Tennis Elbow

Anybody have any advice to help heal tennis (baseball in this case, from throwing with the boys) elbow. I'm 48 and this is my first bout with tennis elbow. I've had it now for 6 weeks and it still hurts to pick things up or twist my wrist and its just now starting to get better. I'd like to accelerate the healing process if possible. I don't need any help with the pain - I'm not going to get shots or take pain killers, but I would like advise on helping it heal faster. Any tips?

Ah! Old age. That's what my doctor told me. The older I get, the longer it will take for this stuff to feel better.

So my advice? Rest it. Take ibuprofen---it reduces swelling and inflammation---and that will make things feel better.

I am a little amused at your post---you want it to get better, but don't want to take medicine...and the only other option is rest and patience.

Use the strap and take anti-inflammatories. The strap is awesome, but it won't cure the problem on its own. Cutting down the swelling is important.

I've had it on and off over the years (common problem for photographers) and this is what works for me.

You guys!...

No miracle cures?

My expectations of the posters on this site are clearly too high.

I have been alternating ibuprofin and naproxin for about a week, and I have been resting the arm, and it has been improving. But, I want it to be better yesterday - like when I was young and no matter the injury, it always seemed to heal in no time. You said it... Ah, old age.

On the other hand, I wouldn't go back to my twenties or even thirties. I'm far happier now than I ever was then... even with the extra aches and pains.

Miricle cures anyone?... restore my faith in you.

No miracles here, just a little addendum: in order for ibuprofen to work as an effective anti-inflammatory, the dosage must be at least 800mg, 3 to 4 times daily. Smaller doses may temporarily relieve pain, but won't help the inflammation.

Not sure what an anti-inflammatory dose of naproxen is, the stuff doesn't seem to do anything at all to me in any dosage.

800 mg ibuprofen is double the standard OTC dose and isn't something I would do without the advice and knowledge of your physician. Ibuprofen is very hard on the kidneys and has all kinds of other dangerous side effects when taken for prolonged periods. Doses like that should always be monitored...

In a nutshell, if you want something to heal faster you have to increase the blood flow. This can be accomplished in several ways including ice, heat, exercise or ultrasound. You probably don't have an ultrasound maching lying around so forget about that unless you see a doctor who will prescribe physical therapy. But you probably have a freezer for cold and a microwave oven for hot. Google "Contrast Therapy" for details. When I have an injury I try to do it 3x/day.

Heat and ice are commonly used in physical therapy. There is nothing magic about them. All they do is speed up mother nature's healing process. Blood carries the building materials that heal tissue. More blood, more building materials. That's overly simplified but you get the idea. The best thing is, it's all natural and no drugs are involved. Just be very careful and don't apply too much heat or too much cold. Skin damage could result.

If the strap makes you feel better, go for it. But don't wear it too much because it's limiting the very circulation you really need.

As someone else pointed out, be patient. Some injuries even when properly treated must be considered in terms of months, not weeks. Be happy so long as you are seeing improvement. At 48 you're not going heal as fast as when you were 20. At 53, believe me I know.

I'm not a doctor or a physical therapist. Be careful with any advice you get on the internet including mine. If your improvement curve flattens out I strongly suggest that you seek professional help.

Excellent advice, Trailrunner!

I've got this thing-
Thera Band Flex Bar
http://www.thera-band.com/store/products.php?ProductID=20
I have the red one. There is a video on YouTube about how to use it. I have no idea if it works, my elbow got better on its own right after I got it.

My wife just got home from work and I read her some of your advice because, don't laugh - OK, laugh, she's a doctor (pediatrician). When I read her the 800 mg ibuprofen dosage she said, "isn't that the amount you've been taking?". I had to say "no, no one ever told me to take more than the OTC dosage of 400mg". Her recommendation is actually 600mg, but she said that 800 would be OK for no more than a week.

Luckily, complaining to you all has seemed to help my recovery (a little recreational complianing can do that). So, I gave up the meds today and have been doing some heat, on and off. It won't be long before I think I'll be ready to work the elbow a little bit to start rebuilding its strength. A doctor friend of my wife's recommended a doctors only website for the exercises - I'll let you know.

Thanks for the advise and encouragement.

Hahahahahahahahahahahahahahahahahahahahahahahahahahahaha

Ok... so you ARE being monitored by a physician... that's good. I'm glad you followed up with what she told you about how long the 800 mg would be ok in case this thread gets read sometime in the future by others. Too many people out there think that OTC meds are safe, and that if 400 mg is good then 800 mg must be better and then they end up wondering why they start having organ problems when they get older. Tylenol is just as bed, if not worse, when taken in high doses over long periods, and the effects of both are exascerbated by the consumption of alcohol.

MNS

I've been on 1600 mg Motrin at a time for the last 4 years... but then again I was injured in Iraq and narcotics are a no go for me

Just for the record - Tylenol (acetaminophen) is not an anti-inflamatory medication. It's main use is as a pain killer. OTC Anti-inflamatrories: Naproxen (Aleve), Ibuprophen (Advil), and Acetaminophen (Aspirin).

Just curious... Is someone doing periodic blood draws to make sure your kidney and liver functions are within normal limits? That is a long time to be taking such high doses of NSAIDS. Good for you, however, for staying off the narcs!

MNS

Hey Richard - I believe midnightsun is referring to you.

Hey midnightsun - do you work in the medical field?

Yes... worked in the ER for 3 years as an EMT and medevac dispatcher, now I'm working on a degree in radiologic science (diagnostic x-ray, CT, MRI, interventional radiology). I had originally planned on PA school so I paid alot of attention to what I was seeing and hearing from the docs in the ER.

MNS

Not to get too personal, but what made you decide on radiology and not PA? I've got a friend thinking about his options in medicine and PA is near vthe top of the list.

PA school is extremely competitive and difficult to get into, especially if your healthcare background is limited and/or your undergraduate degree was obtained a long time ago. I interviewed twice for the U. of Washington PA program and after the second rejection had a follow-up interview where I realized that they look for a specific personality for that program, and what they look for is not what I am. That was really the only program I had any realistic chance of getting into because of my location (AK) and lack of experience and degree from 25 years ago with a GPA that was anything but stellar. So, since I am 45 and don't really have the luxury of time to keep trying I decided to go a different direction. In many ways Rad Tech gives you alot more opportunities, especially to do travel medicine because you're not bound by a relationship with a supervising physician. There are tons of modalities to practice in, and you can usually find something that you like if you're willing to look. I am interested in vascular and interventional radiology, which is a pretty specific niche with a rising demand as the baby boomers get older. If I were a decade younger I'd probably have kept trying for PA, but rad tech really does suit me well... so far I'm loving it. And ultimately the salary will be in the range of something I can live on (not so with EMT), so that and job security is an added benefit. If your friend has questions, PM me his e-mail address and I'll be happy to tell him what I learned in the process.

MNS

Thanks MNS,

He is trending toward chiropractor, having considered PA and a few other options. I'll pass along your email if he has questions.

If he can get into Palmer, then that would be a great way to go. All the best chiropractors I've been to went there. There are definitely some questionable schools out there...


MNS

Observation # 1
I was having sore elbows from doing pull-ups at the gym. I started taking glucosamine sulfite (gs) and the problem went away in a couple of weeks.

As a test I stopped taking the gs and the elbows got sore in a couple of weeks.

When I restarted the gs they got better in a couple of weeks.

I've repeated this testing several times over the last few years and the results are the same. I've concluded that the gs helps me.

Observation # 2
A few days of rest seems to help things. Additional days of rest do not. So my strategy has been to rest the elbows for a few days then get back to doing pull-ups..... but not so many as before. I think that exercising the elbows makes them heal faster. (blood circulation mentioned earlier would explain this)

Thanks,

My elbow is doing better. I can use it for most normal tasks with little pain. But, since the injury is to a tendon and the injury was from "overuse" I am a little afraid to start working it again. I will try the glucosamine (I've taken it on and off for years also, but never correlated any changes) - can't hurt.

For me, I had it and it just appeared to not get better - what eventually did it was two things:

1) Naproxen (aleve) - IMO a better anti-inflammatory than ibuprophen (works for me anyway)
2) A visit to the Glen Sather sports medecine clinic here (at the university) - They gave me a few stretching exercises and things that worked well - After suffering for a couple of months with it just seeming to get more aggravated, this cleared it up in a few weeks, with a noticable improvement in the first week.

If you have a good sports medecine clinic around give them a try.

Thanks Phat,

It has improved quite a bit. I alternated naproxen and ibuprophen. But the recovery has stalled. Maybe it's time for some of those stretching exercises. My wife has access to a few web sites (for doctors only... they don't want you to be able to heal yourself I guess - bad for business) that give exercises and stretches. I'll let you know.

Hey, great new avatar Rio!

As I was doing crunches last night I realized that one thing I've not been doing in the midst of my latest training regimen is STRETCH my muscles after I've used them! I've been doing hill climbing exercises on my bike trying to build up endurance in my quads, and now my quads (surprise surprise) and lower back are really tight and inflexible, which is really unusual for me. I'm probably an injury waiting to happen, LOL... so I plan on adding some yoga and/or general stretching back into my routine (as if I have time for anything else right now). But perhaps for future reference, whenever you find yourself doing repetitive exercises, like throwing a ball, it would probably be a good idea to do the new stretching exercises that you're learning now.

MNS

Thanks MNS,

The picture was taken in Vietnam. We took the boys on a backpacking world trip in 2007 for four months - fantastic. A lot of my light weight backpacking equipment and know how went into that trip.

Hey PHAT:

Have you had a recurrance of the tennis elbow since having it get better? Do you do anything to keep it at bay?

I started my rehabilitation exercises today - definately starting to feel better.

I've once had "twinges" that started to feel like it. I did some of the stretching stuff and it went away.

I know some of you will pooh-pooh this, but my chronic tennis elbow got 95% better when I started taking glucosamine 1500 mg on a daily basis. I probably took it for a couple of months before I noticed a big difference. After having symptoms for years of pain, not being able to pick up things, etc, the glucosamine is the only change I made. If I abuse my elbows they will still hurt for a day, but they recover quickly.

The studies are always contradicting each other, I know, but it is definitely proven to help in animals, and we are animals after all.