T Nation

Elbow Tendonitis Cure?

Hi,

Is there ANY way at all to cure e.tendonitis for good?

I’ve had this for over 2 years now I think. Especially hurts when I do tricep dumbell extensions or skull crushers. Oddly enough, there’s no discomfort in other vertical or horizontal pressing movements. However, I do get slight discomfort when I do behind the neck rope presses from a seated position.

Also, if I inadvertently bang my elbow somewhere, the pain is quite prominent. I’ve tried icing, painkillers such as Iboprufen or Diclofenac…even Paracetamol… but the pain comes and goes. Now, the pain isn’t constant mind you. Only when I nudge my right elbow somewhere, or the next day after tricep training or a ‘push’ workout.

Please feel free to share your thoughts/comments, and tell me how to get rid of this permanently. I am still able to push big weights (sometimes wearing an elbow sleeve), but I don’t know what state my elbow will be in a couple of years down the line.

Dude. Here’s my experience: 3 years ago my medial and lateral tendons started hurting, I ignored it. One day doing reverse curls I felt something bad happen. Bad. Kept lifting until I couldn’t. Couldn’t zip or button my pants without tears coming to my eyes. Went to a sports ortho doc. Diagnosis, bilateral and medial epicondilitis. Combo tennis and golfer’s elbow. Got a few cortisone shots, did nothing. Went to occupational therapy for months. E-stim with medicated pads (forgot the name), stretching, rehab. No luck. Went to another doc, said same thing, did occ. ther. again. Nothing. Did Graston Therapy, which is where they grease up your arm and then manually scrape a dull stainless steel blade down your arm, scraping the scar tissue off the tendon. From the outside. Pain. Crying. Pain. Went from “itis” to “osis”. Didn’t lift for 7.5 months. Nothing. Then I went back to the gym doing full body every other day. Using lifting hook-straps for pulling. Went slowly, but after 6 months or so was pretty strong again. There are many moves I can’t do any more. No upright rows, rev curls, tricep extention/skull crusher/anything tri. Lat/front raises are neutral grip. Basically I can’t squeeze the bar. My bench is good for me and other big lifts as well, check my log if you like. My wife’s friend is a ortho surgeon. He said you can get the operation, there is a 60% chance it can relieve pain 50%. So that sucks. I just live with it, there is really no other way I’ve found, unless you try Prolo Therapy, google Dr. Hauser. I still use the hooks and heavy sleeves. I’m not a BB, but I’m respectable in size and #'s for my age/injuries/surgeries, and have made gains since coming to terms with this.
Helpful at all?

Whoops, forgot to actually be helpful while spilling my guts! I slept in wrist immobilizers for almost a year. That way you don’t flex your wrist in and stretch the tendons all night long. Also slept in loose-ish sleeves for about two years, often using BenGay or Tiger Balm before bed. Always, always, always ice instantly after lifting. Before you leave the gym. Stuff ice packs or bags into the sleeve you sleep in. Fuck the weird looks at the gym. You’ll feel better.

You need to help blood get into the area as much as possible.

  1. Aggro soft tissue work to the medial epicondyle

  2. Eccentric only exercises, google “Julian Saunders, Dodgy Elbows” - 3 sets each exercise twice every second day

  3. google mobility wod elbow flossing - once per day

  4. Ice/Heat therapy on/off works well - as many times as possible

Sounds like an “osis” not an “itis” NSAIDS, fish oil and anything designed to decrease inflammation will considerably delay the healing process. Eccentrics are the cure for tendonosis and if you don’t do them, you will end up like the bloke above. You have to hunt for the painful areas when you are doing the eccentrics. ZERO concentric. Ice afterwards for ten mins. It takes 1 week of eccentrics for every month you have had it to heal it. The tendon has de-generated lots since then

I too tried the eccentric only exercises. It didn’t work for me.
“isis” means inflammation, “osis” means damage, the tendon tearing off the bone, then scar tissue forms.
Be careful with inflammation. It’s the bodies way of healing itself, but left unchecked it will cause nerve damage. I have that too.

The op may not have tennis/golfers elbow.

ill try to do a list so its easier to read.

  1. squat with the bar a bit higher or a better shelf for the bar
  2. ice and heat, contrast showers etc after workouts.
  3. skull crushers,extentions with barbells etc. basically anything that irritates it take time of those you wont lose size or strength… I powerlift and went a month without exntentions such as these and i lost nothing.
    4.also use FULL ROM dont try to keep the tension on ur lats when doing rows all the way up all the way down. same with bicep work and chest work.
  4. IF your bodybuilding try going to a power maintence type of routine such as 5/3/1 and keep welll conditioned till it recovers

Give up skull crushers and the like for good.

http://www.T-Nation.com/article-comments/4_steps_to_fix_your_triceps

Also super light rope/band pressdowns for 100 reps can help, and if you can afford it get some ART

I was also bothered by elbow tendinitis in my left arm earlier this year (for about 4 months). Any type of pressing movement created a lot of pain and tenderness. I tried icing, stretching, ibuprofen, rolling, rest, nothing seemed to help.

I started to search for elbow exercises to help with the tendinitis, and happened to come across a simple exercise developed by a guy named Tim Tyler (http://info.thera-bandacademy.com/flexbarelbow)

It is a simple eccentric exercise that can be done with things like a towel, but most effective with a thing called a Thera Band FlexBar.

I purchased one for around 16 dollars at Amazon. I started off slow then worked my way up to 3 x 15 reps. After a few weeks the pain went away and I was able to resume pressing movements. I did have a slight flare up again recently but it went away quickly after a week (this after not using the FlexBar for months).

[quote]strangemeadow wrote:
Whoops, forgot to actually be helpful while spilling my guts! I slept in wrist immobilizers for almost a year. That way you don’t flex your wrist in and stretch the tendons all night long. Also slept in loose-ish sleeves for about two years, often using BenGay or Tiger Balm before bed. Always, always, always ice instantly after lifting. Before you leave the gym. Stuff ice packs or bags into the sleeve you sleep in. Fuck the weird looks at the gym. You’ll feel better. [/quote]

Hey man, I really appreciate the prompt feedback! :slight_smile:

Before my push workouts I apply something similar to BenGay: it’s called MOOV (oil of wintergreen, nilgiri oil among other goodies, it’s from India, that stuff works!). So it has a similar mechanism to BenGay. You ought to try this…has a nice deep warm penetrating effect, and for the time, the area is virtually pain-free. At other times of the day, usually a good few hours before my workout, I apply Diclofenac, and wrap a sleeve around my elbow, which is supposed to improve absorption. I apply MOOV just before my push workouts, and cover the elbow with a firm sleeve.

Icing right after workouts sounds like a really good idea… should I ice only after triceps and push workouts, or after every upper body workout?

P.s: tiger balm is also very effective, thinking of getting a jar or two.

[quote]thrasher_09 wrote:
You need to help blood get into the area as much as possible.

  1. Aggro soft tissue work to the medial epicondyle

  2. Eccentric only exercises, google “Julian Saunders, Dodgy Elbows” - 3 sets each exercise twice every second day

  3. google mobility wod elbow flossing - once per day

  4. Ice/Heat therapy on/off works well - as many times as possible

Sounds like an “osis” not an “itis” NSAIDS, fish oil and anything designed to decrease inflammation will considerably delay the healing process. Eccentrics are the cure for tendonosis and if you don’t do them, you will end up like the bloke above. You have to hunt for the painful areas when you are doing the eccentrics. ZERO concentric. Ice afterwards for ten mins. It takes 1 week of eccentrics for every month you have had it to heal it. The tendon has de-generated lots since then[/quote]

I found your feedback and the google link extremely helpful.

I’m pretty sure this is elbow tendonitis, aggravated not by lifting but in fact… gaming!

I 've been playing a lot of shooters and driving games for years now, where you guessed it… firing a weapon or speeding up a race car requires the use of pulling the trigger (and often holding it in that position for long periods) with the right fore finger (Xbox 360 controller). I often do this for hours, particularly on the weekends.

Can’t help it, Forza Motorsport 4 has me hooked! Not only my right elbow, but my right fore finger’s started to feel sore too.

Thanks a lot for the FB though, I’m going to give your recommendations a shot, along with the exercises Dr. Saunders recommends.

[quote]strangemeadow wrote:
I too tried the eccentric only exercises. It didn’t work for me.
“isis” means inflammation, “osis” means damage, the tendon tearing off the bone, then scar tissue forms.
Be careful with inflammation. It’s the bodies way of healing itself, but left unchecked it will cause nerve damage. I have that too.[/quote]

Ai yai yai! I hope I’m not nearing the nerve damage stage! But I definitely feel it’s chipping away slowly, and feels a bit tender at times.

[quote]Dil Pickle wrote:
The op may not have tennis/golfers elbow. [/quote]

Hmm, maybe not…but elbow definitely feels funny when doing dumbell, barbell or rope extensions for triceps. Oddly, there’s no discomfort while bench pressing, military or shoulder presses, or any other pushing or pulling movements for that matter.

Gotta take time off from Forza Motorsport!

[quote]brownstown89 wrote:
ill try to do a list so its easier to read.

  1. squat with the bar a bit higher or a better shelf for the bar
  2. ice and heat, contrast showers etc after workouts.
  3. skull crushers,extentions with barbells etc. basically anything that irritates it take time of those you wont lose size or strength… I powerlift and went a month without exntentions such as these and i lost nothing.
    4.also use FULL ROM dont try to keep the tension on ur lats when doing rows all the way up all the way down. same with bicep work and chest work.
  4. IF your bodybuilding try going to a power maintence type of routine such as 5/3/1 and keep welll conditioned till it recovers
    [/quote]

Alrightee, will give it a go. Gave up skull crushers a long time ago. But I use a similar movement, where I hook my elbows on a benching barbell, and do dumbell extensions. Probably should give up those too.

[quote]RampantBadger wrote:
Give up skull crushers and the like for good.

http://www.T-Nation.com/article-comments/4_steps_to_fix_your_triceps

Also super light rope/band pressdowns for 100 reps can help, and if you can afford it get some ART

[/quote]

Right, rope pressdowns sound good…if I go heavy, I start to feel the discomfort while doing these.

I’m sorry, I have heard of ART, but I’m not completely familiar with it.

Stopped doing skull crushers a long time ago, do close grips presses on a flat barbell or EZ curl bar instead.

[quote]RampantBadger wrote:
Give up skull crushers and the like for good.

http://www.T-Nation.com/article-comments/4_steps_to_fix_your_triceps

Also super light rope/band pressdowns for 100 reps can help, and if you can afford it get some ART

[/quote]

P.s: is that Hetfield in your profile pic? Not bad for a rocker in his 50s!

[quote]BigMan2004 wrote:
I was also bothered by elbow tendinitis in my left arm earlier this year (for about 4 months). Any type of pressing movement created a lot of pain and tenderness. I tried icing, stretching, ibuprofen, rolling, rest, nothing seemed to help.

I started to search for elbow exercises to help with the tendinitis, and happened to come across a simple exercise developed by a guy named Tim Tyler (http://info.thera-bandacademy.com/flexbarelbow)

It is a simple eccentric exercise that can be done with things like a towel, but most effective with a thing called a Thera Band FlexBar.

I purchased one for around 16 dollars at Amazon. I started off slow then worked my way up to 3 x 15 reps. After a few weeks the pain went away and I was able to resume pressing movements. I did have a slight flare up again recently but it went away quickly after a week (this after not using the FlexBar for months).

[/quote]

Checked out the video, looks interesting. I think I can do something similar with light dumbells: let my hand hang down, as if I’m about to do a bicep curl, and then rotate it clockwise and anti-clockwise with a full ROM. What do you think?

[quote]Sepulnation wrote:

[quote]strangemeadow wrote:
Whoops, forgot to actually be helpful while spilling my guts! I slept in wrist immobilizers for almost a year. That way you don’t flex your wrist in and stretch the tendons all night long. Also slept in loose-ish sleeves for about two years, often using BenGay or Tiger Balm before bed. Always, always, always ice instantly after lifting. Before you leave the gym. Stuff ice packs or bags into the sleeve you sleep in. Fuck the weird looks at the gym. You’ll feel better. [/quote]

Hey man, I really appreciate the prompt feedback! :slight_smile:

Before my push workouts I apply something similar to BenGay: it’s called MOOV (oil of wintergreen, nilgiri oil among other goodies, it’s from India, that stuff works!). So it has a similar mechanism to BenGay. You ought to try this…has a nice deep warm penetrating effect, and for the time, the area is virtually pain-free. At other times of the day, usually a good few hours before my workout, I apply Diclofenac, and wrap a sleeve around my elbow, which is supposed to improve absorption. I apply MOOV just before my push workouts, and cover the elbow with a firm sleeve.

Icing right after workouts sounds like a really good idea… should I ice only after triceps and push workouts, or after every upper body workout?

P.s: tiger balm is also very effective, thinking of getting a jar or two. [/quote]
Where did you get your “MOOV”? I’m also unfamiliar with Diclofenac. I’ll have to google it. I don’t have any problem with benching, military or major pressing, but those tricep isolation moves…not for me!
I ice after pushing and pulling.
Stop gaming so much!
:wink:

In my experience, be aggressive with your rehab, including, but not limited to:

Stretching
Properly warming up
Foam rolling/soft tissue work/working on fascial adhesion near the joint
Band Pull Aparts
Icing after workouts
Contrast showers

If you’re doing all of that stuff, and you still have nagging pain, then:

Find what movement in causing the problem, and find a solution.
If skull crushers are causing problems, then stop doing skull crushers.

If something more important to your program, say back squats, are causing elbow issues, then you can:
Change bars/bar position - SS bars, cambered bars, front squats

OR

Make sure your technique is down (are you chicken winging it).

If you’re STILL in pain, go see a good chiro, seek out a PT or someone that can help you with ART.

Most importantly, TAKE CARE OF IT NOW ALL CAPS YARRRRRG. Do not let an injury turn into a permanent debilitation.

[quote]strangemeadow wrote:
I too tried the eccentric only exercises. It didn’t work for me.
“isis” means inflammation, “osis” means damage, the tendon tearing off the bone, then scar tissue forms.
Be careful with inflammation. It’s the bodies way of healing itself, but left unchecked it will cause nerve damage. I have that too.[/quote]

The eccentrics have to be done in a very specific way. It is imperative that you ‘hunt’ for pain when performing them. Do zero CONCENTRIC and the eccentric for 6-7 secs. Adjust the angle of your elbow and find the most painful spot (especially useful for the pronator teres exercise) and perform it at that angle for two weeks then modify the position again. Normally starting off with the elbow completely locked out works best (Provides the most pain).

I would definitely continue training everything that doesn’t tear it off the bone. So exercises that cause a little pain are fine but avoid full pullups and isolation work for the triceps. Deadlifts, hammer curls, reverse curls etc are fine. If the eccentrics aren’t done hunting for pain and very controlled you are wasting your time. You need to do them in this manner for a week for every month you have had the injury.

I saw Dr Julian Saunders for a treatment when I had huge elbow problems and he knows literally everything about elbow issues. He works with tonnes of rock climbers and this is apparently the most common climbing ailment. The problem occurs from over-use and/or stretching a tendon that crosses two joints and using it at the same time. Pronator teres needs to be strengthened through eccentrics as it is often weak. During a pullup the bicep is trying to supinate, the pronator teres and pronator quadratus are trying to pronate. The tendon is in the middle of this tug of war and gets ripped apart.

It is possible to have an ‘itis’ and an ‘osis’ on the same arm same side.

Flexor carpi ulnaris (cocking the wrist and performing DB curls)
Pronator teres (Flexing the wrist when performing pullups/skullcrushers/pressdowns/curls)
are the main ones that cause it in a gym environment.