T Nation

Question for PTs (Tennis Elbow)


#1
 I just got over a bad case of lateral epicondylitis (a.k.a. tennis elbow). It was awful. At the worst, I could not even lift a 2lb tub of protein.

Anyway, I was not able to lift for nearly nine months, but now I am back in the gym. I just want to know, what should I include or avoid in my training? I am so detrained, I am physically, more or less, a beginner. I have to work on building a new base of strength.

So, what advice would any of you have? What exercises should I include or avoid? Any particular post-training regimen (not meaning nutrition)? Any sort of special warm ups? Also, are there any common mistakes people make when they come off of an injury like this?

I appreciate any advice any of you have...I would rather ask you guys/gals than the average gym trainer.

Thanks a lot.

          Takuin

#2

You might want to think about directing this question to Mike Robertson or Eric Cressey's locker room.


#3

Thanks. I'll do that


#4

It is impossible to give specific advice to people over the internet when you have not performed their evaluation. It is possible to provide some general information.

  1. As you know, start off easy in terms of weight lifted, volume, etc.

  2. If anything causes pain, stop immediately.

  3. Include direct forearm training. Train wrist extensors and pronation/supination.

If you will provide some more information on your injury, I may be able to provide some more advice. (how did you get injured? aggravating factors? easing factors? previous injuries? treatment received? etc.)


#5

Thanks so much for your reply. I appreciate it.

As far as I can tell, and from analyzing my training log from the time of the injury, it seems to have been caused by too much repetitive, heavy work involving that joint. From my log, I first noticed the pain after performing reverse curls on the EZ bar. Also at that time, I was performing reverse work for triceps, i.e., reverse pulldowns and the like.

Another thing that may or may not have contributed to the injury. I was practicing guitar for at least an hour each day. I play an acoustic guitar and use .13 guage strings. If you are not a guitarist, that will be meaningless, but basically, it is similar to playing guitar with coaxial cables instead of strings...pretty damn thick.

Now, the pain is gone, playing guitar is fine, and working out is fine. But I have lost all the strength I had gained previously. It really is like starting over, which sucks ass. But I would rather be at this point than where I was a few months ago.

Oh, it was my left elbow, and I play guitar right handed. Al DiMeola and John McLaughlin type music. (If you know them)

Thanks for reading. Any advice will be greatly appreciated.

Takuin


#6

Hey Tak,

I don't have any advice, but major sympathy. I'm a hobby lifter who plays guitar.

I got "tennis" elbow a few years back from my job, which included a lot of percussions to that joint (hammer). When I started lifting again, it reappeared, again in my left elbow (I'm left-handed). I backed off, and found that if I avoid certain movements (lying tricep extensions, mostly), it heals. Some people call that movement "elbow-fuckers."

Now I've gotten a sore right forearm from power cleans, we'll see how fast this heals. This time it happened, I suppose, because of weakness and bad technique.

I play guitar right-handed, but I remember that barre chords used to hurt when I had the tendititis. 013s? You might as well play a 12 string. LOL.

Good luck,
Richard


#7

I am not a guitarist, so thanks for the explanation.

It does sound like a repetitive use injury and possibly a muscle imbalance and that you let it rest to heal. Please let me know if you have had any treatment (PT, meds, MD, etc.).

If I were you, I would limit reverse grip work to 1-3 exercises at the most. I would start very light and add weight gradually. Again, if anything causes pain (not muscle soreness) then stop immediately.

I would perform direct forearm work that would consist of wrist extension, pronation/supination and finger extension. If you are still playing the guitar daily, I would either do very little or no wrist/finger flexion exercises as it is already being trained on the guitar. For the finger extension you can use multiple rubber bands or check out ironmind.com for "expand your hand" bands. (For all forearm movements) I would start easy on the weight and do higher reps initially to help train the movement, increase blood flow and have an easier time detecting if a movement is likely to cause injury.


#8

As one who has recovered from this problem twice before, I offer this advice...
1. Manually stretch & heat the affected area before lifting
2. Light, strict hammer curls and reverse curls will aid recovery and strengthen the tendon.
3. Ice after every workout, maybe even after practicing guitar too.
4. A cortizone shot really helps knock down the worst of the inflammation so that your body can begin healing faster. Worked great for me.