yet another middle-age TE sufferer

[wallymann]

first bout of TE was back in 1983. went from a 3/8 to 5/8 and it went away.

fast forward 40 years, it's back! have been toeing the line with slight elbow/forearm discomfort for the last month or so and my game is really coming around...and tuesday this week...POP...my elbow/forearm gave way on a big forehand. like i couldnt make a fist, i couldnt hold my racquet, nothing.

quickly on it with ice and carpet-bombed with various anti-inflammatories...and got it under control.

thursday this week, felt good enough to at least hold my racquet and swing around easily...went out to the courts to test it out.

net: i can hit backhands. i can serve. but forehands...not so much. i can actually *hit* forehands, but the follow-thru is where it my TE starts yelping.

continuing NSAIDS, stretching, and started flex-bar PT. taking the weekend off and will re-evaluate tuesday next week.

 

[Jst21121]

first bout of TE was back in 1983. went from a 3/8 to 5/8 and it went away.

fast forward 40 years, it's back! have been toeing the line with forehand discomfort for the last month or so and my game is really coming around...and tuesday this week...POP...my elbow/forearm gave way on a big forehand. like i couldnt make a fist, i couldnt hold my racquet, nothing.

quickly on it with ice and carpet-bombed with various anti-inflammatories...and got it under control.

thursday this week, felt good enough to at least hold my racquet and swing around easily...went out to the courts to test it out.

net: i can hit backhands. i can serve. but forehands...not so much. i can actually *hit* forehands, but the follow-thru is where it my TE starts yelping.

continuing NSAIDS, stretching, and started flex-bar PT. taking the weekend off and will re-evaluate tuesday next week.

No offense but Give it a 1-3-6 month break and re evaluate. You can still condition yourself by cycling and running. It’s not worth aggravating the situation further. In addition you are older meaning that if you really damage your tendon you won’t heal as well as a 20-30 year old.

I’m going through my first bout of tennis elbow and even though I’m 90% healed, and can literally do all my usual activities without any discomfort, I would rather be safe than sorry. 3 -6 month minimum time off. I’ll be cycling etc during my downtime

 

[wallymann]

No offense...

none taken!

 

[LuckyR]

If it's forehands bothering you, you likely have golfer's elbow. In my experience GE takes longer to heal than TE. But it responds to the same treatments as TE. Just rest 50% longer than you think you should.

 

[socallefty]

If you were playing with poly, cut them out early within 10-15 hours and definitely if you feel even the slightest twinge in your elbow/arm/shoulder.

 

[wallymann]

If it's forehands bothering you, you likely have golfer's elbow. In my experience GE takes longer to heal than TE. But it responds to the same treatments as TE. Just rest 50% longer than you think you should.

nope. definitely TE, its lateral, not medial.

 

[LuckyR]

nope. definitely TE, its lateral, not medial.

Okay you know best, but your description of the FH vs BH thing is let's say, atypical.

 

[wallymann]

Okay you know best, but your description of the FH vs BH thing is let's say, atypical.

Agreed!

 

[ByeByePoly]

nope. definitely TE, its lateral, not medial.

When I had TE (lateral side) same for me. Backhands didn’t hurt at all … forehands hurt, and serving was not possible (I was off for 9 months). Never made any sense to me … other than possible tricep related (read tricep also connects in lateral TE region … not positive on that).

I included tricep massage along with the usual forearm extensor massage just in case … will never know for sure if it actually was the tricep. I never had tricep pain or swelling.

 

[Jst21121]

When I had TE (lateral side) same for me. Backhands didn’t hurt at all … forehands hurt, and serving was not possible (I was off for 9 months). Never made any sense to me … other than possible tricep related (read tricep also connects in lateral TE region … not positive on that).

I included tricep massage along with the usual forearm extensor massage just in case … will never know for sure if it actually was the tricep. I never had tricep pain or swelling.

It took you nine months before you could play tennis again? I’m like 90% there but doc says tennis elbow need to heal 100% before you come back and play and the last percent just takes a while to heal.

When did you know you were ready to come back 100%?
And when you did come back did you make any changes? No poly? Lower tension? Etc? Thanks!

 

[ByeByePoly]

It took you nine months before you could play tennis again? I’m like 90% there but doc says tennis elbow need to heal 100% before you come back and play and the last percent just takes a while to heal.

When did you know you were ready to come back 100%?
And when you did come back did you make any changes? No poly? Lower tension? Etc? Thanks!

You can probably find my ttw TE posts/rants with search. TE was the initial reason I showed up here in 2016 … and never left. I apparently now have left tennis at 65 for that evil wiffleball game.

IMO based on what I read and researched at the time … no one understands TE completely… not the healthcare community, not scientists, not the PT guys, not even ttw posters.

Also … I think it would be unlikely all TE is equal … some don’t stop playing and get past it, others take some (me) initial time off and then hit balls as PT before being able to play matches, and others that need a longer healing period before touching a racquet.

I read enough to where the “just take a year off to totally heal“ fails for some. They come back and have the problem again because they never addressed/rehabbed the injury. Then throw in no one ever knows for sure if time off was the real reason for healing, or did the PT (flexbar, massage, hitting balls, etc) actually help you heal the tendon stronger so when you come back you were less tendon degraded (I could not play with poly anymore … permanently degraded elbow but good to go with multi).

So you asked … this was my process … as you can read above … who knows what good advice is (although playing too early risks worse/permanent TE is probably sound advice … but again … when is too early).

My #1 rule was sharp pain during, or day after … stop. But uncomfortable … I just considered that is what PT is.

So … didn’t play matches for 9 months because the serving sharp pain didn’t end to around then. Would test it … fail … test again later.

First pt for me was regular flexbar and massage … maybe a month before I hit balls. I think that initial healing period is important… giving it a month was a wild a.$.$ guess … but chose the activity I wanted to get back to (tennis) as therapy (ball machine therapy). Initially I could hit any backhand, full baseline forehands uncomfortable but doable, forehands volleys ironically was a big no (I think we grip harder on volleys than full groundstrokes where you let the racquet mass do the work), serves also a big no.

After several weeks of hitting uncomfortable forehands, it vastly improved. By then … I think fh volleys still uncomfortable but sharp pain gone. Rinse and repeat … weeks go by … pretty much other than serves I was good to go. Then I figured out a way to work on serve without much pain. I hit a kick serve … so would barely grazed the ball … and that worked as a doable starting point. Serve pt worked (or time ???) … but at 9 months I could serve 100% with no elbow twinge … unless I went back to poly. Even a year later … with a lot of singles match hours using Head Velocity multi with zero elbow pain … trying poly always produced the elbow warning twinges (sometimes the following day with no problem during match).

Tennis elbow sucks. I got in the habit of massaging my forearm before I left the house for tennis. Guess what … lately started again before pickleball … wife also. I have been TE trained … NEVER want that cr@p again … forearm massage are us. I use the flexbar (green one) on occasion … but forearm massage is forever.

Good luck

 

[S&V-not_dead_yet]

… lately started again before pickleball

Aha! So it's Pball's fault!

 

[wallymann]

update: a-typical TE indeed. i think it's mostly TE-related muscle tear/sprain. the main discomfort is *not* the connective tissues around the bony elbow protrusion, but the extensor muscles that attach to it. i can run my finger along the muscles and 2-3" away from the bony protrusion there are knots that are the epicenter of the pain.

i have very mild discomfort at the bony protrusion, so definitely a mild case of TE as well...it's all inter-related. continuing with massage and flex-bar and rest.

 

[movdqa]

I've had TE over the years but have never had something that could be described as a pop. It's always been gradual. A pop sounds like something could have been torn.

 

[yossarian]

Pain in that area can be radial tunnel syndrome. Try some nerve glides on both sides and see if they feel any different. Good to rule it out

 

[PKorda]

update: a-typical TE indeed. i think it's mostly TE-related muscle tear/sprain. the main discomfort is *not* the connective tissues around the bony elbow protrusion, but the extensor muscles that attach to it. i can run my finger along the muscles and 2-3" away from the bony protrusion there are knots that are the epicenter of the pain.

i have very mild discomfort at the bony protrusion, so definitely a mild case of TE as well...it's all inter-related. continuing with massage and flex-bar and rest.

That is textbook TE (TE is a bit of a misnomer, most of pain will be where the 2 lines are, which are tendons)

 

[Jst21121]

That is textbook TE (TE is a bit of a misnomer, most of pain will be where the 2 lines are, which are tendons)

I know we aren’t doctors here but are there specific symptoms between a “torn” tennis elbow versus an aggravated tendon?

 

[movdqa]

I know we aren’t doctors here but are there specific symptoms between a “torn” tennis elbow versus an aggravated tendon?

The reason I mentioned a tear is that it happened to a hitting partner and it was a detached connective tissue in his shoulder (different kind of accident). It healed up but he lost a lot of strength. He went to have it checked out six months later and it was a detached something-or-other. They told him that they could have reattached it if he had come in right after it had happened. He wound up learning to hit left-handed.

 

[Jst21121]

The reason I mentioned a tear is that it happened to a hitting partner and it was a detached connective tissue in his shoulder (different kind of accident). It healed up but he lost a lot of strength. He went to have it checked out six months later and it was a detached something-or-other. They told him that they could have reattached it if he had come in right after it had happened. He wound up learning to hit left-handed.

Wow. It still boggles my mind that tennis players can play through tennis elbow or aches. I immediately stopped after mine- and my doc says give it 8 weeks minimum- even if you feel 100%...and that's exactly what I'm doing even though right now is the season for adult 18+ USTA.

Oh well.

 

[graycrait]

Get the gadget on the far right in the picture. Run your forearm 10-20 times 4 or 5 times a day. Items pictured are my TE rehab kit. Note an absence of the Flexbar. I had the whole series of Flexbars at one time and found them underwhelming.

 

[movdqa]

Get the gadget on the far right in the picture. Run your forearm 10-20 times 4 or 5 times a day. Items pictured are my TE rehab kit. Note an absence of the Flexbar. I had the whole series of Flexbars at one time and found them underwhelming.

That looks like it breaks up scar tissue which is always useful.

 

[wallymann]

Wow. It still boggles my mind that tennis players can play through tennis elbow or aches. I immediately stopped after mine- and my doc says give it 8 weeks minimum- even if you feel 100%...and that's exactly what I'm doing even though right now is the season for adult 18+ USTA.

Oh well.

in the northern lattitudes, 2 months off is a major part of the outdoor playing season! for better or worse, that fact definitely changes one's attitude toward injury management.

 

[PKorda]

Wow. It still boggles my mind that tennis players can play through tennis elbow or aches. I immediately stopped after mine- and my doc says give it 8 weeks minimum- even if you feel 100%...and that's exactly what I'm doing even though right now is the season for adult 18+ USTA.

Oh well.

I got TE a few years ago in the fall, was about a 5-6 on 1-10 scale, I played through it for exact reason mentioned by above poster, didn't want to stop playing for 2 months right before winter, as I tend not to play a ton in the winter. So I dealt with the pain for a while and then stopped completely for 4 to 5 months. Playing through it didn't seem to make it any worse.

 

[wallymann]

TE was feeling not terrible, so hit for 2hr practice tonite.

Took it really easy to start...about 45 minutes in, the first FH I went for pace and heavy topspin...the FH/elbow muscle spasm "went nucular" again... Had to play gimpy for the rest of the night, couldn't swing freely at all ☹️

the troublesome strokes: hard FH with heavy topspin and once the spasm re-asserted itself...any BH when I get jammed was also fruitless...being unable to swing hard on FH means I got jammed a lot....shellacked 6-1 as a result...

So...Taking a couple weeks off and when I resume, no more extended group practice as that ends up being counter productive for rehab...only solo drills until I can swing freely again and stopping any workout at the first sign of pain.

 

[Jst21121]

TE was feeling not terrible, so hit for 2hr practice tonite.

Took it really easy to start...about 45 minutes in, the first FH I went for pace and heavy topspin...the FH/elbow muscle spasm "went nucular" again... Had to play gimpy for the rest of the night, couldn't swing freely at all ☹️

the troublesome strokes: hard FH with heavy topspin and once the spasm re-asserted itself...any BH when I get jammed was also fruitless...being unable to swing hard on FH means I got jammed a lot....shellacked 6-1 as a result...

So...Taking a couple weeks off and when I resume, no more extended group practice as that ends up being counter productive for rehab...only solo drills until I can swing freely again and stopping any workout at the first sign of pain.

Honestly curious- aren’t you worried about doing serious damage? My teammate ignored all his tennis elbow and even got cortisone shots. Played 3 months in the summer and the final month august- went to hit a forehand and snap and he knew something went bad.

Ended up needing surgery and lots of PT.

Why risk something like that?

 

[wallymann]

Why risk something like that?

my mind is going there!

 

[yossarian]

Coincidentally I just developed some lateral elbow pain after increasing weight during a lifting routine. Typical tests for tennis elbow are positive

Heavy slow resistance and some manual therapy on the area and my only issue is pain that is a about a 0.5/10 with heavy gripping after one week

 

[movdqa]

Coincidentally I just developed some lateral elbow pain after increasing weight during a lifting routine. Typical tests for tennis elbow are positive

Heavy slow resistance and some manual therapy on the area and my only issue is pain that is a about a 0.5/10 with heavy gripping after one week

I've had elbows pinged by weightlifting as well - doesn't even have to be heavy stuff. Pullups could aggravate them. Same thing as tennis, though, rest.

Flexbar has really helped for quite some time.

 

[dannyslicer]

I've had TE over the years but have never had something that could be described as a pop. It's always been gradual. A pop sounds like something could have been torn.

This.

Took it really easy to start...about 45 minutes in, the first FH I went for pace and heavy topspin...the FH/elbow muscle spasm "went nucular" again... Had to play gimpy for the rest of the night, couldn't swing freely at all ☹️

People with TE can easily play tennis with TE. Which is why they do just that, and make it worse over time.
In fact, the TE feeling goes away while playing, then comes back the next day.

See above.

 

[wallymann]

injury update: i'm convinced this is not classic TE.....as i mentioned the pain is a couple inches away from the lateral epywhatever...its in the bundle of muscles that tie to the wrist, feels more like a muscle tear.

it's responding *very* well to reverse forearm curls and reverse arm curls -- things that typically do NOT help traditional TE/connective-tissue injuries.

 

[PKorda]

injury update: i'm convinced this is not classic TE.....as i mentioned the pain is a couple inches away from the lateral epywhatever...its in the bundle of muscles that tie to the wrist, feels more like a muscle tear.

it's responding *very* well to reverse forearm curls and reverse arm curls -- things that typically do NOT help traditional TE/connective-tissue injuries.

Classic TE

 

[wallymann]

Classic TE

perhaps using a colloquial definition of TE...the medical community would call it "radial tunnel syndrome" given the location of the pain.

whatever the case, it's an injury that i'm glad is getting better!

 

[onehandbh]

If you were playing with poly, cut them out early within 10-15 hours and definitely if you feel even the slightest twinge in your elbow/arm/shoulder.

I keep track of when I string my racquet and how many hours I play with it.

I cut it out after about 12-15 hrs. Sometimes sooner if it is already notched deep and about to break or if tension has dropped too low.

When trying a new string or increased tension, at the first sign of discomfort I cut it out.

No tennis elbow or joint injuries so far from poly.

 

[movdqa]

I keep track of when I string my racquet and how many hours I play with it.

I cut it out after about 12-15 hrs. Sometimes sooner if it is already notched deep and about to break or if tension has dropped too low.

When trying a new string or increased tension, at the first sign of discomfort I cut it out.

No tennis elbow or joint injuries so far from poly.

I do this as well. I have marked my racquets 1, 2, 3, 4 and strung with ALU Power since about 2005 and restrung after 8 hours. I switched to Hyper-G last fall and now restrung between 15-20 hours. Different polys tend to be usable for different lengths of time. The main loss with Hyper-G is feel. I'm giving up feel for tension maintenance, spin, comfort and I'm willing to make that tradeoff. I think that the best way to get an idea of how long you should use different polys is to ask other people how long they use it. There is a huge difference between 8 and 15 hours in terms of restringing time and cost.

 

[wallymann]

it's been a few months...i'm back on the courts! if i'd done it *right* i would have been here a couple months sooner....

main lesson learned: when my arm started feeling good, instead of jumping back into playing...i should have kept doing PT and getting it stronger and letting it heal more fully for a few more weeks.

instead, it'd heal --> i'd play --> i'd re-injure it --> heal for another month --> play --> re-injure --> heal --> play --> re-injure --> heal --> repeat ***DONT DO THIS***

when it starts feeling good...keep doing your PT for a few more weeks...and then gradually add easy hitting...and keep doing PT for a few more weeks...and then gradually add point-play

 

[Bud]

You can probably find my ttw TE posts/rants with search. TE was the initial reason I showed up here in 2016 … and never left. I apparently now have left tennis at 65 for that evil wiffleball game.

IMO based on what I read and researched at the time … no one understands TE completely… not the healthcare community, not scientists, not the PT guys, not even ttw posters.

Also … I think it would be unlikely all TE is equal … some don’t stop playing and get past it, others take some (me) initial time off and then hit balls as PT before being able to play matches, and others that need a longer healing period before touching a racquet.

I read enough to where the “just take a year off to totally heal“ fails for some. They come back and have the problem again because they never addressed/rehabbed the injury. Then throw in no one ever knows for sure if time off was the real reason for healing, or did the PT (flexbar, massage, hitting balls, etc) actually help you heal the tendon stronger so when you come back you were less tendon degraded (I could not play with poly anymore … permanently degraded elbow but good to go with multi).

So you asked … this was my process … as you can read above … who knows what good advice is (although playing too early risks worse/permanent TE is probably sound advice … but again … when is too early).

My #1 rule was sharp pain during, or day after … stop. But uncomfortable … I just considered that is what PT is.

So … didn’t play matches for 9 months because the serving sharp pain didn’t end to around then. Would test it … fail … test again later.

First pt for me was regular flexbar and massage … maybe a month before I hit balls. I think that initial healing period is important… giving it a month was a wild a.$.$ guess … but chose the activity I wanted to get back to (tennis) as therapy (ball machine therapy). Initially I could hit any backhand, full baseline forehands uncomfortable but doable, forehands volleys ironically was a big no (I think we grip harder on volleys than full groundstrokes where you let the racquet mass do the work), serves also a big no.

After several weeks of hitting uncomfortable forehands, it vastly improved. By then … I think fh volleys still uncomfortable but sharp pain gone. Rinse and repeat … weeks go by … pretty much other than serves I was good to go. Then I figured out a way to work on serve without much pain. I hit a kick serve … so would barely grazed the ball … and that worked as a doable starting point. Serve pt worked (or time ???) … but at 9 months I could serve 100% with no elbow twinge … unless I went back to poly. Even a year later … with a lot of singles match hours using Head Velocity multi with zero elbow pain … trying poly always produced the elbow warning twinges (sometimes the following day with no problem during match).

Tennis elbow sucks. I got in the habit of massaging my forearm before I left the house for tennis. Guess what … lately started again before pickleball … wife also. I have been TE trained … NEVER want that cr@p again … forearm massage are us. I use the flexbar (green one) on occasion … but forearm massage is forever.

Good luck

We're happy you stayed and now contribute greatly to the pickleball forum

 

[Bud]

update: a-typical TE indeed. i think it's mostly TE-related muscle tear/sprain. the main discomfort is *not* the connective tissues around the bony elbow protrusion, but the extensor muscles that attach to it. i can run my finger along the muscles and 2-3" away from the bony protrusion there are knots that are the epicenter of the pain.

i have very mild discomfort at the bony protrusion, so definitely a mild case of TE as well...it's all inter-related. continuing with massage and flex-bar and rest.

I hope you didn't do that with a sharpie

 

[Bud]

I've had TE over the years but have never had something that could be described as a pop. It's always been gradual. A pop sounds like something could have been torn.

Agreed. Sprained will cause a pop.

 

[ByeByePoly]

We're happy you stayed and now contribute greatly to the pickleball forum

Several new pickleballers friends have been interested in my TE knowledge … tennis knowledge not so much There was a green flexbar sighting once … including demo.

 

[wallymann]

first points-play in several months -- timing was really off as you'd expect...and while the forearm felt decent i ironically (?) pulled something in my shoulder on my first return-of-serve!

it was not catastrophic, just dialed back and finished out the session -- 2 hours later in the sun, i was knackered!

need a couple days rest, then practice tuesday...then doubles-match on thursday!

 

[movdqa]

first points-play in several months -- timing was really off as you'd expect...and while the forearm felt decent i ironically (?) pulled something in my shoulder on my first return-of-serve!

it was not catastrophic, just dialed back and finished out the session -- 2 hours later in the sun, i was knackered!

need a couple days rest, then practice tuesday...then doubles-match on thursday!

Take it easy in this heat if you're coming back. It seems like a lot of the world is dealing with high temp or torrential rains.

 

[FloridaAG]

Different people, different pain tolerance, different severity of injury
Different obsessive need to play tennis

 

[aussie]

perhaps using a colloquial definition of TE...the medical community would call it "radial tunnel syndrome" given the location of the pain.

whatever the case, it's an injury that i'm glad is getting better!

TE is medically labelled lateral epicondylitis. The lateral epicondyle is the bony protrusion on the outside of the elbow joint and the medial epicondyle is the bony protrusion on the inside of the elbow.

My pain was on the epicondyle itself but pain can be further along the extensor muscle towards the wrist.

The surgery to repair TE is called extensor origin repair surgery. Mine was in November 2013 and even with extensive rehab I didn't play competitive tennisa gain until December 2014.

Two very good exercises to either help recover from TE or assist in the rehab process following surgery:

1. Several minutes of firm rolling or massage of the extensor muscles several times daily. I prefer rolling the muscles using a rolling pin against the back of my folded arm against a door or wall.

2. What pro tennis players do: hold affected arm out straight in front parallel to floor. Rapidly open and close fist as many times as possible. I used to do around two hundred in rapid time - my extensor muscles would be aching intensely at the end but the benefits to assist recovery of and prevention of TE are amazing.

I missed two years of tennis from 2013-2014 but have been pain free these last nine years. I still perform these two exercises three times weekly.

Good luck to you all.