So this is my latest ailment which began a few days after returning from a family vacation last week (all of six days out of the water). Only my right elbow is affected, although I breathe bilaterally. And no, I don't play golf. Anyone else have any experience with this?
Former Member
Thanks for the replies. At this point the elbow is only bothering me when I swim. I have been using ice and Aleve and am going to try the Thera-band flexbar. I will probably back off on weights until it is better. And I may look into massage therapy.
Leslie's nitroglycerine patches are an attempt to do this. Other investigational modalities include shock waves and injections of irritants, like talc or saline, into the joint, poking around a bit with needle while the doctor's in there, all in an attempt to provoke a little more damage that causes the body to wake up and take notice.
Perhaps the poking is why acupuncture works too.
Agree with Gull that there could simultaneously be some inflammation with an acute onset and a response to ice or cortisone.
I wouldn't do anything either at this juncture, Gull. Give it a couple months first.
I had golfer's elbow last winter. It started out fairly vague but quickly picked up steam and became a painful problem. I tried exercises I found on-line but they gave me no relief. I tried wearing a tight neoprene band slightly below my elbow while swimming, it didn't work. I finally visited my favorite PT and got 3 very aggressive treatments of Grasston Therapy, it almost killed me but the elbow improved significantly and I was back and easing into the pool soon after.
Good luck Gull!
I'm willing to pay a few more dollars on my USMS dues to get him a chair at work.
And maybe a garage door? :)
That is actually a glass wall behind Jim. Our building has glass walls. His office is in the back corner, so his office has two glass walls.
And we all have stand-up desks, believe it or not! Mine is my dad's old drafting table.
3594
Here is a rehab movement that I use to try to avoid or address this condition. It is a technique that was developed many years ago by someone who used to swim on the Masters Swim team I coach. I think it is called "Active Release" or something like that. He is now independently wealthy (he has his own private jet and a Viper race car) from teaching and using this technique on lots of professional athletes. I will try to describe the motion - please let me know if this does not make sense and I will try to describe it better. This will be if your right elbow hurts.
I start with my right elbow bent at 90 degrees with my right hand pointing to the left, my right arm is in front of my belly button (palm facing either down or towards me). My left hand is grasping the top of my right forearm with my left thumb pressing about 2-3 inches from the medial epicondyle along the tendon. I straighten my right arm, rotating my right hand so that it is now palm up, thumb pointing to the right. While I an straightening my arm and rotating my hand I slowly press firmly with my left thumb along the tendon moving towards the medial epicondyle. I repeat this several times.
This has worked for me many times. I have also shown several swimmers how to do this and it works for them. The theory behind Active Release is that there are supposedly micro scars in the tendon that prevent things from sliding the way they are supposed to. The motion and pressing "breaks up" these micro scars. Whether this is true or not I have no idea. I got this condition from carrying our kids when they were very little on my arm (elbow touching my body), arm extended like a seat). I also got it once from doing too much breaststroke pulling with paddles. Both times this seemed to clear it up. I now do this motion to prevent any new injury. Let me know if it works. Good luck!
I have posted about mine a few times and a search about "elbow pain" should pull up some threads. It is sometimes called "Little League Elbow," but I think "backstroker's elbow" also might be a good name.
Interventions that have helped me include, in no particular order, switching hands with the computer mouse (my job involves a lot of writing, which I do at a keyboard); regular ice (I often would strap an ice pack to my arm while eating breakfast after workout); a cuff that applies pressure right at the tendon attachment (wear it at night); exercising with the Theraband Flexbar; stretching the forearm with the palm against the wall, fingers down, arm externally rotated from the shoulder; and deep tissue massage.
The last time I had a flare-up I muddled along for a while complaining and doing a lot of fist swimming. Then I went for a massage and the therapist worked on my forearm. I thought I would faint from the pain when she started working on the wrist flexor muscles and the tendon that attaches them to the medial epicondyle; they were like little rods in there, so tight and hard. Two or three massages later my forearm was way better, and I quickly ramped my training back up to 20,000+ mostly pain-free yards per week.
Not sure if this will help or not, but both lateral and medial epicondylitis are examples of tendonosis, not tendinitis--i.e., there is no evidence of inflammation in the elbow. Quite the opposite, actually. The current thinking seems to be that these and other poorly vascularized tendons (like the Achilles heel, the Rotator Cuffs, various knee tendons, etc.) would actually benefit from a bit of inflammation, which tends to increase blood supply and bring healing factors to the micro tears of the affected tissues.
Leslie's nitroglycerine patches are an attempt to do this. Other investigational modalities include shock waves and injections of irritants, like talc or saline, into the joint, poking around a bit with needle while the doctor's in there, all in an attempt to provoke a little more damage that causes the body to wake up and take notice.
Interestingly, too, there is a theory that the pain may be caused by abnormal blood vessels and nerves that form post-injury. Some doctors are reporting success by injecting sclerosing agents into the area, which choke down these aberrant vessels. The nerves, in turn, no longer get blood supply and die off, and the pain goes away.
Alleve and cortisone shots are both antiinflammatory drugs (albeit a very mild one and a much more potent one)--but since there is no inflammation there to "anti", the benefits of either approach are most likely analgesia (for the Alleve) and the poking around with the needle, causing "healing trauma" for the cortisone injections.
Eccentric muscle loading (i.e., the part of the biceps curl where you lower the weight back down) may help by triggering tenocyte production...
I suspect weight lifting is the cause of your problem--not all weight lifting, but certain moves you might not realize are hurting at the time of the lifts.
Thanks for the input, Jim. I am familiar with the tendinosis vs. tendinitis debate. In my case, the symptoms arose acutely, which to me (hey, I'm no doctor) implies an inflammatory process that should respond to anti-inflammatory medications and ice. I believe it is probably an overuse injury which occurred when I returned to the pool after a one week lay off and resumed daily training. I actually have not lifted weights in a couple of weeks (and before my vacation I was only lifting once a week anyway).
The eccentric rehab exercises are a great idea. I ordered my Thera-band flexbars today. Not sure that I want anyone to inject anything yet. I try to avoid doctors as much as I can.
Fort and I both have problems with this caused by mostly overdoing the dryland stuff. The only thing That works for me is rest and unfortunately it is a very slow recovery of up to 6 months. I am lucky that it doesn't affect my swimming too much. Fort has been more aggressive in her treatment approach and has used glycerine patches among other things.
Sorry Gull, injuries suck. Rich is right. I'm on my second bout of tennis elbow. Both injuries were caused by deadlifting at the gym. My double jointed elbows don't seem to like the locked out position involved. As Rich indicates, the recovery for elbow issues is very very slow (6-12 months) since not much blood gets to the injured tendon. I first injured my elbow last Nov. and laid off upper body weights until mid-July, then promptly re-injured it.
From what I have read, and you've probably read the same:
1. PT -- I gather not much help with elbows from the literature.
2. Ice, rest and compression -- will help somewhat, compression likely having a more long term healing effect than ice. Rest is the key.
3. Rehab exercises -- yes, especially working the eccentric part, which is connected to fibroblastic activity.
4. Cortisone shot -- definitely helped me with short time pain the first time around, but I don't want to have another after reading some negative things about cortisone and elbows.
5. Nitro patches -- I am trying the nitro patches for the second time. Still very experimental, but promising from what I've read. You've got to use them for a good 3-4 months though. I got headaches the first week that then subsided.
6. Acupuncture -- I'm trying this along with the nitro patches. Just 2 sessions in, nothing to report yet. But, again, I've read some promising things. At the very least, it should help with the pain.
7. PRP -- Not sure about golfer's elbow, but I've read promising things about PRP and tennis elbow. Probably don't want to rush to this, but down the road it may be a valid option. I'm considering it myself, as I'm not the patient sort and have had good luck with PRP and my shoulder.
8. More kicking and less breaststroke.
