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[bati]

I've been suffering from elbow tendonitis (lateral/outer aka tennis elbow) since May last year. I think it came about from doing biceps curls because that is also when I tend to feel the pain the most. I've been told that this is very uncommon and that the usual culprits are triceps exercises. At its worst it was so bad that I literally could not pick up a pan when I was cooking or carry groceries home with the injured (left) arm. No grip strength whatsoever. I've since bought the Theraband flexbar (first red, then green) which proved quite effective in the first few weeks, I got most of my grip strength back within about 3 weeks and the pain subsided enough that I could continue going to the gym if I was careful with which exercises I did and the weight I used. I've also been using a compression sleeve all this time, which is, as stupid as it looks, far more effective than you'd think. In October I started a longish treatment with NSAIDS due to a back injury and it did wonders for my elbow pain as well, but I've been off the medication for about two weeks now and the elbow pain is coming back in force.

Frankly I'm getting sick of it and I'd like to get it over with once and for all, because it's holding me back on most upper body exercises, and I'm really curious if anyone here has had success with steroid shot treatment, what the recovery time was, etc. I've tried taking a break from the gym for 3 weeks once (longest I've been without) but that didn't improve the situation at all and I'm not really inclined to rest for 6+ months for the elbow to heal.

edit: I should mention that my doctor for some reason flips the fuck out every time I mention gym and his first suggestion is always to stop going to the gym, which isn't really an option for me

 

[BigBooper]

Rest and barely usung it is all that cured mine. Your doctor is right. Why go if you don't want his opinion? Being behind a few months on weight lifting is so much better than getting surgery or being disabled.

 

[Prison Mike]

Lay off the skin flicks

 

[Jesus Carbomb]

I had it and dealt with it for a little over a year. Hate to break it to you, but your doc is right. Best thing to do is to just avoid any strenuous activities. You don't have to skip the gym completely, just change your workout routine to where you're not doing much with that arm.

I didn't bother with any special compression wraps or pain relief creams. No pills or steroid shots. I just didn't do shit with the arm and gave it time to heal.

 

[bati]

Rest and barely usung it is all that cured mine. Your doctor is right. Why go if you don't want his opinion? Being behind a few months on weight lifting is so much better than getting surgery or being disabled.

I should elaborate - he's against weight lifting completely, not just stopping temporarily. I know that the only real way to treat tendonitis is rest but reports on recovery time vary wildly, so I'm curious what people's experiences with this type of injury were.

I didn't bother with any special compression wraps or pain relief creams. No pills or steroid shots. I just didn't do shit with the arm and gave it time to heal.

And it still took a year to heal?

 

[BigBooper]

I should elaborate - he's against weight lifting completely, not just stopping temporarily. I know that the only real way to treat tendonitis is rest but reports on recovery time vary wildly, so I'm curious what people's experiences with this type of injury were.



And it still took a year to heal?

Ah, one of "those" kind of "doctors." Yea, it took about two months for mine to completely heal.

 

[Jesus Carbomb]

And it still took a year to heal?

Yeah, it took about a year to get to the point where I didn't notice it anymore and my grip strength was back to normal.

I remember feeling the muscles in my arm spasm all the way down to my fingers and kinda just begin to release from the tension around my elbow. I'm sure there's a medical term for this, but it was an oddly satisfying feeling.

 

[Papa]

Wanking injury?

 

[bati]

Wanking injury?

No, I'm right handed

 

[Come On Tars]

I got the same thing from doing too many pullups. We're fucked. I haven't taken rehab seriously, but I hear eccentric workouts are good. And rest. When I get back into working out ima do pistol grip ups and maybe rings or something.

 

[black_13]

I got the opposite thing which is called Golfers elbow. If i do narrow grip pull ups then I get pain so I just do wide grip.

You should look up rehab exercises from physiotherapists. Move U guys are good but lots of rehab exercises you can do to get better.
youtube.com/watch?v=w1XJg2xagzM

 

[bati]

I got the opposite thing which is called Golfers elbow. If i do narrow grip pull ups then I get pain so I just do wide grip.

You should look up rehab exercises from physiotherapists. Move U guys are good but lots of rehab exercises you can do to get better.

Yeah I did those with the flexbar and they were a huge help. Right now the pain isn't super bad for me, I can still get through a workout doing full volume but I can feel it get progressively worse and I don't want to end up in the same position I was in a few months ago.

 

[Richard Cranium]

I usually recommend a counterforce brace and often add a wrist brace to go along with it. Also a prescription for PT. Cortisone shots usually work pretty well for quicker relief. PRP seems promising but not usually covered by insurance.

 

[Cutty Flam]

I have the same thing I think. I'm pretty sure I damaged at least a tendon in my left ebow as well as a muscle strain in my brachialis possibly. It was from doing pullups, and I was pulling up, letting go up top and getting my grip on the bar right as I descend. I did that maybe 15 to 30 times and the rest was history. Knew I injured it badly about a couple hours after the effects from the workout and long sauna session had lessened. I'm in week three now, just been taking it easy. It's healing, could probably heal a ton faster if I went to a doctor and got some PT sessions but oh well, that's expensive

It's unfortunate man, but this is largely a waiting game until there is minimal pain, then I'd imagine you could start with at least one exercise, get some reps in, build some endurance and do a little bit more the next day or so. It's a long process, but the healing portion is main thing. A litle massage each day, maybe 2-3 min lightly could help with blood flow to area. Sound nutrition, plenty of water, great sleep preferably 8-10 hours, and eventually you'll be able to do an exercise or two and work some endurance back to where it was with care not to do too many reps or anything to aggravate it

 

[DESTROYA]

Rest.
Concentrate on your core and legs during rest, yeah even if it takes 6 months. You'll still get some benefit of going to the gym.
Just gotta change up your workout routine. Not ideal but a compromise you got to make if you ever want to be without pain.

 

[bati]

I usually recommend a counterforce brace and often add a wrist brace to go along with it. Also a prescription for PT. Cortisone shots usually work pretty well for quicker relief. PRP seems promising but not usually covered by insurance.

I was thinking about wrist straps/braces because I tend to subconsciously flex my wrists when doing curls. Might even be the origin of my injury. I try to minimize this as much as possible but it's hard.

Right now I plan to rest for ~2 weeks and then resume workouts with lighter weights and focus on compound movements, no isolation triceps/biceps exercises.

 

[Richard Cranium]

I was thinking about wrist straps/braces because I tend to subconsciously flex my wrists when doing curls. Might even be the origin of my injury. I try to minimize this as much as possible but it's hard.

Right now I plan to rest for ~2 weeks and then resume workouts with lighter weights and focus on compound movements, no isolation triceps/biceps exercises.

I don't mean wrist straps for working out. I mean a standard wrist brace typically used for a wrist sprain combined with the counterforce brace for the elbow. The main tendon that's usually involved with lateral epicondylitis is the extensor carpi radialis brevis (ECRB), which crosses two joints, the elbow and the wrist. The theory is that immobilizing the wrist helps because it further restricts tendon movement. Doing a reverse wrist curl should cause elbow pain if this tendon is involved.

Anyhow, the vast majority of my patients get better with a combination of bracing and PT. I offer everybody a cortisone injection if they want one, but I still have them do bracing and PT. I'll offer PRP if cortisone and PT aren't enough. Very very rarely is surgery the answer, but I give people about a year before I'd consider operating on that.

 

[Elektro Demon]

That an injury from wanking eh? Admit it.

 

[bati]

Anyhow, the vast majority of my patients get better with a combination of bracing and PT. I offer everybody a cortisone injection if they want one, but I still have them do bracing and PT. I'll offer PRP if cortisone and PT aren't enough. Very very rarely is surgery the answer, but I give people about a year before I'd consider operating on that.

Cool, an actual doctor! Would you recommend a cortisone shot to someone who's been having issues for over 6 months, with near 100% improvement at some point and then a relapse? When my pain went away for a few weeks I started doing forearm and wrist strengthening exercises but I think it only made it worse - maybe I used too much weight on some (reverse biceps curls for example), but I wasn't really feeling any effect or improvement from lower weight. What's killing me now is that I can tell I developed a bit of an imbalance because I defaulted to barbell or fixed machine exercises while my elbow was hurting and I think it will only get worse from here if I don't fix the situation because the healthy arm has no problem picking up the slack and in the long run it will only weaken the already injured arm further.

If you don't mind me asking, what is the typical rest period after a cortisone shot and when do you advise your patients can resume physical activity with the injured arm, and at what load? Fwiw, right now I have full grip strength in the injured arm and I can do 10 chinups at once, but if I try the same exercise on a cable pulldown machine I can clearly tell the elbow is holding me back on the left side when the bar is at the apex and the arms are nearly extended (which I never do completely to save the elbows some tension). Other back exercises with palms in pronated position are mostly fine. I've also started to feel the pain when benching, which hasn't been an issue before. If I do any kind of bicep exercises right now I have to drop the weight on the injured side by ~10-20% if I want to finish my sets, and that includes hammer curls which are supposed to be the easiest on the joints.

 

[jdforge]

Have you tried castor oil? Worked for me.

 

[bati]

Have you tried castor oil? Worked for me.

No but I use Voltaren (diclofenac) gel daily.

 

[jdforge]

No but I use Voltaren (diclofenac) gel daily.

Give the castor oil and heat a try. I've been playing tennis since I was 5 and found this to be the only treatment that works for tennis elbow.

 

[V2Tommy]

Took me 18 months to get rid of it in my shoulder. Nothing worked but time.

 

[Dis]

I have spondyloarthritis and deal with inflammation

Diclofinac (oral) effectiveness wore off after 2 weeks

If u cant rest try to avoid pain as much as possible. I use naproxen + paracetamol so that i can avoid pain as much as i can during training (if i have flare up)

I alternate between lower weight high rep and higher weight lower rep. I cant do xxkg x 8 max weight shit.

Also there is an accord version of naproxen.

Maybe u can combine ( gel + oral + paracetamol?) (!u cannot combine different nsaid!) everything and avoid the pain completely for a period of time during training and just ease yourself slowly back into ur old training weight intensity?


I used cortisone shots. They started immediately but wore off quickly for me. I felt my tendon being weaker or something too.(for a small period of time)
I havent heard good stuff about cortisone shots from other people either

 

[Richard Cranium]

Cool, an actual doctor! Would you recommend a cortisone shot to someone who's been having issues for over 6 months, with near 100% improvement at some point and then a relapse?

Yeah, I usually do recommend a cortisone injection for that situation. A single shot is fairly benign, but I wouldn't advise getting them repeatedly if you're younger.

If you don't mind me asking, what is the typical rest period after a cortisone shot and when do you advise your patients can resume physical activity with the injured arm, and at what load?

I generally tell people to give it a week to two weeks before going back to more strenuous activity, but there are no hard and fast rules here. I will have people go into therapy right away, though. Like I said, the main tendon involved is the ECRB, and targeted exercises can be very helpful.

The other thing to note is that tendinitis of the lateral epicondyle is not really a tendinitis. It's a tendinosis. If you look at the tendon under the microscope, you won't see inflammatory cells there; you just see degenerated tissue, so it's not this acute inflamed elbow that you'd typically think of. In the operating room, you can tell the bad tissue from the good tissue by scraping it with a scalpel. Also the tendon just looks visibly abnormal, just gelatinous crappy tissue. This stuff takes time to get better, but 95% of people recover without surgery.

 

[bati]

*snip*

Thanks for taking the time to reply. I went to my doctor again and immediately got an appointment with a specialist who put me on some medication and prescribed 3 weeks (10 sessions) of physiotherapy, so for now I've pretty much accepted the fact that I won't be able to do any upper body exercises for about two months while I hopefully heal. One thing I have going for me now is that the pain is minimal and that I decided to stop before it got worse again. The doctor also advised against cortisone shot (due to my age - 35) until other options have been exhausted. So for anyone reading this, don't be an idiot like me, seek help sooner.

edit: I do have a question though R Richard Cranium : do you recommend continued use of compression sleeve after the elbow is fixed or will that make the joint weaker in the long run?

 

[Richard Cranium]

Thanks for taking the time to reply. I went to my doctor again and immediately got an appointment with a specialist who put me on some medication and prescribed 3 weeks (10 sessions) of physiotherapy, so for now I've pretty much accepted the fact that I won't be able to do any upper body exercises for about two months while I hopefully heal. One thing I have going for me now is that the pain is minimal and that I decided to stop before it got worse again. The doctor also advised against cortisone shot (due to my age - 35) until other options have been exhausted. So for anyone reading this, don't be an idiot like me, seek help sooner.

edit: I do have a question though R Richard Cranium : do you recommend continued use of compression sleeve after the elbow is fixed or will that make the joint weaker in the long run?

Cortisone works well for the short term but doesn't last. I used to reserve the shot for the second visit if bracing and PT aren't working well enough, but now I just offer it everyone if they want it. Cortisone is superior to PT short term, but the effect isn't sustained. PT is more effective long term, but not as good as cortisone in the first 6 weeks. I'd disagree that 35 is an old age to give a shot, but everyone does things differently. My partner is a wrist and elbow specialist and he offers the shot on the first visit as well.

I'd discontinue the counterforce brace once your elbow is feeling fine, but I don't believe it makes a huge difference either way. The purpose of the brace is to decrease tension on the affected tendons at the elbow.

 

[bati]

. I'd disagree that 35 is an old age to give a shot, but everyone does things differently.

I should've been more clear - his reasoning was opposite, at this age the natural healing ability is supposed to still be good enough that all other options should be tried before cortisone shot.

 

[bati]

R Richard Cranium

One more question if you don't mind - I finally started doing PT after nearly 3 weeks of looking for a suitable place (during which time I rested and didn't put any stress on the tendon) and trying to fit in the treatments into my schedule and now that the first three treatments are behind me I feel like the symptoms are getting worse. My treatments consist of 30 mins of modulated TENS, 20 minutes of micro-something (I don't know the term, they use the same pads as for tens but with very low current), 10 minutes of ultrasound, 6 minutes of laser and some deep tissue massage at the end (honestly the best part). Right after treatment I don't feel any pain but I feel a significant increase the next day, pretty much the same as if I did a normal workout. My arm also feels a little weaker than usual.

I'm worried that the PT is having an opposite effect but I heard from people who went through similar steps that it's supposed to hurt in the beginning. I'll consult with the doctor at the clinic when I go next week but I wouldn't mind hearing an (unofficial) opinion from an expert. If you can take time out of your schedule to answer the question I'll be very grateful.

 

[Tesseract]

tendonitis is super taxing on the body and a colossal pain in the ass to recover from, but it can be done

mechanical offset unloading exercises are vital

PT usually hurts in the beginning, there's no getting around the inflammation you will experience as your tendons are getting the shit shocked out of them

 

[bati]

Figured I'd update this thread - physical therapy (10 sessions, ~1h mixed ultrasound, TENS, laser, massage) didn't help at all. In the end I went for a cortisone shot (in my cases it was Diprophos) - pain went away almost immediately. The first week after the injection I felt zero pain in the most critical spot, but I could feel it move a bit further down the tendon where I apparently also had an inflamed spot. It's been about 3 weeks since the shot and my elbow feels like I never had any issues at all, absolutely amazing. Apart from a hematoma that I got from the injection I'd recommend it 10/10.

 

[diffusionx]

I had elbow tendinitis bother me for a solid year. I did exercise and stuff. I'm not sure there is data that says a complete stoppage of activity speeds it up, honestly.

 

[The Pleasure]

Lay off the skin flicks

Especially with those machines that do it for you.

 

[Come On Tars]

Golfers elbow for me was an insanely easy fix. Just massage across the medial epicondyle with 2 fingers and it goes away immediately. Now I got the other end (tennis elbow) that's proving more troublesome. Stretching seems to make things worse. Massage helps. Just need to figure out the right spot and technique. I need to get rings for my pull-up bar since that's what fed me up in the first place. I am now experimenting with running the back of a butterknife down my forearm.

 

[Tesseract]

isolate, rest, ice, tens unit, strength train, massage

 

[Cutty Flam]

Figured I'd update this thread - physical therapy (10 sessions, ~1h mixed ultrasound, TENS, laser, massage) didn't help at all. In the end I went for a cortisone shot (in my cases it was Diprophos) - pain went away almost immediately. The first week after the injection I felt zero pain in the most critical spot, but I could feel it move a bit further down the tendon where I apparently also had an inflamed spot. It's been about 3 weeks since the shot and my elbow feels like I never had any issues at all, absolutely amazing. Apart from a hematoma that I got from the injection I'd recommend it 10/10.

Serapin injections are even better, try those next time instead as cortisone injections will cause tendon and structural weakness / breakdown over time if you continue to get them. I've had maybe two cortisone injections and then four or so serapin injections when I was going through a crazy amount of injuries at one point

 

[bati]

Serapin injections are even better, try those next time instead as cortisone injections will cause tendon and structural weakness / breakdown over time if you continue to get them. I've had maybe two cortisone injections and then four or so serapin injections when I was going through a crazy amount of injuries at one point

Thanks, I'll look into it if it comes back. This was my first ever cortisone shot - I read about the risks beforehand, and my doctor who administered the shot warned me as well. But I've had the issue for so long and nothing else really worked (I figured a complete stop of all exercise for 2 months would make at least a little difference, but it didn't), so this was more or less the last option before operation.

Golfers elbow for me was an insanely easy fix. Just massage across the medial epicondyle with 2 fingers and it goes away immediately. Now I got the other end (tennis elbow) that's proving more troublesome. Stretching seems to make things worse. Massage helps. Just need to figure out the right spot and technique. I need to get rings for my pull-up bar since that's what fed me up in the first place. I am now experimenting with running the back of a butterknife down my forearm.

If it's in early stage I'd recommend the flexbar, it did wonders for my initial pain management and getting my grip strength back. They're also ribbed and you can use them as a roller - rolling the outer side of my forearm on them provided a fair amount of pain relief after ~3 days.

 

[bati]

isolate, rest, ice, tens unit, strength train, massage

That might help some, but not everyone. I also (as well as my doctor) found strength training completely pointless for my stage of the injury - I can do 10 pullups per set and I'm not exactly a light guy, so doing those strengthening exercises where they use super light weights would do absolutely nothing for me. My pain was long term, I think your tips would apply more to someone who just started experiencing the issues.

 

[Cutty Flam]

The healing and rehabilitation process is a very complicated stage for all of us in life. Sometimes even giving everything you have in the tank with routine visits to therapy, your own side workouts, proper nutrition, rest, stress reduction, and a lot of water each and every day can be a frustratingly long journey. It takes a lot of time, dedication, belief, and heart to recover and get strong enough to eliminate pain and any residual pain from problem areas. But from my experiences, a very good program that you can build upon to build yourself a foundation of strength is a great remedy, coupled with excellent nutrition getting everything you need and maybe a little surplus as well for health. I've gone from deep in the hole borderline strength of a fragile 120 year old back to strength of a healthy young man in his prime a few times. It usually takes about 3-5 solid months of full body routines to get your base well off enough to not have to worry about injuries

But yeah, I just wanted to emphasize that I'm glad your body found its way back to health, because it is a very confusing path sometimes even when consulting with many professionals, or so called professionals in some cases haha

 

[Come On Tars]

Thanks, I'll look into it if it comes back. This was my first ever cortisone shot - I read about the risks beforehand, and my doctor who administered the shot warned me as well. But I've had the issue for so long and nothing else really worked (I figured a complete stop of all exercise for 2 months would make at least a little difference, but it didn't), so this was more or less the last option before operation.



If it's in early stage I'd recommend the flexbar, it did wonders for my initial pain management and getting my grip strength back. They're also ribbed and you can use them as a roller - rolling the outer side of my forearm on them provided a fair amount of pain relief after ~3 days.

bought. Will check out

 

[bati]

many professionals, or so called professionals in some cases haha

No kidding. Some of the physiotherapy clinics I checked out before I found a suitable one...nope, just nope.

 

[bati]

bought. Will check out

This is the exercise I did:



If you put the flexbar on or against a hard surface and roll your arm on it it will work as a roller substitute. You can also do the reverse tyler twist for golfer's elbow if it comes back. Good luck.

(fwiw, I started with red and then upgraded to green after a few weeks, but I had the most improvement in early stages with red)

 

[The Pleasure]

Glad your dad isn't hank hill