elbow tendonitis

[midlife crisis]

Anyone else plagued by "tennis elbow"? I've had it before and it took months to get better. It's my right elbow. I've heard both sides of the cortisone argument. I'm not terribly anxious to have a needle stuck in my elbow.
It's worse when I'm skating before playing. My elbow is somewhat straight down carrying my stick. I skated without my stick Friday night but halfway through the game it felt like someone had stuck a knife in. It took 800 mg of Motrin to feel better.

[Danish]

Hi midlife crisis,

I had elbow tendinitis earlier this spring. I guess its because of my age, but the pain was gone after 5 days. I kept working out through it, just made sure not to use my arms to much in the workouts.

The pain in my elbow began when i was playing tennis (high school tryout), It was then worsened by working out. I went to the doctor and he just told me no physical activity for the next week. That was impossible for me, since i had tryouts two days later. So i kept doing much of my workouts and "physical activity" but just limited the amount of activity by the arms.

I'm really not sure since i didn't need any cortisone, since i didn't need it. But my mother who has had knee problems her entire life had a cortisone shot about a month and a half ago and she loved it. She was able to go to her annual tennis camp down in Florida 5 weeks after having knee surgery. Eventually, you will come to a period where the cortisone will not help you any more and you will begin to feel the pain again.... and it will suck. But from what I heard she loved the shot.

Danish

[TeamSleep]

Yes I have the same thing. Mostly from playing baseball though, never does my hockey playing effect my elbow that way, but, I use something when I play baseball. You can go buy it at wal-mart in the Pharmacy section. It is basically a band that you wrap around your elbow - on the band is a gel squishy thing that keeps pressure on that tender tenden and allows you to move freely without much pain. I dont use it for hockey, but I do for softball still - has saved me from having to get sergury. Go check it out - it is made my Mueller. Also, always ice your elbow after you play... even if it doesnt hurt. This will help heal and decrease the chances of more pain. Hope that helps.

[midlife crisis]

Thanks Team Sleep,
I have 3 versions of the band you mentioned. I do wear it while I play. I even wore an OTC pain patch under it the other night.

You mentioned having problems while playing baseball. I'm the catcher for my softball team and the elbow isn't a problem even with all the throwing back to the pitcher.

I will try ice next time.

[TeamSleep]

Also, Strech - Strech - Strech. I am a little confused on how playing hockey goalie is hurting your elbow, but before bring in a tennis ball, throw it against the wall, and catch it with your glove. Good to warm up your elbows as well as loosen up. Also, if you have the capabilities put a warm heat pad on before you go out. That will help loosen up the tendens.

I play left field so I am throwing it as hard as I can hehe... definitely feel it then.

[geojedi]

I stretch and massage it. My PT gave me some exercises and informed me that massage to it disrupts the scar tissue to help it. Ice after excercise and NSAIDs as needed.
Heat before is great also.

[jambon20]

For now... lots of rest, stretching, avoidance of the activity (or motion) that causes the problem, ice, an "good" brace that will basically give you an new insertion point for the muscle, thereby giving the tendon a rest.

Certain types of soft tissue treatment will be of great benefit... Active Release Techniques, Graston Technique, and Ultrasound should all help.
See your local chiropractor, physiotherapist, athletic therapist for these things.
After the pain is gone, you will want to strengthen the area so that it is less likely to happen again.

For curiosity's sake.... is it the inside of your elbow or the outside?
Medial Epicondylitis is the inside... also known as Golfer's Elbow... involves an overuse of the forearm flexors (wrist and finger flexors).

Lateral Epicondylitis is the outside... Tennis Elbow... involves overuse of the forearm extensors (wrist and finger extensors).

I believe there are a few other threads about this... I'll try to find them.
Cheers!, and best of luck.


Pain In Elbow When I Twist My Forearm

Forearm pain

Elbow pain source???

[sherwood5030]

Originally Posted by jambon20

For now... lots of rest, stretching, avoidance of the activity (or motion) that causes the problem, ice, an "good" brace that will basically give you an new insertion point for the muscle, thereby giving the tendon a rest.

I had a problem that came on gradually that I too thought was tennis elbow. I think it started from getting hit with pucks a lot on my stick arm. Those caused bruises, or contusions, which if untreated result in the formation of scar tissue. Scar tissue formation causes the muscle to shorten, which resulted in the muscle pulling on its insertion point(s). It is that pulling that causes pain. In my case it started to feel like I was getting stabbed in my stick arm with a knife everytime I grasped the stick paddle.

I took two months off (which hurt the most of all) and got massage therapy to reduce the scar tissue; in addition, I iced the heck out of the area on a regular basis and wore a tennis elbow brace that changed the insertion point and let the ligament rest. The result is that now the pain is gone, and I didn't have to have surgery.

A friend of mine, who plays forward, was not so lucky. He kept playing and playing and playing and developed a serious case of tennis elbow that got so painful that it prevented him from sleeping at night; finally, he had to have surgery because an MRI revealed he had shredded his ligaments beyond repair.

Recently, I reinforced the padding on both arms of my Vaughn Epic 8000 c/a with extra-heavy foam and hope to continue to play pain free.

My point is that you might want to look at what is causing the pain and take some preventative steps before you have to go under the knife.

[jambon20]

Originally Posted by sherwood5030

I had a problem that came on gradually that I too thought was tennis elbow. I think it started from getting hit with pucks a lot on my stick arm. Those caused bruises, or contusions, which if untreated result in the formation of scar tissue. Scar tissue formation causes the muscle to shorten, which resulted in the muscle pulling on its insertion point(s). It is that pulling that causes pain. In my case it started to feel like I was getting stabbed in my stick arm with a knife everytime I grasped the stick paddle.

I took two months off (which hurt the most of all) and got massage therapy to reduce the scar tissue; in addition, I iced the heck out of the area on a regular basis and wore a tennis elbow brace that changed the insertion point and let the ligament rest. The result is that now the pain is gone, and I didn't have to have surgery.

A friend of mine, who plays forward, was not so lucky. He kept playing and playing and playing and developed a serious case of tennis elbow that got so painful that it prevented him from sleeping at night; finally, he had to have surgery because an MRI revealed he had shredded his ligaments beyond repair.

Recently, I reinforced the padding on both arms of my Vaughn Epic 8000 c/a with extra-heavy foam and hope to continue to play pain free.

My point is that you might want to look at what is causing the pain and take some preventative steps before you have to go under the knife.

Tendons in this case, not ligaments.

[sherwood5030]

Originally Posted by jambon20

Tendons in this case, not ligaments.

Oops. My bad. Indeed: tendons not ligaments. But both hurt like heck when aggravated, yes?

[slippifish]

Originally Posted by jambon20

For now... lots of rest, stretching, avoidance of the activity (or motion) that causes the problem, ice, an "good" brace that will basically give you an new insertion point for the muscle, thereby giving the tendon a rest.

Certain types of soft tissue treatment will be of great benefit... Active Release Techniques, Graston Technique, and Ultrasound should all help.
See your local chiropractor, physiotherapist, athletic therapist for these things.
After the pain is gone, you will want to strengthen the area so that it is less likely to happen again.

I second jambon20's advice. I developed a bit of tennis elbow recently and seeing a good physiotherapist helped significantly.

I went for a few sessions and she used a combination of massage (possibly Active Release Techniques...I don't know enough to be sure), ultrasound, and...speaking of needles...acupuncture and a bit of intramuscular stimulation, aka IMS (for info on the latter, there is a little description at Intramuscular Stimulation).

The acupuncture / needle treatments made a noticeable difference. Within an hour after the first session with them, I suddenly noticed that things that were painful prior to the appointment were suddenly much less painful. I had had a session with just ultrasound and massage prior to that and didn't notice nearly as dramatic a difference.

A friend of mine noticed similarly dramatic results with just IMS (and exercises). He'd had tennis elbow for years, kept mostly at bay by avoiding racquetball. When it flared up after practicing a lot of slapshots, he saw his physio for about 3 weeks, got the needles and hasn't had a problem since.

I didn't get a cortisone shot but certainly doing something to calm down the inflammation could be very helpful. In my case I didn't feel it was necessary and I felt the treatment I did get addressed the problem more specifically. I was happy with all my needles even if there were a lot more of them than there would have been had I just gone for a shot. Any pain from needles is also pretty much momentary...certainly nowhere near as lingering and debilitating as ongoing tendonitis.

I also wore a brace (a tennis elbow brace -- the one described earlier with the little pad on it) when playing goal or doing other things that could potentially stress on the area, and I mostly avoided activities that seemed to stress the area a lot (stuff requiring a lot of gripping or twisting, or explosive motions involving the forearm, like throwing a frisbee). I'm also doing some stretching and exercises to reduce the likelihood of getting the injury again. The tennis elbow isn't completely gone -- it got about 80% better with the first two or three sessions and the last little bit is slow to heal (I'm at about 95% now, I'd say), but that's the way it is with this injury.

anyway, whatever you decide do, good luck and hope you heal quickly.

[jelaltd]

Stop pulling the goalie. Your elbow will get better.

[midlife crisis]

Thanks everyone for your advice. I am considering every option except taking time off from playing. I have the oportunity to play 3 times a week and need all the work I can get.

[MURCIELAGO R-GT]

my last bout with it seemed to take forever to go away, over 1 1/2 mo. I wore the brace and did the icyhot and did the ice. It really sucked!. But it went away

[slippifish]

Originally Posted by midlife crisis

Thanks everyone for your advice. I am considering every option except taking time off from playing. I have the oportunity to play 3 times a week and need all the work I can get.

hey midlife, give a little thought to taking a little time off from playing -- depending on where you're at in the healing, a well-timed (even if short) rest might help you turn the corner enough to go back to playing with a less irritable tendon.

I mostly *didn't* stop playing -- playing goal really didn't seem to make things worse for me -- but I would have taken a rest of a game or two if (a) it truly hurt to play and (b) I noticed significant setbacks after games. I should say that I was very aggressive about getting physio early in the game, and the brace was a great help.

This is how I chose to rest:

(1) I opted out of anything else that definitely hurt and seemed to make things worse. So, for a few weeks, I stopped doing grip-centric workouts, let my boyfriend open jars and bottles for me, put off trying to handle the puck, and stopped playing ultimate frisbee (which actually hurt the worst).

(2) I opted out of one or two drop-in sessions near the beginning of my physiotherapy, just at the point where I was seeing rapid improvements. My reasoning: the elbow was getting better really quickly, and I figured if I got it just past a certain point, it would heal much better on its own even if I still chose to play. The drop-in sessions were ones where I knew I would be taking continual shots, as the last couple of sessions were ones where only 1 or 2 people showed up and practiced shooting on me for an hour and a half. The practice was great, but the stress on the tendon was likely to be a lot more than a game.

I think the short investment in a bit of selective rest really paid off. After skipping one session of drop-in following a particularly useful physio session, I felt about 70% better, and my tendon was much less irritable after that. I still played games/shinny during this time (a couple or sometimes 3 times a week). I also think the timing of the rest was important.

So give rest a second thought. You might be able to get away with a lot less than you think. If you want to your tendonitis to get better, you have to be aggressive about getting better. And sometimes getting aggressive means figuring out when and how you can get the most benefit from resting.