Anybody using anything new to treat elbow tendinitis?

[Pax]

Had it several years ago from playing too much. At the time, I gave it rest and applied pressure with one of those arm bands. Seemed to work, but took some time. I can tell it's coming back again.

Really bums me out to deal with this.

Find or hear about anything new or a better approach?

 

[Spoonful]

Just got over it. Took ten months. Started with rest, arm brace and Advil for about 2 weeks. Moved on to stretching exercises and wearing the brace while I played. Could only play for about 10 minutes at a time but built back up slowly. After a couple months, I stopped using the brace. Kept at the stretching and strengthening exercises.

Almost as soon as this got better I started having rotor cuff issues in the same arm. I blame this on not being able to keep up my workout routine the way I should have while the tennis elbow stuff was going on. Between trying to get back into the swing of things and being able to play guitar for longer periods of time, I overdid it and my shoulder didn't like it.

What a mess. The shoulder is healing up a lot faster than the tennis elbow thank goodness.

I say, see a doctor. Too much bad information and too many "devices" out there that don't really help and can actually make things worse.

 

[Pax]

Ten months!

Noooooooo!!!!!!!!!!!!!!!!

 

[jzgtrguy]

Not a doctor...I don't play one on T.V. either but...

I got a news magazine from my Alma mater Berklee College of Music a few years back. In it was an article on musicians injuries and how they are often misdiagnosed and mistreated.

The article said that often musicians injuries are diagnosed as tendinitis when it is not, it's tendonosis which is a deterioration of the tendon not inflammation. Basically it said that tendon's don't have a good blood supply so toxins build up from repetitive use. Since they don't have good blood supply the toxins continue to build up and not get flushed out, the body interprets that as an injury so it tries to repair the injury with scar tissue which further restricts blood flow, more toxins built up. Repeat. It becomes a cycle. Your Tennis elbow might be the same thing.

The article championed Active Release Technique or ART. Look it up. I've had problems with my hands since is was in my 20's. ART works. I found a practitioner in my area. The guy does it for the San Diego Chargers. I've gone back a couple of times for some maintenance. He also gave me some stretches that hard really helped me a lot.

Check it out. Before I found this I had tried everything. Mega vitamin therapy, DMSO, Acupuncture, Acupressure and finally surgery. Wish I'd found this first I never would have had surgery.

 

[BBSuggs]

It hit my right elbow about a month ago. I take it easy, and expect it'll be OK in about a year. That's how it went years ago in my left elbow. I ice it down and take naproxen, as needed. Life doesn't slow down.

My goal is to make sure I don't inflame the left elbow. I'd be in bad shape with tendonitis in both elbows.

Hang in there. Maybe a doc can get you some relief. I'll deal with it while it heals - just like I did before, and just like I did with the plantar fasciitus.

Growing old sucks! (55)

 

[Secret Ingredient]

Not a doctor...I don't play one on T.V. either but...

I got a news magazine from my Alma mater Berklee College of Music a few years back. In it was an article on musicians injuries and how they are often misdiagnosed and mistreated.

The article said that often musicians injuries are diagnosed as tendinitis when it is not, it's tendonosis which is a deterioration of the tendon not inflammation. Basically it said that tendon's don't have a good blood supply so toxins build up from repetitive use. Since they don't have good blood supply the toxins continue to build up and not get flushed out, the body interprets that as an injury so it tries to repair the injury with scar tissue which further restricts blood flow, more toxins built up. Repeat. It becomes a cycle. Your Tennis elbow might be the same thing.

The article championed Active Release Technique or ART. Look it up. I've had problems with my hands since is was in my 20's. ART works. I found a practitioner in my area. The guy does it for the San Diego Chargers. I've gone back a couple of times for some maintenance. He also gave me some stretches that hard really helped me a lot.

Check it out. Before I found this I had tried everything. Mega vitamin therapy, DMSO, Acupuncture, Acupressure and finally surgery. Wish I'd found this first I never would have had surgery.

I've had debilitating hand and forearm issues for years; mainly due to computer use. I was unable to play at all for a few years, and now, my playing is limited. I went through 2 bouts of physical therapy, and I've got an ergo keyboard etc. I've improved, in that I can at least now use my hands fairly well, but I'd say they are 70% of what they used to be. This ART thing looks interesting. I'll check it out. Thanks for mentioning it.

 

[Pitar]

Had it several years ago from playing too much. At the time, I gave it rest and applied pressure with one of those arm bands. Seemed to work, but took some time. I can tell it's coming back again.

Really bums me out to deal with this.

Find or hear about anything new or a better approach?

Probably get poo-pooed here by the medically savvy crowd (don't care) but when both of mine went south on me I treated them to rigorous exercise with 6 lb dumbbells. Hurt like hell, seemed to immediately make them worse but in 3 weeks of bringing tears to my eyes the elbows began to stop hurting. I graduated to 10 lb dumbbells and kept a daily routine (evenings) of working them out. I stopped using the dumbbells and stayed pain free for 8 years.

I did the above because the doctor's prescription was anti-inflammatory pills and taking it easy for however long I needed to take the pills and take it easy. That was not a workable solution for me. The pain kept me from going to sleep. So, having nothing to lose and needing the use of my arms, I began the dumbbell routine with the thought that I'd better use them or lose them. It was a gamble but it paid off. Each evening I'd work out until my elbows went numb from the pain. I could fall asleep then. The mornings brought them back but I could cope through my day until the evening work-out again.

Recently the left elbow began acting up and I quickly began using the dumbbells again. The pain retreated and all is back to normal. I keep one 10 lb dumbbell in my car and exercise with it going to and coming from work now.

 

[Pax]

Wow! Some interesting approaches here. I had never heard of ART. Now that I've read a little I actually remember people I know using it and I just assumed it was regular physical therapy. Studies on it a very limited at this point, mostly individual case studies and anecdotal information. Nevertheless, I'd like to find out more. Thanks for the info.

Pitar, that is hard core! You said it got worse before it got better. You must have been concerned at that point that you were doing more damage, no? How much total time did you do this routine? Did you ever discuss it with your doc? Very glad you found something that worked. Thanks for you info.

 

[gearmeup]

Celebrex did wonders for mine..... Less harmful than Advil and Alieve I had it for 4 months couldn't work out or anything related to pushing then a few weeks on it and boom ...gone

 

[Ricardo P]

The article said that often musicians injuries are diagnosed as tendinitis when it is not, it's tendonosis which is a deterioration of the tendon not inflammation. Basically it said that tendon's don't have a good blood supply so toxins build up from repetitive use. Since they don't have good blood supply the toxins continue to build up and not get flushed out, the body interprets that as an injury so it tries to repair the injury with scar tissue which further restricts blood flow, more toxins built up. Repeat. It becomes a cycle. Your Tennis elbow might be the same thing.

Interesting, thanks!

Suffering from a tendinitis for many years in my left hand. I practice at home almost every evening and what I do is ice it after my sessions. Since extreme temperature changes affects mainly the local blood supply I believe this theory in reasonable.

To make my life easier my freezer has many party balloons filled with water to the size of an apple and fits very well in my hand

I've never got it fully healed be its pretty much under control.

Good luck!

 

[Strat]

re: tendonitis vs tendinosis

Well, you're close but, like love and marriage, you can't have one without the other.
-osis is simply a long term -itis.

There are no toxins but there ARE micro-tears of the musculotendinous junction of the common extensor muscle wad at the lateral elbow. Either version is first and foremost an overuse or strain injury and the one is fresh while the other has gone for a longer period of time , is no longer an acute inflammatory condition and scarring and degradation of the tendon.

While there is a wealth of both information and mis-information easily found on the topic it's best to think of tennis ( musicians ? ) elbow as an overuse injury of the ECRB ( extensor carpi radials brevis ) muscle and other wrist extensors and go from there.

If you consider that for a moment you might realize that first and foremost the matter is one of excessive loading due to incorrect hand positioning which, in musician ( and i use the term loosely with this TGP crowd ) terms means your hand position and arm posture sucks.

Poor blood supply does mean slow healing but functional gains are made with re-orienting the collagen fibers being laid down by prolonged wrist/forearm stretches - lock out the elbow and hold steady pressure with the other hand on a flexed wrist for 40 - 60 sec and repeat ad -nauseum as damaged muscles want to contract for protection. You will notice a large difference between left and right.

Do not try to strengthen a muscle until it has a reasonable normal eccentric range of motion ( lengthening ) as the muscle is already contracted and power is developed through fibril contractions ( i.e., you risk further tears with the load. )

Ice is good and so is realizing the arm and wrist as platforms for placing the hand in space so think about what makes sense and what maybe does not.

( yes, I do this for a living )

 

[whitehall]

Here's what fixed mine. I have one of those big Shiatsu massagers, the kind you can rest you neck in. I would put the elbow in it for awhile, then the forearm and finally position it on the shoulder. Relief came after one day, and after 5 it was great. This was way faster than hot/cold packing it. Sometimes I also slept with a compression band on my wrist.

 

[Spoonful]

I think that recovery from the initial damage is critical before you start the strength training. I'm not sure how much rest is needed, but I'm sure it partially is case by case dependent. The anti-inflammatories help reduce the inflammation and the discomfort. It's not the solution - it's part of the treatment.

The arm brace helps protect your muscles and tendons during the initial healing process. The stretching routine has already been explained.

Strength training will help once you get to the right point in the healing process. It can end up setting you back if you start too soon.

Agreed, this is caused by overuse and probably some bad body mechanics. When I did start back playing again I focused on slow tempo and lighter touch, paying close attention to hand, arm and body position. Obviously, not close enough, since I hurt my shoulder. Maybe that came from trying to hard to make adjustments to my playing position.

So many variables at work.

Anyway, best of luck. Oh, and its important after you recover to pay attention and if you start to get those warning signs, take a break for 10 or 15 minutes.

 

[Pax]

Thank you, Strat. Always welcome a professional PoV.

@ you and Spoonful:

For the record, I think I know what I did wrong and I think it tracks with what you're saying.
-First, played too long without a break several days in a row.
-Second, played a bunch of songs with barre chords at the further end of the neck, frets 1-3 a lot. I was having some fun with a bunch of easy classic rock songs one after the other.
-Third, I'm heavy-handed. Never been able to develop a light touch.
-Fourth, bad positioning. I actually wear my guitar a little above waist level, but I probably need to go even a little higher. I'm just having to bend at the wrist too much.

Combination of all these and there you have it.

Wondering if a combo of anti-inflammatory, stretching, and aggressive massage would speed initial healing.

 

[boo radley]

I had a bad case of tennis elbow (from something else; not the guitar) and finally ended up getting a cortisone shot. Worked terrifically, and was able to do the necessary stretching and strengthening exercises later, to stay healed.

 

[JiveJust]

Physical therapy massage to break up the scar tissue and 2000 IUs of Natural Vitamin E with mixed Tocopherols. I've recommended just the Vitamin E to half a dozen friends and they all swear by it now.

 

[Strat]

Yes the NSAIDs, and cortisone injections are very useful for quieting the pain so that you can do the real work.

I had a bad case of tennis elbow (from something else; not the guitar) and finally ended up getting a cortisone shot. Worked terrifically, and was able to do the necessary stretching and strengthening exercises later, to stay healed.

 

[Tone_Boss]

Naproxin knocked mine right out.

 

[Jon Silberman]

In Western medicine, the doctor takes you from totally f-ed up to minimally functional. The physical therapist takes you from minimally functional to healed.

See a doctor and then a PT and follow the PT's directions religiously. I cured my own debilitating case of tennis elbow this way.

Two additional tips:

(1) If you use your hand on the same arm as the tennis elbow for your computer mouse, switch your mouse use to the other hand (it will feel really weird at first; a month later, you won't think twice about it).

(2) Do these exercises regularly (I use 15 lbs. weights/hand and arm for the first 4 exercises):

 

[gearmeup]

Yes the NSAIDs, and cortisone injections are very useful for quieting the pain so that you can do the real work.

Yeah but those injections are only temporary and studies show it becomes even worse in the future