to tough it out, apply pain meds and keep going, you're going to become like those 30-40 year olds who only talk about all their chronic pain and what surgeries they need. Don't be those people.
 

TennisCanada1

Professional
It's been 10 days of no tennis. I have lost about 40% sensation in my two little fingers on two of those 10 days. It feels like it's not even getting better and I haven't picked up a racquet. I get it takes time but it feels the exact same as 10 days ago, if not worse. I did my MRI yesterday, so I'm just waiting for the report..
 
It's been 10 days of no tennis. I have lost about 40% sensation in my two little fingers on two of those 10 days. It feels like it's not even getting better and I haven't picked up a racquet. I get it takes time but it feels the exact same as 10 days ago, if not worse. I did my MRI yesterday, so I'm just waiting for the report..
Usually a radiologist-Dr writes a report on the MRI findings. Get a copy of that written report from your Dr or the imaging lab. The MRIs images themselves are very hard to interpret so I don't usually request those as I do for X rays (DVDs or email attachments).

Read carefully everything that is in the report. It is a checklist of many of the structures of your elbow and most of those that become injured.

Is that both little fingers?

Little finger numbness one hand research - Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome)
http://orthoinfo.aaos.org/topic.cfm?topic=a00069
 
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TennisCanada1

Professional
Yea its both little fingers. Yea my dr. is going to give me the findings from the report. He thought it was my ulnar nerve as well.
 

crabdoc

New User
try out of the box therapies. Maybe acupunture to stimulate blood flow to the area or cryotherapy to reduce inflammation. also supplementing with cissus/glucosamine or "Elbow Revive", using a "Flex Bar", and "Voodoo floss". good old self applied massage is great for loosening up tthe muscles in the forearms as well.
I used both elbow revive and the flex bar with great results. flex bar hurts at first if the the tennis/golfers elbow is bad. i rested completely for a week before i started any exercises or stretches, then began with the flex bar. i took elbow revive for 4 or 5 weeks (one bottles worth) and definitely felt significant improvement. other than that, icy hot helped as far pain management in the beginning, but obviously that's a short term fix.
 
Yea its both little fingers. Yea my dr. is going to give me the findings from the report. He thought it was my ulnar nerve as well.
I would think that the ulna nerve affects one little finger. There are probably right and left ulna nerves at a certain vertebra of the neck.

I don't know what affects 2 little fingers, make sure the Dr understands that your little finger symptoms were bilateral.

My son used to get finger numbness, maybe in both hands (pain too?) after some weeks after starting a new workout at the gym. He did some shoulder conditioning exercises to better align his scapulas and it went away. I guess that some muscle got bigger or some exercise irritated or pinched certain nerves. I have never has a pinched nerve.

There must be several causes. I guess your Dr is a specialist?
 
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RogueFLIP

Professional
Hey rogue! I was reading through and I found your comment interesting. I was dealing with Te and a little GE for 3 months, after it pretty much healed up I started playing and gut rotator cuff tendinintis. After reading your post I'm wondering if my shoulder could have caused both. I could hit groundstrokes as hard as I wanted as long as I had a motrin or two, but serving was excruciating. I am pretty sure my shoulder issue was caused by the repetitive movement of tennis causing my shoulders to roll forward due to imbalance.
If things start to go chronic despite you treating the symptomatic area, you have to look elsewhere for potential "kinks in the chain" so to speak.

People understand the kinetic chain analogy for tennis, on how getting power to hit the ball starts from the ground up.....it's the same thing for injuries.

I've treated people's hips to address and correct their symptomatic elbows.....everything is all connected.
 

RogueFLIP

Professional
I would think that the ulna nerve affects one little finger. There are probably right and left ulna nerves at a certain vertebra of the neck.

I don't know what affects 2 little fingers, make sure the Dr understands that your little finger symptoms were bilateral.

My son used to get finger numbness, maybe in both hands (pain too?) after some weeks after starting a new workout at the gym. He did some shoulder conditioning exercises to better align his scapulas and it went away. I guess that some muscle got bigger or some exercise irritated or pinched certain nerves. I have never has a pinched nerve.

There must be several causes. I guess your Dr is a specialist?
The dermatomal pattern for the hands is easily Googled, and the ulnar nerve covers both little fingers. However clinically, I rarely find that people present with symptoms that present from the textbook.

If the OP is complaining about BOTH pinkies going numb, I'd make sure I'd check out what's happening higher up the chain, IE shoulders and neck.
 

mikeler

Moderator
If things start to go chronic despite you treating the symptomatic area, you have to look elsewhere for potential "kinks in the chain" so to speak.

People understand the kinetic chain analogy for tennis, on how getting power to hit the ball starts from the ground up.....it's the same thing for injuries.

I've treated people's hips to address and correct their symptomatic elbows.....everything is all connected.
My tennis elbow did not get better until I got the knots out in my upper back. I'm having much less hamstring pain now that I'm wearing plantar fasciitis gel pads under my heels. My heel pain is almost gone as well. Yes, everything is connected.

This circumstance sounds like something different though. It's definitely wise to get a doctor's advice first.
 
............and the ulnar nerve covers both little fingers. ...................
..............................................
Aren't there two ulnar nerves, a right and a left?



Could a problem at C8 or T1 affect both ulnar nerves?
 
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You had numbness in both pinkies, correct?

I'm sure that there are two ulnar nerves, one on the right side and one on the left side.

If you have numbness on both sides then that implies that you have swelling in the ulnar nerves on both sides.

Why?
 

TennisCanada1

Professional
I'm not sure, but my doctor didn't mention anything about tendinitis or tendinosis, just the ulnar nerve swelling.
What's the treatment for this? Just rest? Does elbowrevive really help?
 

RogueFLIP

Professional
Yes there are two ulnar nerves. Left and right.

Yes a cervical issue can affect right and/or left nerves.

But I'm a little confused when teamcanada refers to both little fingers:

Is it 'both' left and right 5th digits go numb?

Or is it 'both' 4th and 5th digits on the SAME hand that's showing symptoms?
 

TennisCanada1

Professional
I have not.
Should I be resting for this, or can I play tennis?
It only hurts when I serve, so can I hit groundstrokes?
It's been 12 days of no tennis and it's hell.
 

magnut

Hall of Fame
Reverse forearm curls helped my golfers elbow a lot and gave me pretty immediate relief (like 24 hours). forearms had become a bit unbalanced through years of tennis and causes some flexibility issues which i believe was the culprit. I also sleep with a splint to make sure my arm is extended through the night instead of flexed along with some stretching routines. Not sure how much pain you are in though. Rest never worked for me.

its similar in my case to when i started getting foot problems and planter flascielis. i was having a lot of pain. tried different shoes, taping etc. etc. the culprit was all the tennis and calve raises. i started doing a lot of reverse calve raises and sleeping with splints and have no foot issues whatsoever now.

then there was my back. years of tennis gave me pelvic shift. i struggled with it for ten years. my pelvis would shift and throw my back out. i could not walk for four to five days sometimes crawling to the bathroom and taking as many pain pills as my body could handle. i went to doctors and physics who told me i had spinal degeneration and needed to be fused etc. etc. i stretched all the time, heating pads, chiropractors etc etc. nothing worked. bought myself a roman chair and started doing a lot of back extensions. I have not had a back problem in three years.

tennis is rough on the body. There is a lot of anterior work going on and if you neglect posterior you can have a lot of issues when you get older. If your young, new to tennis, and a good athlete it doesnt really cause problems. As the years go on and your body kind of molds to the movements a lot of imbalance can happen causing problems. especially when you get older and the body is not as supple. golfers go through a lot of the same thing.
 

magnut

Hall of Fame
Also do you think the poly will make a difference in this case? I hate the natural gut so far.
i never had an elbow problem in my life until i switched to poly. when i was in my early twenties I started using it because i was breaking strings every 45 minutes. i developed an extreme case of tennis elbow and had to play lefty for a full year for it to heal. My arms are not fragile. i used kevlar for years and never had any issues. Poly is a joke of a string. now i just use klippermate 15g nylon with string savers. Its soft, plays well, and lasts a decent amount with the use of string savers. I dont use kevlar anymore because the tennis elbow really ticked me off and i dont want to risk it even though it never bothered me. If I could find a 13 or 14 gauge nylon i would be all over it. its my favorite string. give it a try. if you want people to think your playing with something hi tech get some black nylon and tell people its poly.

I like natural gut but its pretty powerful. i can see why many dont like it. one of the things i liked about kevlar was how dead it felt. the ball doesnt fly with kevlar and i always felt like the control was second to none. If I ever go with natural gut again i will probably just use it fog the crosses and stick 15g nylon in the mains. i do like the feel of nylon though.

If i were you i would stick with naty gut until you figure out whats going on with the tennis elbow. just temporary until your good to go. then try some nylon or a soft synthetic. I wouldnt go near poly. Most people playing with poly are no where near the level for it to make a difference anyways regardless of what they might think does for them. its all placebo. Your talking 5.5 and up level players that cut it out after a couple of hours. It also kills frames twice as fast from my experience. its just not a nice string. its more like wire cable.

You might try a shock watch and elbow brace as well for some additional protection. I never felt much of a difference useing the braces but i do think the shock watch helped funny enough. I am convinced that ball of mercury actually works a good bit. could be placebo though. honestly when your injured you will take anything you can get.
 

TennisCanada1

Professional
I'm a 6.0 at least and I can definitely notice the difference in playability with a poly. I break poly after 1-2 hours on average depending on the poly. If I put the gut in the crosses though, instead of the mains, would that maybe help with the issue of too much power?
 

magnut

Hall of Fame
I'm a 6.0 at least and I can definitely notice the difference in playability with a poly. I break poly after 1-2 hours on average depending on the poly. If I put the gut in the crosses though, instead of the mains, would that maybe help with the issue of too much power?
kind of depends how you set up your racquet. The poly should deaden it some. try pre stretching your gut. It should also reduce some of the arm harshness that is inherit with poly.
 

TennisCanada1

Professional
UPDATE: Took my MRI to an orthopaedic surgeon (elbow specialist) this morning.

It turns out, it's not golfer's elbow and its not a nerve issue either. This makes sense because I've always had a strong forearm and I wasn't feeling it exactly where golfer's elbow is, but rather more in the centre than on the side.

I have something called lateralis impingement, which is where the bicep and forearm don't attach properly. It's so rare/new that further consulting has to be done between different doctors, and I might be the first in my city to have the procedure.

Great :\
 

magnut

Hall of Fame
UPDATE: Took my MRI to an orthopaedic surgeon (elbow specialist) this morning.

It turns out, it's not golfer's elbow and its not a nerve issue either. This makes sense because I've always had a strong forearm and I wasn't feeling it exactly where golfer's elbow is, but rather more in the centre than on the side.

I have something called lateralis impingement, which is where the bicep and forearm don't attach properly. It's so rare/new that further consulting has to be done between different doctors, and I might be the first in my city to have the procedure.

Great :\
I would get a second opinion before letting doctors experiment on you.
 

RogueFLIP

Professional
To correct myself, it's "Lacertus Fibrosis Syndrome"
Well, at least now you know where to start with some gentle soft tissue work.

And figuring out how to gently stretch that area.

You need to open up/decompress the region in order to give your body a chance to heal itself and decrease your symptoms.

Good luck.
 
To correct myself, it's "Lacertus Fibrosis Syndrome"
Do you know if this is the injury? The name is a little different - Lacertus Syndrome in Throwing Athletes. It sounds like a baseball pitching injury.
http://www.msdlatinamerica.com/ebooks/SurgicalTechniquesinSportsMedicine/sid229720.html

I have not heard of this injury before.

NCBI search, free full online reports. Only 12 finds. Add tennis and it gets 7 finds.
http://www.ncbi.nlm.nih.gov/pmc/?term=Lacertus+Fibrosis+Syndrome

This is a clear example of why we need to see a Dr for a diagnosis.

(In my opinion, this looks more hopeful than chronic Golfer's Elbow (tendinosis).)
 
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RogueFLIP

Professional
How would I go about that?
I would go to a massage therapist and ask for soft tissue work of the lacertus?
That's one option. Again, it's a region to start. IIRC, you felt your symptoms with serves, so I'm sure there's a connection to the rest of your arm bc...well, there always is.

There's plenty of YouTube videos on how to do self trigger point release, or since the structure in question is essentially fascia (although what isn't :twisted: ), self myofascial release.

As long as you don't force anything, you won't injure yourself.

I mean it's worth a shot trying to decompress the region conservatively before you opt for the surgical option.
 

TennisCanada1

Professional
UPDATE: I saw a second elbow specialist (surgeon) and contrary to the first surgeon, she said she can't conclude that it is Lacertus Syndrome, and it's not something an MRI can prove, so she wants me to rest and not play. I haven't played since January 17th, and I'm not supposed to play until March 2nd. I'm losing my mind. I don't know who is right, and I don't even know if the rest will help because if it is Lacertus Syndrome, then it won't. This picture is EXACTLY where it hurts.

http://www.tenniselleboog.nl/fig20.jpg

It doesn't hurt now since I'm not playing.
 

TennisCanada1

Professional
The EXACT spot. It's not like TE or GE where it's on the side, and it only hurts when I serve. (Haven't played in weeks though so I don't know how it is now)
 
Chastennis any ideas?
I recognize GE pain now and if I got a TE injury would know it also. GE is distinct. Mine is small, sharp, painful on stressing. It is very close to where the illustrations show that it should be. GE may not show the same symptoms for everybody. There may be several other injuries that fit this description.

There is an issue where a nerve goes through that area of the arm and is pinched under some forearm muscle, the pronator, I believe. The syndrome is common and has a name.
http://en.wikipedia.org/wiki/Pronator_teres_syndrome
Nerve pinches can cause pain and numbness farther away from the brain than the pinch. Numbness is clear. I don't know what nerve pain feels like. Other symptoms? Issues may be away from the pinched nerve and vary. Doctors may know of a 100 possible injuries where I have heard of a few of the more common ones. I can't recall the nerve injuries that well.
 
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TennisCanada1

Professional
I recognize GE pain now and if I got a TE injury would know it also. GE is distinct. Mine is small, sharp, painful on stressing. It is very close to where the illustrations show that it should be. GE may not show the same symptoms for everybody. There may be several other injuries that fit this description.

There is an issue where a nerve goes through that area of the arm and is pinched under some forearm muscle, the pronator, I believe. The syndrome is common and has a name.
http://en.wikipedia.org/wiki/Pronator_teres_syndrome
Nerve pinches can cause pain and numbness farther away from the brain than the pinch. Numbness is clear. I don't know what nerve pain feels like. Other symptoms? Issues may be away from the pinched nerve and vary. Doctors may know of a 100 possible injuries where I have heard of a few of the more common ones. I can't recall the nerve injuries that well.
Thanks for the reply.
Yes, I was told it's pronator syndrome. Lacertus Fibrosus syndrome is basically the same thing as pronator syndrome. Pronator syndrome is supposed to be entrapment of the median nerve but I don't feel median nerve symptoms. Ocassionally, my two little fingers get numb, which is the ulnar nerve, but both surgeons told me that it is irrelivant from my issue. The only real symptom I have that they believe to pertain to my issue is that I feel pain in the exact spot in the photo when I serve, and the more I serve, the worst it gets. I haven't played since January 11th and I don't plan on playing since March 2nd, because the second surgeon doesn't want to conclude that it is pronator syndrome because it's not something that you can confirm on an MRI, but she doesn't know what it is so she wants me to take a close to 2 month rest from tennis to see if it may be some type of muscle or ligament injury that could heal. I have no idea if it's helping, being halfway through my rest period now, because when I don't serve it's fine but usually when I serve it hurts, so I will see on march 2nd. But in the grand scheme of things, I want resolution and I don't know what to do because I have 2 surgeons with conflicting views and I want to be able to play tennis again.
 
Thanks for the reply.
Yes, I was told it's pronator syndrome. Lacertus Fibrosus syndrome is basically the same thing as pronator syndrome. Pronator syndrome is supposed to be entrapment of the median nerve but I don't feel median nerve symptoms. Ocassionally, my two little fingers get numb, which is the ulnar nerve, but both surgeons told me that it is irrelivant from my issue. The only real symptom I have that they believe to pertain to my issue is that I feel pain in the exact spot in the photo when I serve, and the more I serve, the worst it gets. I haven't played since January 11th and I don't plan on playing since March 2nd, because the second surgeon doesn't want to conclude that it is pronator syndrome because it's not something that you can confirm on an MRI, but she doesn't know what it is so she wants me to take a close to 2 month rest from tennis to see if it may be some type of muscle or ligament injury that could heal. I have no idea if it's helping, being halfway through my rest period now, because when I don't serve it's fine but usually when I serve it hurts, so I will see on march 2nd. But in the grand scheme of things, I want resolution and I don't know what to do because I have 2 surgeons with conflicting views and I want to be able to play tennis again.
I have had more than one GE injury including one on my non-tennis arm. I would expect pain up to 3 months after a new tendon injury if I stopped immediatelty. I am not young. At 2 months I would expect pain because tendons heal slowly. I can't find some table of healing times for new tendon injuries that used to be posted. Search and you'll find lots of information on healing times. Don't be concerned if the healing time that you had expected is not what is happening. Research healing times for new tendon injuries and ligament injuries. Also, you should make a time line of your injury from the beginning and see how long you played on it in pain and how long you have not stressed it. It is at 2 months now of no stress? Correct? How long did you try to play on it after being injured? Make a complete timeline.


Also, I am getting confused. You have some symptoms of a pinched nerve at the location of your pain but it is not related to your injury? Is that what you said?
 
....................
Yes, I was told it's pronator syndrome. Lacertus Fibrosus syndrome is basically the same thing as pronator syndrome. Pronator syndrome is supposed to be entrapment of the median nerve but I don't feel median nerve symptoms. Ocassionally, my two little fingers get numb, which is the ulnar nerve, but both surgeons told me that it is irrelivant from my issue. The only real symptom I have that they believe to pertain to my issue is that I feel pain in the exact spot in the photo when I serve, and the more I serve, the worst it gets. .............................because the second surgeon doesn't want to conclude that it is pronator syndrome because it's not something that you can confirm on an MRI, but she doesn't know what it is so she wants me to take a close to 2 month rest from tennis to see if it may be some type of muscle or ligament injury that could heal. .................... I don't know what to do because I have 2 surgeons with conflicting views ..........................................
See Ulna Entrapment. Research this injury and what tissues might be pinching the ulna nerve.
http://www.chiro.org/ChiroZine/FULL/Paresthesias.shtml

https://www.google.com/search?q=ulna+nerve+entrapment+images&tbm=isch&tbo=u&source=univ&sa=X&ei=X1fbVIzUL5ftoASxpYAQ&ved=0CB8QsAQ&biw=925&bih=575

Can you identify a part of the service motion that causes the pain?

Leading to impact any forearm pronation involves a twisting at the elbow. Upper arm internal shoulder rotation does not. How is your serving technique?
 
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One other unlikely issue is growth plates, a very specialized area. Bones grow by adding bone in the growth plates located near joints. Before growth ends around puberty the growth plates are weaker than the final bone. Most often, growth is over by late teens, but people vary on when growth stops. Also, did you play serious tennis when younger and did you have any elbow injuries? I guess X rays might show these special bone problems. ? If there is a written report that accompanied the X rays read the written analysis.

http://www.hopkinsortho.org/throwing.html
 
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RogueFLIP

Professional
Why don't you use the same person who helped your hip in your other thread to use the ART manual work to work on your forearm?
 
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