Anyone have any tips for Tennis Elbow recovery?

[Zimmerframe]

Try earthing or 'grounding' daily. Decreases inflammation.

@BAMBAMODA once told me that he tries grinding daily, but it always increases inflamation.

(Zimmer, Age 12 3/4).

 

[Bigfathairybiker]

Anyone tried sticking a walking stick in one ear and spinning around on one leg whilst singing Bad by Michael Jackson?

 

[Mikerb]

I was initially hoping the same thing as it was caused by a whack but I forgot to mention that I did it back in June so if it was bruising then it would have been better now. I think you're right about the fine line between using it and damaging it further, I do still use it at work but I'm very careful that I don't use it enough to cause pain and that's also the whole logic behind the Theraband Flexbars as you are supposed to use the ones that don't cause pain and only when you can do the days exercise with no pain you move on to the next strength level bar so I'm definitely keeping that up too.

My point was....and I accept it may be controversial......if the tendon tissue tears have healed the pain experienced when using it is due to the lack of elasticity in the repaired tissue....and avoiding that pain merely lengthens the time it takes to regain full function.
One example. I broke several bones in my foot and damaged tendons on both sides of my ankle playing football. I used painkillers to cope initially and hot/cold treatments. Went to 1 NHS physio session and it was excruciatingly painfull. I devised my own routine after that! The point was .....use it or be left with permanent lack of movement. Yes.....after each DIY physio session it hurt a lot!
My foot was essentially locked at 90 degrees....I could not flex my ankle.
As a keen windsurfer I was desperate to get back on the water even if it meant going slow and not using the footsteps. That didn't last long! End result was the ankle started to flex....and flexed more with every session. I had to take pain killers after each session but only for a few hours. The fact it was winter helped....the sea was darned cold!!

 

[RipGroove]

My point was....and I accept it may be controversial......if the tendon tissue tears have healed the pain experienced when using it is due to the lack of elasticity in the repaired tissue....and avoiding that pain merely lengthens the time it takes to regain full function.
One example. I broke several bones in my foot and damaged tendons on both sides of my ankle playing football. I used painkillers to cope initially and hot/cold treatments. Went to 1 NHS physio session and it was excruciatingly painfull. I devised my own routine after that! The point was .....use it or be left with permanent lack of movement. Yes.....after each DIY physio session it hurt a lot!
My foot was essentially locked at 90 degrees....I could not flex my ankle.
As a keen windsurfer I was desperate to get back on the water even if it meant going slow and not using the footsteps. That didn't last long! End result was the ankle started to flex....and flexed more with every session. I had to take pain killers after each session but only for a few hours. The fact it was winter helped....the sea was darned cold!!

So I need to figure out some decent stretches then.

 

[Zimmerframe]

So I need to figure out some decent stretches then.

Drinking !

You never hear of anyone saying they have beer elbow or wine elbow !

A cold beer or a chilled wine can also be rested against the sore area by holding it with the other hand in between sips.

The drinking method of stretching is also unique, compared to the many other stretching and meditation routines, in that it's one of the few systems which encourages many of us to continue working at our routine - often for hours.

Drink stretching is believed to have been successfully used by Humans for about 9000 years !

** Whist Drink stretching has been used by billions of people, It should be noted that many alcoholic stretching accessories have a picture of a pregnant lady on the bottle - this is a warning that too much drink stretching can lead to unwanted pregnancy's. Always stretch in moderation.

 

[Mikerb]

on a more serious note..............for arm injuries I would try hanging from a bar ( not by the neck!!) with feet able to touch the floor so that you can regulate the degree of stretch. Done for set periods of time and alternating palm forward or palm back will both stretch and rotate the tendon in a controlled way.

 

[RipGroove]

on a more serious note..............for arm injuries I would try hanging from a bar ( not by the neck!!) with feet able to touch the floor so that you can regulate the degree of stretch. Done for set periods of time and alternating palm forward or palm back will both stretch and rotate the tendon in a controlled way.

I've done this for a rotator cuff problem in the past and it's surprising how good just hanging from bar is for you. Not really thought about doing it for the arm so will give it a go.

 

[RustyIron]

Drinking !

You never hear of anyone saying they have beer elbow or wine elbow !

Or maybe poor Rip just needs to get himself a girlfriend and give that elbow a rest.

 

[Zimmerframe]

Is everything drinks and bars with you guys ?

To quote Mike .

on a more serious note.

I believe hanging (not from the neck) was also suggested at the start of the thread. Ok, it was suggested by an idiot, but it was suggested

I think ultimately you have to accept that time will be the healer, but you can hopefully aid that.

Every injury is different and how the body responds to rest or work is always different. As others have said, but I think @Pdoz surmised it best. If you can find someone who specialises in multiple injury types/recovery types (which maybe is a poor example of "specialises" ......) that will give you the best route to recovery advice. Imagine in your head that this will be like this for 12 months. Then calculate what you're willing to invest to reduce that if you are willing to seek professional assistance.

I think you'll know quite quickly if hanging benefits you or not - again, depending on what the injury is and where it is, grip type will make a huge difference. A beam/Door top/mantle piece with your lower legs bent up/bambams ego - there's always something around.

 

[Zimmerframe]

Or maybe poor Rip just needs to get himself a girlfriend and give that elbow a rest.

To quote mike again ..

on a more serious note..............for arm injuries I would try

In my case, though I guess that would depend enormously on who you are and what you do, but the girlfriends option I found actually aggravated the injury !

I'll now sign of this thread for good as I keep leading it astray with nonsense, whilst it's actually full of really useful information.

As a parting note to at least leave with amusement which Rip can keep in mind for his dating (if he's married his wife will not be happy ....)

I went on a tinder date a few months ago. She suggested apero on the beach, I bring the food and the chilled rose ..

I got there to find it was a nudist beach !

Ok .. needs must as I carted my cool box along ..

If anyone has a tinder date on a nudist beach for apero, don't bring chicken wrap !

Mine collapsed and dumped it's contents into my groin.

I said "I presume you're not going to help with this ..... "

She didn't ...

The sea was cold.

 

[Swissrider]

A steroid injection is one solution but can be a double edged sword. It can feel like a miracle cure, with no pain but then it’s easy to overuse the joint and tear the tendon again, so one has to take it easy to let the tendon repair and because tendons have a relatively poor blood supply this takes time. However, steroids are very effective anti inflammatory treatment and at least there is no risk of stomach problems from ibroprofin and other NSAIDs. Subsequent steroid injections tend to work less well and most doctors will limit you to three maximum in any case. I’ve had very good results from acupuncture (as have others above) and it allowed me to continue to ski which I had to do for work. All of the mentioned treatments are worth a try and most can’t do any harm even if they don’t work. If all else fails, there is a surgical solution: the tendon is cut which reduces the tension and allows the tendon to knit back onto the bone attachement (tennis elbow is often the tendon partially tearing away from its attachment on bone). The cut then heals. I’ve no experience of this, but I’ve heard of it and it’s something to discuss with your doctor or even better, a doctor that specialises in sports medecin.

 

[Jeff McD]

Just saw this thread now for the first time. So I'm a sports medicine physician in the USA. Not trying to be offensive but you don't need one off opinions, you need science. Here's the science on this. This is a challenging injury due to poor circulation and overstressed design of the elbow extensor/supinator tendons. Average time to healing: 1.5 yrs for all patients with this injury. Yup, one and a half years. However you can speed this up. "All patients" includes many who aren't consistent with the proper treatment which extends the injury time in many of the medical studies. You were in this group with your earlier injuries/recurrence of injury. What is the hallmark of inadequate rehab? Multiple, repeated injuries.

First thing is to understand a basic physiologic principle that many athletes are unaware of: what actually STIMULATES healing of musculoskeletal injuries in the human body?

None of the PASSIVE therapies actually stimulate healing. These include

total rest – just get atrophy,
anti-inflammatories- just mask the pain, you end up doing too much and irritating it, not indicated for long-term use/actually interfere with healing after the first few weeks (many true statements in the threads above by various people such as this one),
heat/ice (I never recommend heat anymore since ice is more advantageous for increasing circulation and reducing swelling, but still it does not actually stimulate the healing process),
braces/splints foam rollers,
the heavy hitters: chiropractic, acupuncture, acupressure, deep tissue massage.

There's always going to be someone who says that one of these treatments worked magically for their injury but the science does not back this up. They are talking about a one-off result, while science involves thousands of patients and is more accurate therefore.

Here's what the science actually proves: Only ACTIVE therapy (weight lifting, or any similar resistance exercise keeping the muscle perfectly aligned while resisting the motion) stimulates the NERVES to heal the injury. Period. Anybody who says differently is selling something or sincere in their belief but actually not backed up by the science. Professionally, physical therapy is the only treatment that scientific reviews of the entire medical literature have shown that actually works to stimulate full rehabilitation of musculoskeletal injuries. Yes, some additional treatments like steroid injections etc can speed the process initially but they will not get you fully healed because they will not induce full strength/flexibility recovery. Steroids only suppress excessive information with initial injury.

You must recover flexibility and control swelling with compression wraps/ice in the 48 hours post injury before lifting weights. With elbow straight gently stretch arm down while rotating entire arm inwards and hold. Repeat this or any other lateral epicondylitis stretch many times throughout the day. Strength recovery will happen quicker if you maintain flexibility.

48 hours post injury, this is when you begin the strengthening phase while continuing the stretching indefinitely. Yes, that is the magical window for an injury like this before atrophy sets in. Strengthening exercises are easy to do at home. It's not complicated like sciatica or multiple trauma recovery where are you really need the expertise of a physical therapist. All you need is are 3 isolation exercises. Always work the opposite flexor forearm muscles also because these will get the inflamed extensors strength back to normal quicker.

So, 1-wrist curls, 2-reverse wrist curls, 3-forearm supination. Start with a larger water bottle for wrist curls, a smaller water bottle for wrist extensions, and a crescent wrench, hammer, water bottle, or small dumbbell for #3. Find the balance point of tool you're using for #3, then choke down a little bit in your grasp, with the heavier part extending medially, with forearm resting on mid-thigh & pointing straight forward/slight bend in the elbow, tool held in the hand perpendicular to the long axis of the arm. Rotate the heavier medial end of the tool down then back up again. You will feel this at the injury area as it pulls on the injured elbow tendons as it drops down. Let pain be your guide do not push it through pain. Increased range will come later as the pain subsides. As you get stronger, choke further and further out on this tool so there is more weight medially. If this doesn't make sense to you just Google lateral epicondylitis PT exercises and you will see it. Move from water bottles to light dumbbells for exercises one and two, and progress gradually.

The best method for quickest healing is not three sets of 10 reps, but the ultra slow method of 1 set of 5-8 reps, 10 seconds up/10 seconds down. One set you're done, move on to the next exercise. Whole workout takes less than five minutes 2x/d. Because this forces you to use a lighter weight, this prevents slowing the healing because your macho balls are too embarrassed to be lifting pussy weights initially, so you keep setting yourself back with heavier. Then increase the weight gradually as tolerated until you get up to something like 15–25 pound dumbbell for curls and 10-15 pound dumbbell for reverse curls, and a heavy metal pipe/bigger heavier tool for supinations hopefully by three months of rehab. I can't stress enough the value of an ice pack on the elbow for 20 minutes right after the weight workout & before bedtime -speeds up strength recovery with the resistance exercise.

The other thing that is very helpful for this elbow injury initially is an elastic sleeve with a wad of toilet paper placed over the sore spot on the elbow under the sleeve to reduce any swelling and calm the irritable nerves. The sleeve cannot be too tight or you won't be able to wear it all day long. This really helps with pain initially. Do without it as soon as you can or it will slow the regaining of strength with weightlifting.

So why does this work? After an injury in any area of the body the nerves in the injury get stuck in a vicious cycle of pain/swelling/more pain/more swelling/etc. If you simply start the resistance exercises at 48 hours after two days of gentle stretching, the master nerve, the brain, sends a message down to the injured nerves "Hey idiots, get busy and do your job. He's trying to strengthen this injury so stop your whining and get to work." This kicks it out of the vicious cycle and the local nerves actually begin stimulating healing.

The nervous system is the electrical system for the human body. It directs all chemical/physical processes in the body. You have to find the key that convinces the brain to kick the local injured nerves in the butt to get working. This is an instinct, an instinctual drive that we are all born with, to pack on muscle in response to weightlifting technique. The passive therapies cannot trigger this instinct in the brain. Professional athletes will frequently tell you they value their Physio the most. This principle can be adapted to musculoskeletal injury anywhere in the body. You can always find a good stretching and strengthening exercise online for the injured area by googling "PT exercise for……". But look for a reputable PT website rather than forums or blogs.
I had this injury twice and I've never had it last longer than three months. Having said this however, a really large tear in the tendon sadly may require surgical debridement if adequate PT fails.

Pain must be your guide. This means you have to stop activities that really irritate it. However it doesn't mean you have to be off the bike for a year and a half. There are supportive wraps for lateral epicondylitis that would allow you to go mountain biking gently fairly soon in the treatment regimen & not set it back, along with continuing strengthening and an ice pack right after riding.

So hey, crank up your patience, really believe this will work, and stick with it. Hope this helps. It sure doesn't cost much.

 

[RipGroove]

Just saw this thread now for the first time. So I'm a sports medicine physician in the USA. Not trying to be offensive but you don't need one off opinions, you need science. Here's the science on this. This is a challenging injury due to poor circulation and overstressed design of the elbow extensor/supinator tendons. Average time to healing: 1.5 yrs for all patients with this injury. Yup, one and a half years. However you can speed this up. "All patients" includes many who aren't consistent with the proper treatment which extends the injury time in many of the medical studies. You were in this group with your earlier injuries/recurrence of injury. What is the hallmark of inadequate rehab? Multiple, repeated injuries.

First thing is to understand a basic physiologic principle that many athletes are unaware of: what actually STIMULATES healing of musculoskeletal injuries in the human body?

None of the PASSIVE therapies actually stimulate healing. These include

total rest – just get atrophy,
anti-inflammatories- just mask the pain, you end up doing too much and irritating it, not indicated for long-term use/actually interfere with healing after the first few weeks (many true statements in the threads above by various people such as this one),
heat/ice (I never recommend heat anymore since ice is more advantageous for increasing circulation and reducing swelling, but still it does not actually stimulate the healing process),
braces/splints foam rollers,
the heavy hitters: chiropractic, acupuncture, acupressure, deep tissue massage.

There's always going to be someone who says that one of these treatments worked magically for their injury but the science does not back this up. They are talking about a one-off result, while science involves thousands of patients and is more accurate therefore.

Here's what the science actually proves: Only ACTIVE therapy (weight lifting, or any similar resistance exercise keeping the muscle perfectly aligned while resisting the motion) stimulates the NERVES to heal the injury. Period. Anybody who says differently is selling something or sincere in their belief but actually not backed up by the science. Professionally, physical therapy is the only treatment that scientific reviews of the entire medical literature have shown that actually works to stimulate full rehabilitation of musculoskeletal injuries. Yes, some additional treatments like steroid injections etc can speed the process initially but they will not get you fully healed because they will not induce full strength/flexibility recovery. Steroids only suppress excessive information with initial injury.

You must recover flexibility and control swelling with compression wraps/ice in the 48 hours post injury before lifting weights. With elbow straight gently stretch arm down while rotating entire arm inwards and hold. Repeat this or any other lateral epicondylitis stretch many times throughout the day. Strength recovery will happen quicker if you maintain flexibility.

48 hours post injury, this is when you begin the strengthening phase while continuing the stretching indefinitely. Yes, that is the magical window for an injury like this before atrophy sets in. Strengthening exercises are easy to do at home. It's not complicated like sciatica or multiple trauma recovery where are you really need the expertise of a physical therapist. All you need is are 3 isolation exercises. Always work the opposite flexor forearm muscles also because these will get the inflamed extensors strength back to normal quicker.

So, 1-wrist curls, 2-reverse wrist curls, 3-forearm supination. Start with a larger water bottle for wrist curls, a smaller water bottle for wrist extensions, and a crescent wrench, hammer, water bottle, or small dumbbell for #3. Find the balance point of tool you're using for #3, then choke down a little bit in your grasp, with the heavier part extending medially, with forearm resting on mid-thigh & pointing straight forward/slight bend in the elbow, tool held in the hand perpendicular to the long axis of the arm. Rotate the heavier medial end of the tool down then back up again. You will feel this at the injury area as it pulls on the injured elbow tendons as it drops down. Let pain be your guide do not push it through pain. Increased range will come later as the pain subsides. As you get stronger, choke further and further out on this tool so there is more weight medially. If this doesn't make sense to you just Google lateral epicondylitis PT exercises and you will see it. Move from water bottles to light dumbbells for exercises one and two, and progress gradually.

The best method for quickest healing is not three sets of 10 reps, but the ultra slow method of 1 set of 5-8 reps, 10 seconds up/10 seconds down. One set you're done, move on to the next exercise. Whole workout takes less than five minutes 2x/d. Because this forces you to use a lighter weight, this prevents slowing the healing because your macho balls are too embarrassed to be lifting pussy weights initially, so you keep setting yourself back with heavier. Then increase the weight gradually as tolerated until you get up to something like 15–25 pound dumbbell for curls and 10-15 pound dumbbell for reverse curls, and a heavy metal pipe/bigger heavier tool for supinations hopefully by three months of rehab. I can't stress enough the value of an ice pack on the elbow for 20 minutes right after the weight workout & before bedtime -speeds up strength recovery with the resistance exercise.

The other thing that is very helpful for this elbow injury initially is an elastic sleeve with a wad of toilet paper placed over the sore spot on the elbow under the sleeve to reduce any swelling and calm the irritable nerves. The sleeve cannot be too tight or you won't be able to wear it all day long. This really helps with pain initially. Do without it as soon as you can or it will slow the regaining of strength with weightlifting.

So why does this work? After an injury in any area of the body the nerves in the injury get stuck in a vicious cycle of pain/swelling/more pain/more swelling/etc. If you simply start the resistance exercises at 48 hours after two days of gentle stretching, the master nerve, the brain, sends a message down to the injured nerves "Hey idiots, get busy and do your job. He's trying to strengthen this injury so stop your whining and get to work." This kicks it out of the vicious cycle and the local nerves actually begin stimulating healing.

The nervous system is the electrical system for the human body. It directs all chemical/physical processes in the body. You have to find the key that convinces the brain to kick the local injured nerves in the butt to get working. This is an instinct, an instinctual drive that we are all born with, to pack on muscle in response to weightlifting technique. The passive therapies cannot trigger this instinct in the brain. Professional athletes will frequently tell you they value their Physio the most. This principle can be adapted to musculoskeletal injury anywhere in the body. You can always find a good stretching and strengthening exercise online for the injured area by googling "PT exercise for……". But look for a reputable PT website rather than forums or blogs.
I had this injury twice and I've never had it last longer than three months. Having said this however, a really large tear in the tendon sadly may require surgical debridement if adequate PT fails.

Pain must be your guide. This means you have to stop activities that really irritate it. However it doesn't mean you have to be off the bike for a year and a half. There are supportive wraps for lateral epicondylitis that would allow you to go mountain biking gently fairly soon in the treatment regimen & not set it back, along with continuing strengthening and an ice pack right after riding.

So hey, crank up your patience, really believe this will work, and stick with it. Hope this helps. It sure doesn't cost much.

Thank you very much for taking the time to write that, it's very helpful. I did ice it a few times a day for a couple of weeks right after I injured it starting within a couple of hours of it happening. I've pretty much stayed away from painkillers as well because like you said I've found pain is the best guide.

The first few weeks after the injury it seemed like it was getting better almost daily with the exercises and icing and I was just getting on to the strongest blue Flexbar but then I must have done something to it (probably at work lifting something heavy with that arm or something) because suddenly got worse again and now I'm back on the weakest yellow Flexbar. Just holding my arm out straight hurts the tendon at the minute without even trying to lift or grip anything with my hand so I assume this is down to the tendon needing a lot of stretching?

I guess I need to up my stretching routine to be more frequent because I definitely haven't been doing enough of that and keep at the Theraband Flexbar exercises 3x daily and icing (after riding aside is there a good time to ice it, like before or after exercise or just whenever?) And probably find an acupuncturist as well.

As a side note I haven't been able to find any braces that aren't made of neoprene and for some unknown reason I'm allergic to it, I get contact dermatitis from it, not allergic to anything else in the world apart from the one material that almost all MTB protection is made from Ironically if I wasn't allergic to it I would have probably have been wearing elbow pads when I came off the trials bike and whacked my tendon right near the elbow so possibly wouldn't have even injured it in the first place.

 

[Luca 50]

My chronic epicondylitis lasted more than five years……. I tried every possibile treatment either having the meanstream or the weird ones…….but at the end was some well practiced massages by an experienced physioterapist who solved the issue by elongating the forearm muscles whose contraptions wher the cause of the epicondyl inflammation.
My further suggestion is to avoid any treatment that foresee the use of cortison and surgery!

 

[Simmo3801]

I currently have it in one arm (the 'elbow' in the name is misleading really because it's actually damage to the tendon in the forearm near the elbow and its proper name is lateral epicondylitis), this time I've caused it by trauma by falling off my trials bike and just happening to whack that part of the tendon on a log. I've had it before once in each arm and both times it took almost exactly 12 months of no riding and trying not to use the arm at work or at home at all to heal on its own

12 months is a long time to not use your arm and not ride any bikes so wondering if anyone here has had it and has any recovery tips I'd like to hear them. I have every colour Theraband Flexbar and do the exercises 3 times a day as recommended and in the past couple of months managed to go from the weakest one to almost the strongest one with no pain but I must have done something recently to hurt it again so I've set myself back to the weakest one again

I did go to physio but after having the initial assessment and actually getting the first appointment it had pretty much healed itself so no sessions were needed.

I've already been all over YouTube and other than the Theraband Flexbar exercises and some stretches there doesn't really seem to be any other info on recovery.

I have a dog walking business and got it from dogs pulling on leads particularly by pulling across my body as opposed to out in front. Went to a private physio and within 5 mins she had the needles in my arm. After that she taped my arm so that the muscle was basically rolled across from outside towards inside of my arm. Two more appointments and I was cured.

 

[StillKicking]

After a stupid fall while clipped in on pavement this summer I have been using the suck it up method, which seemed to be working until I started doing push-ups again. Definitely not helpful. 25 year old Speedplay frog pedals also not helpful as a preventative measure.

 

[Utah Rider]

I'm a diesel mechanic in my 50s. I've had tennis elbow for many years. Riding dirt bike and ebike plus my job makes sure the tennis elbow always returns. The best advice that I can give is do not wear those compression bands while riding. It will make a bad situation worse. You don't want pressure on those tendons while riding. Anyway, I tried physical therapy, tens treatment, cold treatment, exercises, the hard scraping. None of that worked. I get a steroid injection once a year for the past five years. No pain.

 

[veryoldfart]

Nearly thirty years a heating engineer I got tennis elbow too, I went to the doctor and she injected it with steroids, I’ve never had any pain in it since, that was ten’ish years ago, might be worth a try

Another endorsement for this approach. Over last forty + years of riding had both “ golf “ &” tennis “ elbows. Non intervention recovery was slow & frustrating, so saw a Doc in Belgium( was working there at time) and he injected the tendon with steroids. After 2/3 repeats and a month of abstinence, all fine.

But not all docs will do this - need to find someone sympathetic to fixing sports injuries.

 

[Hartley Hare]

I currently have it in one arm (the 'elbow' in the name is misleading really because it's actually damage to the tendon in the forearm near the elbow and its proper name is lateral epicondylitis), this time I've caused it by trauma by falling off my trials bike and just happening to whack that part of the tendon on a log. I've had it before once in each arm and both times it took almost exactly 12 months of no riding and trying not to use the arm at work or at home at all to heal on its own

12 months is a long time to not use your arm and not ride any bikes so wondering if anyone here has had it and has any recovery tips I'd like to hear them. I have every colour Theraband Flexbar and do the exercises 3 times a day as recommended and in the past couple of months managed to go from the weakest one to almost the strongest one with no pain but I must have done something recently to hurt it again so I've set myself back to the weakest one again

I did go to physio but after having the initial assessment and actually getting the first appointment it had pretty much healed itself so no sessions were needed.

I've already been all over YouTube and other than the Theraband Flexbar exercises and some stretches there doesn't really seem to be any other info on recovery.

Yes, I have used a technique for about 25 years now, which cures tennis elblow whenever I get it from typing. Not sure it would work with injury but you can try. It is a bit of an embarrassing one, so probably best done in the privacy of your bedroom, and certainly on a carpet because it would otherwise be painful. Only needs five minutes a day, or possibly twice a day. Get on your hands and knees and walk backwards around the room. This flexes the muscles which have been tensed in the opposite direction. It hurts the injured arm at first, but every time I have used it for about a week my tennis elbow has resolved, and only comes back many months if not years later.

 

[RipGroove]

Yes, I have used a technique for about 25 years now, which cures tennis elblow whenever I get it from typing. Not sure it would work with injury but you can try. It is a bit of an embarrassing one, so probably best done in the privacy of your bedroom, and certainly on a carpet because it would otherwise be painful. Only needs five minutes a day, or possibly twice a day. Get on your hands and knees and walk backwards around the room. This flexes the muscles which have been tensed in the opposite direction. It hurts the injured arm at first, but every time I have used it for about a week my tennis elbow has resolved, and only comes back many months if not years later.

Haha brilliant, I'll try that!

 

[Like a Boss]

I tried everything in multiple countries (USA, Germany, France). Electric current, massage, stretches, local injections via fine needles (not cortisone in the tendon), etc. Eventually I broke my scaphoid and I was casted for almost three months in the arm with lateral epicondlytis. So the pain subsided. But it still wants to rear its head even years later. I found that the Armaid (google climbing recovery tools), or a hard rubber ball to massage that area was helpful. Also, looking at this problem as a whole arm shoulder situation might help. I started doing neutral pull ups with bands as necessary (grip perpendicular to the body, like with dips) and also doing shoulder presses with dumbbells, shoulder lifts (the type you would do for shoulder/shoulder rotator cuff recovery-strengthening) along with easy wrist curls both normal and reverse grips, as well as sideways. In other words going right at the painful tendon doesn't really work. But using a jedi mind trick and going after the whole chain of connections from finger tips to past the shoulders and cervical area might lesson the severity in the elbow tendon. This is all a true story.

 

[Jeff McD]

Hey RipGroove, the answer to why it is back again was in your reply to my post. Either you advanced up to the blue flex bar too rapidly and blew it up again, or that heavy lifting at work caused re-injury. The thing you have to understand about this is particular injury is that that tendon complex is so under-engineered by Mother Nature that once it gets broken down, because of an inadequate circulation bringing in all the elements for rapid healing, the inflammation takes a long time before it subsides. The healing cannot be pushed faster than the circulation will allow. During this time if you advance the weghtlifting too rapidly or lift too heavy, you will blow it up again. In other words you might've needed three months to get to the blue flex bar for proper healing, or you should've asked somebody else to lift that at work.

Also another poster mention contractions that were broken up by deep tissue massage. I wanted to comment on this issue. These can form after long periods of chronic inflammation without any improvement and are basically tiny scar tissue bands that grow in around the muscle bundles, and stiffen and shorten the muscle. However, since you were improving fairly rapidly then you don't have these contractions. So you will get over this but you simply have to advance the resistance more slowly and absolutely must ask for help with heavy lifting or just let someone else do it. Main problem with this is we are frequently too embarrassed to ask but you will keep reinjuring it if you don't.

I also prefer using simple water bottles initially and then advancing to dumbbells rather than any kind of flex bar or other machine strengthening. The reason is because as you're doing the reverse wrist curl your wrist and forearm must be able to move in perfectly neutral alignment for each one those inflamed tendon-muscle bundles. Frequently machine type strengthening tweaks that alignment at some point. This is perpetuates the pain or actually blows it up once the resistance gets high enough. Physical therapists will always stick to dumbbells. If you watch, that dumbbell is going to rotate slightly as you come up into full extension on the reverse wrist curl. It is critical that it be allowed to do that.

So don't be disheartened. Just go back to a very light dumbbell and advance more slowly. Also remember to only increase by 10% each time you increase weight. If you are steadily improving you are doing the right thing. At work, just put your healing first.

Finally, we all have to realize that the main cause of this injury for e-mountain bikers is the weight when lifting the front wheel or even trying to lighten it so you don't slide off a slippery root. Don't always have the time to compress the fork first and use the rebound to get the wheel up so we just yank it. The arm is in a vulnerable position for this complex when doing that. So this injury is always waiting in the shadows for us to just fall on it and it blows up. That is why it is a regular part of my strengthening routine twice a week forever. If I begin to feel some twinges they go away quickly because the strength is at its max and continuing the strength training resolves it rapidly. You never get the severe tear because you've kept peak strength in the tissues. This is the way strength training consistently actually prevents injuries. Something you might consider.

 

[Ranu]

I Had tennis elbow and purchased some OneUp carbon fibre handlebars that are supposed to have more flex than the alloy ones my bike originally had. Haven’t had a problem since. Could be the placebo effect, but it works for me

 

[Jeff McD]

Yeah that sounds quite reasonable. The incredible amount of vibrations to come up through our handlebars is probably responsible as well as trying to lift the front wheel. Also a constant death grip on the handlebars. Good point though.

 

[Like a Boss]

I have given much thought to bike setup and reducing stress on the elbow tendons. Front tire type, size, and pressure is a start point for tuning. Then fork pressure and compression, and service to keep it running as smooth as possible. The best fork damper you can afford (Fox Grip2 seems to have the best small bump compliance-opinions vary. Rockshox Charger 2.1RC, now Charger 3). Handlebar material, diameter, width and associated cockpit setup. Maybe carbon has better damping- I bought a Oneup carbon bar and there seems to be something to it. But it is 35mm diameter at the stem which makes it stiffer. We are seeing more 31.8 bars again, and more sweeps are available. I'm not convinced the typical 7-9 degree rearward sweep is where it's at. I ordered an alloy SQ Lab 12 degree back sweep 31.8 diameter bar and I'm looking forward to trying it. They sell 16 degree backsweep as well, and more makers are offering these sweeps. The lower angle sweeps can feel like riding with a broom stick handle bar. The larger sweeps seem more comfortable. and neutral on the arms and elbows. Finally, the brake lever position, service, and rotor size are important. I went as far as putting a 220 rear rotor on my bikes to have the lightest pull on the lever for a given brake power, and careful lever adjustment to lessen the pressure on my elbow tendon. Regular fluid flushing seems to keep the brakes working the best. So far my tennis elbow has been in check and I think these bike setup considerations have helped.

 

[RipGroove]

Hey RipGroove, the answer to why it is back again was in your reply to my post. Either you advanced up to the blue flex bar too rapidly and blew it up again, or that heavy lifting at work caused re-injury. The thing you have to understand about this is particular injury is that that tendon complex is so under-engineered by Mother Nature that once it gets broken down, because of an inadequate circulation bringing in all the elements for rapid healing, the inflammation takes a long time before it subsides. The healing cannot be pushed faster than the circulation will allow. During this time if you advance the weghtlifting too rapidly or lift too heavy, you will blow it up again. In other words you might've needed three months to get to the blue flex bar for proper healing, or you should've asked somebody else to lift that at work.

Also another poster mention contractions that were broken up by deep tissue massage. I wanted to comment on this issue. These can form after long periods of chronic inflammation without any improvement and are basically tiny scar tissue bands that grow in around the muscle bundles, and stiffen and shorten the muscle. However, since you were improving fairly rapidly then you don't have these contractions. So you will get over this but you simply have to advance the resistance more slowly and absolutely must ask for help with heavy lifting or just let someone else do it. Main problem with this is we are frequently too embarrassed to ask but you will keep reinjuring it if you don't.

I also prefer using simple water bottles initially and then advancing to dumbbells rather than any kind of flex bar or other machine strengthening. The reason is because as you're doing the reverse wrist curl your wrist and forearm must be able to move in perfectly neutral alignment for each one those inflamed tendon-muscle bundles. Frequently machine type strengthening tweaks that alignment at some point. This is perpetuates the pain or actually blows it up once the resistance gets high enough. Physical therapists will always stick to dumbbells. If you watch, that dumbbell is going to rotate slightly as you come up into full extension on the reverse wrist curl. It is critical that it be allowed to do that.

So don't be disheartened. Just go back to a very light dumbbell and advance more slowly. Also remember to only increase by 10% each time you increase weight. If you are steadily improving you are doing the right thing. At work, just put your healing first.

Finally, we all have to realize that the main cause of this injury for e-mountain bikers is the weight when lifting the front wheel or even trying to lighten it so you don't slide off a slippery root. Don't always have the time to compress the fork first and use the rebound to get the wheel up so we just yank it. The arm is in a vulnerable position for this complex when doing that. So this injury is always waiting in the shadows for us to just fall on it and it blows up. That is why it is a regular part of my strengthening routine twice a week forever. If I begin to feel some twinges they go away quickly because the strength is at its max and continuing the strength training resolves it rapidly. You never get the severe tear because you've kept peak strength in the tissues. This is the way strength training consistently actually prevents injuries. Something you might consider.

Again, thank you

 

[Kingerz]

I got into MTBing because I had this from rock climbing. It took 2 years to get better, but it has.
Change and stop the activity that caused it, which might not be what you think. Computer use could be the problem.
Eat well, take ginger and eat oily fish, take glucosamine.
Do exercises like the spiderman one etc, whatever you find works.
And sleep with straight arms.
Otherwise, it's time heals.
Good luck friend!

 

[Hardtail]

Just saw this thread now for the first time. So I'm a sports medicine physician in the USA. Not trying to be offensive but you don't need one off opinions, you need science. Here's the science on this. This is a challenging injury due to poor circulation and overstressed design of the elbow extensor/supinator tendons. Average time to healing: 1.5 yrs for all patients with this injury. Yup, one and a half years. However you can speed this up. "All patients" includes many who aren't consistent with the proper treatment which extends the injury time in many of the medical studies. You were in this group with your earlier injuries/recurrence of injury. What is the hallmark of inadequate rehab? Multiple, repeated injuries.

First thing is to understand a basic physiologic principle that many athletes are unaware of: what actually STIMULATES healing of musculoskeletal injuries in the human body?

None of the PASSIVE therapies actually stimulate healing. These include

total rest – just get atrophy,
anti-inflammatories- just mask the pain, you end up doing too much and irritating it, not indicated for long-term use/actually interfere with healing after the first few weeks (many true statements in the threads above by various people such as this one),
heat/ice (I never recommend heat anymore since ice is more advantageous for increasing circulation and reducing swelling, but still it does not actually stimulate the healing process),
braces/splints foam rollers,
the heavy hitters: chiropractic, acupuncture, acupressure, deep tissue massage.

There's always going to be someone who says that one of these treatments worked magically for their injury but the science does not back this up. They are talking about a one-off result, while science involves thousands of patients and is more accurate therefore.

Here's what the science actually proves: Only ACTIVE therapy (weight lifting, or any similar resistance exercise keeping the muscle perfectly aligned while resisting the motion) stimulates the NERVES to heal the injury. Period. Anybody who says differently is selling something or sincere in their belief but actually not backed up by the science. Professionally, physical therapy is the only treatment that scientific reviews of the entire medical literature have shown that actually works to stimulate full rehabilitation of musculoskeletal injuries. Yes, some additional treatments like steroid injections etc can speed the process initially but they will not get you fully healed because they will not induce full strength/flexibility recovery. Steroids only suppress excessive information with initial injury.

You must recover flexibility and control swelling with compression wraps/ice in the 48 hours post injury before lifting weights. With elbow straight gently stretch arm down while rotating entire arm inwards and hold. Repeat this or any other lateral epicondylitis stretch many times throughout the day. Strength recovery will happen quicker if you maintain flexibility.

48 hours post injury, this is when you begin the strengthening phase while continuing the stretching indefinitely. Yes, that is the magical window for an injury like this before atrophy sets in. Strengthening exercises are easy to do at home. It's not complicated like sciatica or multiple trauma recovery where are you really need the expertise of a physical therapist. All you need is are 3 isolation exercises. Always work the opposite flexor forearm muscles also because these will get the inflamed extensors strength back to normal quicker.

So, 1-wrist curls, 2-reverse wrist curls, 3-forearm supination. Start with a larger water bottle for wrist curls, a smaller water bottle for wrist extensions, and a crescent wrench, hammer, water bottle, or small dumbbell for #3. Find the balance point of tool you're using for #3, then choke down a little bit in your grasp, with the heavier part extending medially, with forearm resting on mid-thigh & pointing straight forward/slight bend in the elbow, tool held in the hand perpendicular to the long axis of the arm. Rotate the heavier medial end of the tool down then back up again. You will feel this at the injury area as it pulls on the injured elbow tendons as it drops down. Let pain be your guide do not push it through pain. Increased range will come later as the pain subsides. As you get stronger, choke further and further out on this tool so there is more weight medially. If this doesn't make sense to you just Google lateral epicondylitis PT exercises and you will see it. Move from water bottles to light dumbbells for exercises one and two, and progress gradually.

The best method for quickest healing is not three sets of 10 reps, but the ultra slow method of 1 set of 5-8 reps, 10 seconds up/10 seconds down. One set you're done, move on to the next exercise. Whole workout takes less than five minutes 2x/d. Because this forces you to use a lighter weight, this prevents slowing the healing because your macho balls are too embarrassed to be lifting pussy weights initially, so you keep setting yourself back with heavier. Then increase the weight gradually as tolerated until you get up to something like 15–25 pound dumbbell for curls and 10-15 pound dumbbell for reverse curls, and a heavy metal pipe/bigger heavier tool for supinations hopefully by three months of rehab. I can't stress enough the value of an ice pack on the elbow for 20 minutes right after the weight workout & before bedtime -speeds up strength recovery with the resistance exercise.

The other thing that is very helpful for this elbow injury initially is an elastic sleeve with a wad of toilet paper placed over the sore spot on the elbow under the sleeve to reduce any swelling and calm the irritable nerves. The sleeve cannot be too tight or you won't be able to wear it all day long. This really helps with pain initially. Do without it as soon as you can or it will slow the regaining of strength with weightlifting.

So why does this work? After an injury in any area of the body the nerves in the injury get stuck in a vicious cycle of pain/swelling/more pain/more swelling/etc. If you simply start the resistance exercises at 48 hours after two days of gentle stretching, the master nerve, the brain, sends a message down to the injured nerves "Hey idiots, get busy and do your job. He's trying to strengthen this injury so stop your whining and get to work." This kicks it out of the vicious cycle and the local nerves actually begin stimulating healing.

The nervous system is the electrical system for the human body. It directs all chemical/physical processes in the body. You have to find the key that convinces the brain to kick the local injured nerves in the butt to get working. This is an instinct, an instinctual drive that we are all born with, to pack on muscle in response to weightlifting technique. The passive therapies cannot trigger this instinct in the brain. Professional athletes will frequently tell you they value their Physio the most. This principle can be adapted to musculoskeletal injury anywhere in the body. You can always find a good stretching and strengthening exercise online for the injured area by googling "PT exercise for……". But look for a reputable PT website rather than forums or blogs.
I had this injury twice and I've never had it last longer than three months. Having said this however, a really large tear in the tendon sadly may require surgical debridement if adequate PT fails.

Pain must be your guide. This means you have to stop activities that really irritate it. However it doesn't mean you have to be off the bike for a year and a half. There are supportive wraps for lateral epicondylitis that would allow you to go mountain biking gently fairly soon in the treatment regimen & not set it back, along with continuing strengthening and an ice pack right after riding.

So hey, crank up your patience, really believe this will work, and stick with it. Hope this helps. It sure doesn't cost much.

Just saw this thread now for the first time. So I'm a sports medicine physician in the USA. Not trying to be offensive but you don't need one off opinions, you need science. Here's the science on this. This is a challenging injury due to poor circulation and overstressed design of the elbow extensor/supinator tendons. Average time to healing: 1.5 yrs for all patients with this injury. Yup, one and a half years. However you can speed this up. "All patients" includes many who aren't consistent with the proper treatment which extends the injury time in many of the medical studies. You were in this group with your earlier injuries/recurrence of injury. What is the hallmark of inadequate rehab? Multiple, repeated injuries.

First thing is to understand a basic physiologic principle that many athletes are unaware of: what actually STIMULATES healing of musculoskeletal injuries in the human body?

None of the PASSIVE therapies actually stimulate healing. These include

total rest – just get atrophy,
anti-inflammatories- just mask the pain, you end up doing too much and irritating it, not indicated for long-term use/actually interfere with healing after the first few weeks (many true statements in the threads above by various people such as this one),
heat/ice (I never recommend heat anymore since ice is more advantageous for increasing circulation and reducing swelling, but still it does not actually stimulate the healing process),
braces/splints foam rollers,
the heavy hitters: chiropractic, acupuncture, acupressure, deep tissue massage.

There's always going to be someone who says that one of these treatments worked magically for their injury but the science does not back this up. They are talking about a one-off result, while science involves thousands of patients and is more accurate therefore.

Here's what the science actually proves: Only ACTIVE therapy (weight lifting, or any similar resistance exercise keeping the muscle perfectly aligned while resisting the motion) stimulates the NERVES to heal the injury. Period. Anybody who says differently is selling something or sincere in their belief but actually not backed up by the science. Professionally, physical therapy is the only treatment that scientific reviews of the entire medical literature have shown that actually works to stimulate full rehabilitation of musculoskeletal injuries. Yes, some additional treatments like steroid injections etc can speed the process initially but they will not get you fully healed because they will not induce full strength/flexibility recovery. Steroids only suppress excessive information with initial injury.

You must recover flexibility and control swelling with compression wraps/ice in the 48 hours post injury before lifting weights. With elbow straight gently stretch arm down while rotating entire arm inwards and hold. Repeat this or any other lateral epicondylitis stretch many times throughout the day. Strength recovery will happen quicker if you maintain flexibility.

48 hours post injury, this is when you begin the strengthening phase while continuing the stretching indefinitely. Yes, that is the magical window for an injury like this before atrophy sets in. Strengthening exercises are easy to do at home. It's not complicated like sciatica or multiple trauma recovery where are you really need the expertise of a physical therapist. All you need is are 3 isolation exercises. Always work the opposite flexor forearm muscles also because these will get the inflamed extensors strength back to normal quicker.

So, 1-wrist curls, 2-reverse wrist curls, 3-forearm supination. Start with a larger water bottle for wrist curls, a smaller water bottle for wrist extensions, and a crescent wrench, hammer, water bottle, or small dumbbell for #3. Find the balance point of tool you're using for #3, then choke down a little bit in your grasp, with the heavier part extending medially, with forearm resting on mid-thigh & pointing straight forward/slight bend in the elbow, tool held in the hand perpendicular to the long axis of the arm. Rotate the heavier medial end of the tool down then back up again. You will feel this at the injury area as it pulls on the injured elbow tendons as it drops down. Let pain be your guide do not push it through pain. Increased range will come later as the pain subsides. As you get stronger, choke further and further out on this tool so there is more weight medially. If this doesn't make sense to you just Google lateral epicondylitis PT exercises and you will see it. Move from water bottles to light dumbbells for exercises one and two, and progress gradually.

The best method for quickest healing is not three sets of 10 reps, but the ultra slow method of 1 set of 5-8 reps, 10 seconds up/10 seconds down. One set you're done, move on to the next exercise. Whole workout takes less than five minutes 2x/d. Because this forces you to use a lighter weight, this prevents slowing the healing because your macho balls are too embarrassed to be lifting pussy weights initially, so you keep setting yourself back with heavier. Then increase the weight gradually as tolerated until you get up to something like 15–25 pound dumbbell for curls and 10-15 pound dumbbell for reverse curls, and a heavy metal pipe/bigger heavier tool for supinations hopefully by three months of rehab. I can't stress enough the value of an ice pack on the elbow for 20 minutes right after the weight workout & before bedtime -speeds up strength recovery with the resistance exercise.

The other thing that is very helpful for this elbow injury initially is an elastic sleeve with a wad of toilet paper placed over the sore spot on the elbow under the sleeve to reduce any swelling and calm the irritable nerves. The sleeve cannot be too tight or you won't be able to wear it all day long. This really helps with pain initially. Do without it as soon as you can or it will slow the regaining of strength with weightlifting.

So why does this work? After an injury in any area of the body the nerves in the injury get stuck in a vicious cycle of pain/swelling/more pain/more swelling/etc. If you simply start the resistance exercises at 48 hours after two days of gentle stretching, the master nerve, the brain, sends a message down to the injured nerves "Hey idiots, get busy and do your job. He's trying to strengthen this injury so stop your whining and get to work." This kicks it out of the vicious cycle and the local nerves actually begin stimulating healing.

The nervous system is the electrical system for the human body. It directs all chemical/physical processes in the body. You have to find the key that convinces the brain to kick the local injured nerves in the butt to get working. This is an instinct, an instinctual drive that we are all born with, to pack on muscle in response to weightlifting technique. The passive therapies cannot trigger this instinct in the brain. Professional athletes will frequently tell you they value their Physio the most. This principle can be adapted to musculoskeletal injury anywhere in the body. You can always find a good stretching and strengthening exercise online for the injured area by googling "PT exercise for……". But look for a reputable PT website rather than forums or blogs.
I had this injury twice and I've never had it last longer than three months. Having said this however, a really large tear in the tendon sadly may require surgical debridement if adequate PT fails.

Pain must be your guide. This means you have to stop activities that really irritate it. However it doesn't mean you have to be off the bike for a year and a half. There are supportive wraps for lateral epicondylitis that would allow you to go mountain biking gently fairly soon in the treatment regimen & not set it back, along with continuing strengthening and an ice pack right after riding.

So hey, crank up your patience, really believe this will work, and stick with it. Hope this helps. It sure doesn't cost much.

Nice post @Jeff McD
I’m only early 40’s but have a very physical job, Peptides BPC-157 and now TB-500 changed my life. Do your own research and reap the benefits, along with regular physio you will be impressed how quickly you heal. I favour TB-500 as ot is only injected 2x per week as opposed to BPC-157 which is usually 2x daily…

 

[irie]

Wife says topical NSAIDS and rest.

 

[RipGroove]

So I've come to the conclusion that any type of tennis elbow stretches or exercises are a no-go for me current because anything I do with it is super painful. So I'm currently giving it a couple of weeks of rest, and by rest I mean still working but trying to avoid using it as much as possible, just not specifically exercising or stretching my arm and icing it after work until it stops hurting enough for me to start stretching it and exercising it again. Bit annoyed as it's been about 4 months since I injured it and it's still unuseable