Golfer's Elbow

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).
That's great. (That fascia surgery disturbed me.....)

Nerve issues are very common. I would think that the symptoms would have pointed it out. From the picture, what is pinching the nerve, the collar bone and scapula? Or the more usual location at the vertebra?



Learn as much as you can now about the details to avoid the issue in the future. Posture issues are a priority for you as RogueFLIP points out. Posture issues can be difficult in general and are often overlooked in treatments targeted for injuries as I have experienced also. Since you have an unusual issue with your leg length difference, your posture issues are more difficult to understand or treat. Did anyone else treating you notice the leg issue? You are extremely lucky to have found someone that was able to diagnose that injury!

Please consider informing those who treated you of your very difficult diagnosis and great results.
 
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Now at 7 weeks. When I vigorously dry my hair with a towel, it doesn't hurt as much. Daily use is still fine, generally.

I can tell something is off with the arm, however. It feels susceptible to minor muscle pains (not the actual injury). It just feels generally weaker, like one of my arms has aged 10 years. Minor aches and pains or stiffness just from sleeping, etc.

I also feel healing rate has leveled off. I think my initial estimate of 1 year is accurate. I have yet to do a pull-up or a bicep curl, in fear of re-injury. I almost 100% will not play tennis this year.
 
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.
 
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.
Pull ups are a very heavy exercise, but I don't know about elbow stress. If you take off for months then there is an serious issue of getting back in shape before doing anything stressful. The older you are I guess the more time you should spend to get in shape.

Charliefedererer used to post tables with tendon healing and 'remodeling' times for new acute injuries. I thought that maybe a year was there and 3 months was not so significant. Find similar information. I could not find the table threads but that information is important. It also looks as if attempting tennis and heavier exercises at 4 months might be too much. That is assuming that tendinosis has not become significant.

Easy to search
http://tt.tennis-warehouse.com/index.php?threads/have-te.465335/#post-7467528

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.
 
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Thanks. I have been active the last 3 months, just not around the elbow.
I have been doing cardio and weight work and Yoga and core.
I am just now testing out the elbow in the 3rd and 4th month, very carefully, and nowhere close to max load.
 
The link was validating. I know I am making the right decision to lay off the elbow for a YEAR.
In fact, I am not going to attempt pull ups again until the 1 year mark, so as not to inflame and interrupt the healing process.
 

TennisCanada1

Professional
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....
 
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.
 

TennisCanada1

Professional
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.
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.

We have a number of differences:
1) Your issue is tendon, mine is muscle. Muscle heals much quicker than tendon.
2) Yours is elbow, mine is the end of the forearm flexor near the elbow.
3) I have a 4mm micro tear at this point. The 7mm didn't even show up on an MRI.
4) From what your issue sounds like, the pain you are going through is far worse than what I have ever experienced.
 
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?
 

TennisCanada1

Professional
Has anybody done PRP before here for a MUSCLE injury (NOT TE/GE tendon injuries)?
If so, how long did it take to heal or improve?
 

TennisCanada1

Professional
update: 9 weeks post prp, just had a checkup today, and the tear is officially closed. went from 7mm to nothing in 9 weeks. Pretty remarkable stuff. As for the bad news, my tissue is supposed to look smooth like a 'river stream' but it's very fibrous and rough, so I'm very susceptible to re-tearing it. I've been ordered to take FOUR months off, take 200mg of magnesium every night, and start doing rubber band exercises as to be prescribed by my physiotherapist.
 

TennisCanada1

Professional
FINAL UPDATE:

After nearly 2 years of confusion, headache and heartache, I'm back playing. I've visited multiple surgeons and it turned out I had a forearm flexor tear. It was NOT TE or GE. I got PRP in August, and 6 months later I've been cleared to play. I've been strengthening the forearm with eccentric exercises and I've been hitting groundstrokes. I'm going to slowly return to serving in the coming weeks.

Thanks everyone for your inputs, different ideas, and your help! What a great community this is.

Cheers
 
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mkedda

New User
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: 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.
Here is a later update -

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 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.
 
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TennisCanada1

Professional
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.
 
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’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.
The critical knowledge is to stop stressing an injured tendon when it is first injured, quit during the match...... Of course with the typical behavior to 'try my sore arm to see how I will do' and then the player realizes that it still hurts after a month, the chance for optimal healing is past.

A poster named Charliefedererer, a doctor, used to post time line charts on healing of new tendon injuries. They did not describe your time lines, the times were longer with stages of tendon healing and tendon strength. For muscle injuries there may be different time line for healing but for a tendon injury the times are longer. Search for timelines for healing new tendon tears. I prefer to post links to medical publications.

One issue is to realize the large forces that are on tendons. If you curl a 30 lb dumbbell and, say the tendon attachment on the forearm is 10% of the distance from the elbow pivot to the hand, then your tendon is applying 300 lb of force to lift the 30 lb dumbbell. Swinging a tennis racket and having it collide with ball at the end of a racket causes unknown but probably large forces on the tendon. If that tendon is torn the forces may concentrate at the tear and increase it.

I injured my rotator cuff getting on an escalator. The injury was a small 'full thickness' tear of the supraspinatus, probably the most common rotator cuff injury. In a discussion with my orthopaedic specialist, he said I could heal and play tennis without surgery but that it was likely that the tear would enlarge. With my 1 cm tear the chance of a good surgical outcome was 95%. As the size increased, the chance of a good outcome for surgery went down significantly. The shoulder felt normal by, say, a year and 3 months after the surgery. The Dr described the tendon repair as "scar" tissue. But in my recovery that scar tissue was not stressed and treatment was under the direction of a physical therapist. The recovery was 6 months of stretching to maintain range of motion and then light strength training exercises could begin for another 3 months. Then ease back into normal activity. I am not certain of the operation details, some (maybe all?) of the tendon was reattached to the bone with special sutures.
 

Dartagnan64

Legend
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.
Well rest followed by slow and steady re-conditioning will likely work for 90% of people and hence is why it is often recommended by physicians. But if I rested for 6 months after every tendinitis acted up, I'd never play tennis for more than a few weeks a year.

Learning to manage the tendinopathy with warming up prior to play, bracing during play, stretching and eccentric exercises between play, I've managed to recover from achilles tendinitis (both sides), patellar tendinitis, wrist tendinitis, Tennis elbow. I'm now working on golfer's elbow and with that same approach I've kept up my usual amount of play and am slowly healing the tendon.

But as a physician, if a patient asked me how to fix their tennis/golfer's elbow, of course I'd tell them to rest and stretch until the pain is gone then do 6-8 weeks of eccentric exercises to build the strength and tendon resiliency back up. It's the most prudent instruction.
 

sredna42

Hall of Fame
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.
 
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.
Read the OP's various UPDATES in this long thread carefully, start at the end and move back. The nerve issue turned out not to be the final diagnosis. See my post #167. Nerve issues can be very tricky. Tendon injuries are very common. I hope that you can find a well qualified specialist.

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....
 
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Eiki Saito

New User
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 have the same pain (only serving)...

Try this tips:


For me is a Workaround... until I have pain cure



Enviado do meu iPhone usando Tapatalk
 

dak95_00

Hall of Fame
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/
THANK YOU x1,000,000 !!!!’

I hurt myself doing pull-ups back in January/February. The pain just got worse and worse so I stopped doing arm curls lifting weights and pull-ups. Tennis was also aggravating it to the point I realized I couldn’t play at or near my normal level. My forehand was 75% and my serve was 40%. I couldn’t carry things around because my arm hurt so bad. I’m talking lifting simple things. I just went to an orthopedist just last week and am scheduled for PT next Monday when I stumbled upon this post.

I’ve done this stretch now a few days. It was excruciating at first. I’ve been out playing tennis in the Hilton Head Island heat on vacation. The pros here are convinced I’m a 4.5 even though I play 3.5 and 4.0 USTA back home. I’ve got my game back. I can lift things. My arm isn’t as stiff in the morning.

This post/stretch should get its own sticky. Everyone should do it! It will forever be in my stretching arsenal.
 
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.
 

dak95_00

Hall of Fame
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.
My pain went from I cannot carry the groceries or hold the dog leash in my right arm to mush you huskies! I went from not being able to hit to smashing down the line rockets. I went from hitting little spinner serves to hears comes the missile.

I’ve only done this exercise for four days and only 2-3 times per day. Just as the author, I also originally injured my arm doing pull-ups. This stretch has helped me regain my strength and tennis play. I still feel slight stiffness in my elbow but the change has been dramatic. I bet I’m pain free by next week at this time.

I’m 47 and never had an elbow issue in my life. I’ve played a full bed of original Big Banger at 70lbs without issue. I’ve never had elbow issues. Damn pull-ups got me! I’ve played Kevlar just as tight. I’ve played thousands of rounds of golf. Nothing!

If this helps someone, great! It’s worth a try. It hurt at first. I was desperate and ready to quit. I’m now ready to head to district and win matches for my team.
 
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.
 

dak95_00

Hall of Fame
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.
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.

Elbows are simple but complicated areas of the body. There could be tendon, ligament, muscle, nerve, or all issues inside there. It’s doubtful that a stretch could make anything worse. Simply telling everyone over and over to just rest for up to a year is likely more damaging and dangerous than stretching. Think of the mental side to giving up and the depression it causes. That’s very damaging both mentally and physically to people.
 

Dartagnan64

Legend
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

Legend
TE is an overuse injury.
If it were degen, millions of non-tennis people would have it.
They don't.

REST
See I view it as a weakened, degenerating tendon that was overused.

The tendon has to be in poor condition first. Many people play tennis with healthy young tendons and don't get TE. Neither overuse nor weakness is sufficient in itself to cause TE/GE.

And TBH, millions of non-tennis people do get TE and GE. In fact they make up the largest percentage of victims. In my medical practice i would see it all the time in non-athletes. All universally with poorly developed forearms. Don't think I ever saw an actual tennis player with TE. Probably because they knew what it was and what to blame.
 

Dim Sim

Rookie
My experience: caused by a gripping the racket too hard as a result of the grip size being too large (happened when I started using Dunlop overgrips); fixed by going down a grip size and doing strength work (wrist curls with an open hand, ie not gripping the bar, working up from light weights); and, rotating a weight around the arm (eg arm and wrist at perpendiculr, rotating the weight from 9 to 11 then 3 to 12). Load those tendons with slow, heavy weights.
 

HouTex

Rookie
I had what would be considered full blown TE. I was out of tennis for about 20 months. I could not have played even if I wanted to play. Just too much pain. So I rested it but I also did doctor prescribed therapy by a licensed PT. It included exercises, stretches, light weights, and other therapies. Except for the graston therapy I never had pain during the PT treatments. But on the issue of resting, if you have a serious case of TE you won't have a choice. I also have to say that I failed to rest my elbow early on and it certainly made it worse. I thought I could play through the pain and that was a huge mistake.
So a clear warning to everyone who starts to feel elbow pain--especially tennis junkies who think they won't survive without playing 5 times a week or more, keep playing at your own peril. You can easily turn a few month layoff into 20 months like I did.
 
Due to shared wisdom of people like @HouTex the smartest thing I did was to stop immediately.
I played again one week after the initial symptoms and it was still there. I had the dreaded TE.
So, I then took a total of 5 months off and came back 100%. The smartest thing I did.
 

Dim Sim

Rookie
Yes, load tendons with weight, but not when they are injured.
Injured = rest
Not injured = go nuts with PT and weights
That’s contrary to advice I’ve got from several physiotherapists, which is to commence the rehab asap. Obvs immediately after a traumatic injury causing event you need to rest (rice etc) but tendinopathies don’t (from what I’ve been told and in my experience) get better unless you load the tendon and it is acceptable and necessary to work through pain. Pain of itself doesn’t mean more harm is being caused. If you are suggesting one needs to be completely pain free before starting the rehab process then I disagree as doing so simply lengthens the total recovery time and increases the likelihood of further degeneration and atrophy.
 
I was doing a full weight lifting circuit within days of getting TE.
I worked out 4x a week, all winter.

When I say rest, I meant NO TENNIS.

DO NOTHING THAT AGGRAVATES THE TE
For me, weightlifting, kettlebells, Crossfit
Nothing aggravated the TE.
Only pull ups.
I still have not done pull ups in almost 9 months.
 
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DO NOTHING THAT AGGRAVATES THE TE
For me, weightlifting, kettlebells, Crossfit
Nothing aggravated the TE.
Only pull ups.
I still have not done pull ups in almost 9 months.
 

Dim Sim

Rookie
@TTPS - why the aggro mate? Expressing yourself more completely and accurately might help. Exercise that isn’t specific and done with precise attention to form and volume isn’t going to be anywhere as efficient and effective as that which is (and can be counterproductive): I’ve got no idea what your gym routine’s got to do with the purpose of this thread (though of course exercise in general is beneficial etc and compound exercises that work the upper body will work the elbow joint but at the risk of overloading the tendon that is already hurt and susceptible).
 

Dartagnan64

Legend
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.

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.
 

Dartagnan64

Legend
@Dartagnan64
What is the story with your TE or GE? Let's hear the back story.
Took up tennis actively 4 years ago, initially suffered through Achilles tendinopathy until I started doing eccentric heel drops. Was using a Babolat Pure drive with gut/poly and taking serve lessons when i started to notice elbow pain about 1 year or so into the tennis bug. Diagnosed it as tennis elbow and started working on it but played tennis through it. Ditched the poly. Ditched the Pure Drive for a Blade, eventually ditched the Blade for a Phantom. After about 9 months of issues it started to resolve and I was fine from an arm standpoint for about a year. During that time I developed some patellar tendinopathy and worked on that with angled squats and knee brace. Then this spring I started to notice some pain on the opposite side of my elbow. Diagnosed it as GE and have started working on rehabbing it. Went back to my softer Phantom racquet with multi strings, flexbar, stretches, elbow brace. Slowly seems to be improving.

Through all these tendinopathies I've never stopped playing. But as soon as any discomfort starts I get on it right away with exercises and stretches to improve it and just brace it during play and use a softer frame and string. If that fails I guess I would rest it more judiciously, but I've been able to get all these things better while still playing so why would I change up a successful formula?

Of course, if you were my patient, I'd tell you to rest it, and start gradually strengthening once the pain goes away like all good doctors. But as they say, doctors make the worst patients.
 

dak95_00

Hall of Fame
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.
 

Dartagnan64

Legend
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.
Yeah I know I should stretch more. I've always relied on my overly tight ligaments just to hold all my joints together lol.
Someday when life isn't so busy I might actually start doing yoga. Right now I have a tennis specific stretch routine.

I did modify the exercise so I can do it against a wall just for the affected arm. Might stick to that for now. It is a good stretch as it really supinates the arm and stretches the pronators.
 
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