I know this post won’t be for everyone, but for anyone else out there who’s dealt with chronic tennis elbow and had a hard time finding a way to fix it, this is for you. This is the type of post I wish was out there when I was going through my never-ending search for a way to fix my elbow. It can be a frustrating injury to say the least, and even downright scary at time if it’s your dominant side. Everyday tasks you take for granted, such as driving, writing, holding a mug, or opening a door, are suddenly a challenge. No matter how long it takes you (it took me over 1.5 years!), you can get better!
Last year will forever be the year of injuries. I ended up going to physical therapy for a total of three different problems. In case you forgot or you’re new to the blog, I’ll give you a visual.
The latest stint at physical therapy was for my seemingly never-ending tennis elbow saga. I was actually discharged back in early September of this year, but have been wary of proclaiming myself officially discharged since it’s been such a relentless injury that didn’t respond to anything. A quick timeline:
- April 2013: Injured; PCP thinks my blown-up elbow is from an infection since it came out of nowhere so I get 10 days of antibiotics.
- May 2013: Elbow still bothering me and chiropractor mentions that the inflammation could have been from tennis elbow. Schedule appointment with orthopedist who confirms I have lateral epicondylitis with calcific tendonitis (tennis elbow with a calcium deposit). Receive cortisone injection.
- June 2013: Cortisone didn’t help, but decide to forego all treatment suggestions at the time as dealing with my glute injury
- September 2013: Seems to be feeling better after resting it through the summer, so I start trying to use it again
- December 2013: Injury is back with a vengeance
- January 2014-June 2014: Try multiple modalities (see list below) while on and off resting right arm
- February 2014: Get MRI, doesn’t show anything new
- July 2014: Elbow gets even worse, have a freak-out session because I’m hardly able to use my dominant hand and wonder what the future holds after trying so much and it still isn’t better
- Mid-July 2014-early September 2014: Amazing physical therapists try all kinds of techniques to fix me and it seems to work! I start slowly working out my arm again…
All of the modalities I tried in chronological order:
- Cortisone injection
- Prescription strength ibuprofen
- Tennis elbow strap (I used this tennis elbow strap and wore it off and on for about a year<affiliate link)
- Ergonomics consultation at work
- Active Release Technique (ART)
- Graston with ART, laser, ultrasound
- Ice baths
- Occupational therapy (with iontophoresis)
- Prednisone taper
- Changing my mouse
- Sports massage
- Thera-Band Flexbar
- Addressing it as Tension Myositis Syndrome (more on this in another post)
- Physical therapy
- Changing my desk set-up at work so my forearms rest on the desk
Things I looked into or was suggested to try but didn’t:
- Second cortisone injection (I was very opposed to this)
- A second round of occupational therapy
- Prolotherapy (6 month waitlist to see the doctor PLUS not covered by insurance)
- Dry needling (not legal in Massachusetts?)
- Trigger Point Therapy
- Feldenkrais Method
- Platelet rich plasma (also not covered by insurance)
- Surgery (last resort)
I had a two-week check-in with PT after being discharged and I was really glad because my elbow was starting to bother me again after two weeks. I thought, “Oh, no, here we go again…” But a quick consult and taping and I’ve been pretty good ever since (knock on wood). It hasn’t been a linear improvement, more of an inclined squiggly line, but at least I’m going in the right direction. It may not feel perfect every day, but I try not to panic when it’s feeling less than fansastic and ease off exercise. I was injured for 1.5 years, so I don’t expect it to be as good as new overnight.
So why did physical therapy help when all else failed? I think a big part has to do with my specific therapists. They understood what I was going through in a way that only someone with tennis elbow would know. How is that possible?! They treated both my body and my mind and I think I really needed both to be able to move toward recovery. All of the doubts, the fears, the past failures were haunting me, but they found a way for me to believe in the treatment.
Also, they focused on my entire body, not just my elbow. Turns out that my wonky shoulder had a lot to do with it. I’ve had an issue with my right shoulder (same side as my elbow) ever since I injured it playing a Wii game over five years ago. Yup, you read that correctly. I hurt myself playing a video game. I was acting like a goof wielding a light saber in some Star Wars game. There just so happens to be photographic evidence of that fateful night:
When I woke up the next morning my shoulder was killing me and I had limited mobility. It got better over a few days but I continued to have issues with it over the years. I would baby it so that (unbeknownst to me) it progressively became weaker. I would unknowingly use my forearm muscles instead of my shoulder muscles, so that I overloaded my forearm and eventually something had to give. I’m sure doing tons of plank variations also didn’t help.
The taping techniques my physical therapists really helped. The first technique they tried is the one you saw in this post. This one didn’t do as much as we hoped, but I wanted to show you anyway. I found a picture (below) that shows a better angle.
The taping method that worked like a charm is the one shown below. It’s a bit of an odd method and uses regular old athletic tape because you actually don’t want the stretch; you need the support of the stronger tape.
And here’s another angle to show where the tape starts and ends on the arm (had to zoom in on an otherwise very pretty picture from our trip to Colorado this summer):
What I continue to do now that I’m done with physical therapy:
Below is a picture of the strengthening regimen that I was prescribed in addition to a few other moves for my forearms and shoulders. I do this routine 1-2 times a week.
I also do stretches for my forearms, shoulders, chest, and neck, such as:
From one of my favorite PT resources, PhysioAdvisor.au
I always do the stretches 1-2 times each and hold them for 20 seconds each time. Another great resource for tennis elbow stretches and strengthening is this one and closely mimics what I do.
I’m also sure to keep up with ice massage. I use the same technique as I showed you in this post about icing for plantar fasciitis, but use it along my forearm muscle and up into the elbow joint a little bit. It’s important not to push it in too hard because you could actually end up irritating the tissue as I did early on. I try to do it after any exercising that uses my arms, and though this has been tough to want to do since the weather has gotten colder, I know as long as I keep at it, I will continue to not only feel good, but keep getting better.
Finally, I’m sure to take it slow and easy as I build my strength back up. I may not do every single down dog in yoga or every push-up that Jillian wants me to. I’m careful not to workout my arm two days in a row for now (for example, no upper body exercising the day after yoga). I’ve tried to restrict my evening and weekend computer use as this tightens up my neck, shoulders, and forearms, and I believe definitely contributed to my tennis elbow pain lingering. After dealing with this for so long, I’m happy to just not be in any more constant pain, so I’m just fine with taking it slow.
I hope this helped anyone looking for answers. Don’t be afraid to speak up for yourself! This is your body, after all, and you know it better than anyone else. I finally asked my orthopedist if he could just send me to physical therapy even though he never mentioned it as an option in the year I had been seeing him.
Questions: Have you ever had tennis elbow or another injury? Have you had a chronic injury? How did you deal with it? Have you ever had to really speak up for yourself with a doctor?