Tennis Elbow; Part 4

 

 

 

 

 

 

 

 

 

For the moment let’s assume that you’ve got lateral epicondylitis/tennis elbow and not cancer on the outside of your elbow. I’m always a little nervous about giving medical advice to people I can’t see or touch. I would hate to tell you to put a tennis elbow brace on your arm if the pain you’re experiencing is actually due to a clogged coronary artery. So suffice it to say that if there is something growing or draining over there on your elbow, or if you experience shortness of breath at the same time you are feeling pain in your left arm…it’s probably not tennis elbow and you probably don’t need a brace! You need a doctor!

Hey! I am a doctor and I can help you with your tennis elbow! Go to the local Walgreens or sport store and buy a…tennis elbow brace! That’s easy. Put it on like they show you on the instruction sheet. I like the ones that are shaped like the one in the picture. The sleeve-like things don’t really accomplish the goal. So get one of those strap-like ones and use it as much as you can tolerate using it. It’s really hard to predict when you’re going to strain those muscles. You could go all day with no pain and then suddenly grab a doorknob which will bring you to your knees. So just wear it for a while every day. And certainly put it on when you’re going to be doing some repetitive activity you know will aggravate it. Like playing tennis. Duh. That’s why they call it a tennis elbow brace.

Tighten it up enough to make the veins on your hand stick out just a tad, but not so tight that your fingers get tingly or swollen.

Get a wrist brace. That might seem strange, since you’re not having pain in your wrist. But remember, the muscles which raise your wrist and fingers are attached to that little  bone, so if you rest your wrist, you rest those muscles. If you experience pain in your elbow in the morning when you wake up, it’s because you’ve slept with your elbow bent and your wrist flexed down all night (remember the fetal position). Those muscles and tendons have been under tension all night. So if you wear the wrist brace to bed, it will eliminate that strain on the elbow! Remember how I love to multi-task. It’s a huge bonus to treat something while I sleep!

Massage your elbow. Then do it some more. Then do it with Tiger Balm or Ben-Gay or anything that gets warm. Frankly I think it’s good to massage most anything that hurts…unless it’s draining, has stitches in it or causes shortness of breath.

You could try taking an over-the-counter (OTC) anti-inflammatory (NSAID) for a while. Of course you need to follow the directions on the label and make sure there’s no reason not to take them; like a stomach ulcer, or liver or kidney disease. And you shouldn’t take them if you’re already taking prescription anti-inflammatories like Celebrex, or Mobic or Relafen, to name a few.

So what have I done for you lately? Next time I’ll tell you what your doctor can do for this condition.

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9 Responses to Tennis Elbow; Part 4

  1. Chuck Hickey February 10, 2012 at 1:45 am #

    Dr. B, I have had this condition for about one year. I bought the brace and use it after an episode lifting dumbells. It does relieve the pain during lifting or golf….my question is how would I elimiate it all together if possible???
    Thanks,
    Chuck

    • Barbara February 10, 2012 at 4:09 am #

      You’re probably going to have to back off on the weight lifting and golf if those are the activities which cause the most pain. Docs who are practicing “sports medicine,” like to be able to keep you participating in your sport while trying to get you well, but at some point, when the sport is contributing to the disease, you’ve got to rest. But remember, sometimes it’s also other activities of daily living which contribute to tennis elbow.

      If you work out at a gym, try using the equipment which doesn’t require that you tightly grasp a bar. For example, instead of doing a bench press, try using the pec deck for a while and don’t grab the handle. Just leave your hands open. Wear weight lifting gloves or leather gloves. They’ll keep you from grasping the bars tightly.

      With golf, you can sometimes try adjusting your grip. You might need professional (coaching) help on that.

      You’ve had this for a year. It’s time to get serious, maybe give something up for a while…and it might be time to go see your favorite orthopod… 🙂

  2. Jennifer Withers July 20, 2012 at 3:20 am #

    “Denial-Not just a river in Egypt”

    I have had this condition in my elbows a lot longer than I was willing to admit. Finally, late last year when the annoying pain in my right elbow was getting on my nerves, I decided to get help. I left Dr. Bergin’s office with my brace and wealth of advice-now I could do everything I was doing before because I now had the “miracle brace” and my left arm. Dr. Bergin’s advice got lost in all my denial.

    Fast forward 7 months-I was back at Dr.Bergin’s office getting help for my left elbow, it was just a matter of time. Sleeping wrist braces help lesson the pain in the morning (I was in denial about that too) and resting them when ever I can. Certain actions I just don’t do anymore if it hurts.

    • Barbara July 20, 2012 at 5:46 pm #

      Denial of symptoms is a common phenomenon and it can result in a lot of unnecessary suffering. In general, we doctors appreciate our patients who have “high pain tolerance.” They don’t tend to wind up taking bunches of pain pills, and they just have a greater degree of peace with their pain. I would never encourage patients to see their doctor immediately for every little ache and pain, but in general, it’s hard to say exactly when you should seek medical attention. From an orthopedic standpoint; if a limb is facing the wrong way, or if white, boney objects are sticking out of your flesh, or if blood or pus is flowing, it’s probably wise to seek immediate attention. Otherwise, it might be okay to give some pains a few days, weeks or even months to get better!
      That being said, I can’t tell you how many times a day I wish someone had come to see me sooner. I wish they hadn’t continued to try to “work through the pain.” We’re busy. We’re active. We’re tough. And so we deny pain…in some cases too long.
      I have an advantage. The very day I get an ache or pain, I can usually figure out what it is and what to do about it. And when to start doing it. I often head off problems before they can get a stranglehold on my body. Good for me, right? What good does that do all the rest of you?
      That’s why I have my blog. I hope someday to cover a huge range of orthopedic conditions and injuries; giving you ways to self diagnose, have greater awareness, and even enable you to initiate some rudimentary treatments, much as I do for myself. I hope the blog will help you figure out when to see a doctor.
      Sorry your pain came back. Is it time for a shot??

  3. Tennis Elbow April 4, 2016 at 10:52 am #

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  4. Shane May 9, 2016 at 8:23 pm #

    Hi Barara,

    You Rock! Great blog.

    I have read your blogs on bursitis and tendonitis (tennis elbow lateral thing). Unfortunately I have both! 🙂

    I have bursitis in both my shoulders (from the gym) and tendonitis/tennis elbow/golfers elbow? in my left elbow from rock climbing.

    I love to be active, I go to the gym every morning and do sports every evening. I am 27 years old. I have had bursitis off and on for a year. I rest, use anti inflams, it goes away. But it always seems to come back.
    The tennis elbow pain is really not bad at all, I can put up with it, but I assume it will get worse.

    I just have a couple of questions:

    1. Is it ok to take anti inflams? I heard they actually weaken the tendons and may disguise the pain?

    2. Tennis/golfers elbow I have got from rock climbing about 4 times in one week, having never done it before. I know, that was silly. Is it because my tendons were not strong enough? So if i go back and do once a week, then twice a week etc will they just get stronger – Is that how it works?

    3.I am using tiger balm at the moment and it feels great, does the heat just hide the pain, or does it actually heal?

    Thanks for your help,

    Shane

    • Barbara May 10, 2016 at 4:43 am #

      Shane,
      Thanks for reading my blog! Let’s get right to work. Firstly, you’re situation is complicated and I have to say that I can’t simply address it as if I were your doc, since obviously, I can’t examine you or take X-rays of your shoulder. But in general it’s rare to see a person your age with either of those two conditions. Shoulder bursitis and tennis elbow (lateral epicondylitis) are more often seen in older people. I call them adult repetitive strain disorders, and even though you’re an adult by definition…you are young to suffer those two conditions. That being said, rock climbing is a very strenuous activity and can certainly put parts of your body at great risk both for traumatic harm as well as for repetitive strain. But in general, I wouldn’t assume you have shoulder bursitis. You may have some underlying ligamentous problem, so please have this checked out by a professional: your primary care doc or an orthopedic surgeon if you haven’t done this already. Ligamentous laxity can contribute to the development of certain shoulder problems at a relatively young age.
      I am not a fan of “working through” a painful condition, unless you’re making a lot of money doing it. And even then… So my recommendation to you is that you stop doing the things that are currently hurting you. Humans have this amazing ability to persevere with things even when it hurts. Animals don’t do that. They rest in order to allow things to heal. I have chickens. They love to get under the horse feeders to pick up pieces of dropped grain. One of my horses accidentally stepped on a chicken. It was obvious that it had broken its leg. The chicken promptly went into the roost and squatted down on the ground. It didn’t come out of the roost for a couple of weeks, preferring to stay squatting on the ground. I thought it would certainly die, but it still had a bright eye so I waited. And in a couple of weeks it popped up and began hobbling around with the other chickens. Humans don’t do that. We want to go, go, go. But sometimes our bodies are begging for rest. And pain is your bodies way of telling you to rest. Take a break from rock climbing, and frankly anything that hurts your shoulder. Then see your friendly orthopod and make sure there’s nothing else going on.
      True tennis elbow…if that’s what you have…can be a bugger bear to get rid of because we absolutely can’t stop using that arm. But try you must. Follow the directions on my blog and quit using it as much as you can. I had it in my right arm for TWO YEARS. I modified activities as much as I could and believe me, it beat me into submission. Finally it went away, but because I had been overusing my left arm…I got it on that side about 6 months later and it took six months to get rid of it there. It took less time because I immediately stopped doing the things that hurt, rather than “working through” it on the right side.
      Not a big fan of long term use of NSAIDS. They have potential side effects, as do all medications. They don’t mask a problem though, and they can be helpful when used appropriately and on a short term basis. Sometimes patients with bad arthritic conditions have no choice but to use them long term. But for situations like your own, I would not recommend their repeated and long term use in order to keep rock climbing.
      Tiger balm is benign. It won’t mask a problem. When I had tennis elbow I liked to use it because warmth actually felt better to my elbow. Rub away!
      Stop rock climbing and go see your fave orthopod.

  5. Barbara July 25, 2016 at 3:05 pm #

    It’s hard to put your finger on the best sleeping positions in general, never mind for sporting injuries! We pretty much sleep how we sleep and it’s hard to change that position unless you are wearing a cast, brace or have some disability. Elevate your legs if they’re swollen. Try to avoid bending your wrists, which is almost impossible unless you wear a brace.

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