Elbow pain advice

So I've been suffering with golfers elbow for a while now. I had stopped doing all upper body for around 2 weeks and been careful with other everyday activities which would flare them up and for the last couple of days i haven't really felt any pain.

Although I know this does not mean that are healed I tried some SPL/PE3 planks holds for 5 x 60s and felt no pain afterwards but I am still wondering if this was a good idea or not even though there was no discomfort from them?

Any advice would be really appreciated.

Thank you

Hi Gary, I would follow the advice of any medical practitioner who evaluates you. However, barring that, here are some ideas.

I've had similar elbow issues in the past before. In general, lack of pain is a good guide. If it doesn't hurt while doing it, and more importantly, if it's not worse the next day, then I'd say you are good to go. Sometimes it won't hurt during activity but the next day it will be more sore. Avoid that scenario by being conservative in trying new, more intense, or longer duration movements as you advance through your healing.

Activity and movement are great therapy for tendinopathy. So staying as active as you can and working around the injury as much as possible will facilitate healing. You are being smart to avoid pain. As Coach Sommer has said, the fastest way to make progress is to not get injured. But once you are injured it has to heal completely before getting stronger again.

There is also evidence for heat and eccentrics for helping tendon healing. Some others, myself included, also use myofascial release and voodoo flossing (see youtube) to help with issues like this. Hope this helps.

Best,

Matt

44 minutes ago, Matthias Schwartz said:

If it doesn't hurt while doing it, and more importantly, if it's not worse the next day, then I'd say you are good to go. Sometimes it won't hurt during activity but the next day it will be more sore.

Good advice. I was actually looking for instant pain so will wait and see how things are tomorrow. I was avoiding pushing and pulling but wasn't sure if straight arm work should also be avoided?

Thanks for the advice Matthias

Great advice from Matthias. In some case, my physio has had me use isometric holds for this, but most common are eccentrics. A sports physio will be able to provide specific advice for your situation.

As was mentioned above, be delicate, avoid the pain completely, and be sure to feel it out tomorrow before getting overzealous with upper body training. The straight arm work should be okay, however. 

OK thanks Everett

I can just about cope with losing my push ups and ground rows but not my planks so hopefully thing will be OK tomorrow.

I think you'll be fine Garry! That movement is pretty different than the mechanism for aggravation of golfer's elbow. Let us know!

Best,

Matt

OK so no pain from straight plank training yesterday which is good news but they did twinge slightly from riding my bike home so that's out as well.

I actually thought I was taking GST at the right pace but looking back through my written training logs of PE1 GR and PU I don't think I appreciated the importance of these first stages and did actually rush through them if I'm honest, plus I was doing PE2 ground rows on my dinner break at work with a scarf hung over a rafter which I think has been one of the main causes due to the way I was gripping the scarf and reps being to advanced.

This has been yet another lesson learned the hard way through my own ignorance I guess so when I'm recovered I will be returning back to PE1's and wont advance until each stage is done with ease. Rushing only ever seems to cost more time!

I found and posted this on another thread a couple of weeks ago but think it's a great quote. 

''Happiness doesn't come from big pieces of great success, but from small advantages hammered out day by day''

I've also been doing this. It seems to help

A scarf over a rafter? I love it! That's very creative, Garry. Yes, tougher on the grip muscles for sure, but points for creativity when rings aren't available.

I, too, in hindsight, realized I rushed through the first few steps of this section. Upper body I rushed, but core, I managed to keep a reasonable pace in relation to my ability. Odd, yes? I'm bumping myself off of ground rows, back to incline rows today, after noticing my form on the proscribed incline rows during a CrossFit workout last night wasn't up to par.

It's good that we've realized this. It's better to take it slow, or even temporarily backwards, to do it right!

Good luck with your elbow. Don't rush it. 

Thanks Jennifer

I feel like a classic case of an ''if only'' person at the moment 

Does anyone know how jump rope effects the elbows? I do a lot of this but have but it aside as well just in case.

I read that @Winter Phoenix is a jump rope ninja! Is this something you have ever come across?

Hi @Garry Barker,

It is not something that I have personally come across. Generally, if you are jumping with the correct technique there shouldn't be too much movement in the elbows with most of the movement coming from the wrists. Do you feel aggravation in the elbow after you jump rope?

Can you share a video of your jump rope so I can take a look?

I also think that it was quite creative using the scarf and I love the fact that you are fitting in workouts during your dinner break that definitely scores points with me. When you have fully healed regressing your upper body work is a great idea. "The slow way is definitely the fast way". Don't be too disheartened this a journey that we are all on and there will be plenty of bumps in the road. Pick your self up learn from the experience and keep going this is the only road to success. 

Hi @Winter Phoenix

Thanks for the reply. I thought I was jumping with the correct technique but I've never actually had a look on a video so not so sure now, hopefully I haven't been adding to the problem with bad skipping form, it never even crossed my mind.

I will post a video tonight when I get home from work, It will be good to hear your opinion.

Thanks again!

Hi @Winter Phoenix

I noticed my right elbow flaring up during this It's a heavy rope and has 100g weight in each handle. I was doing between 10 and 15 mins 5-8 times a week.

I now wondering if this might be a one of the causes of the problem in the first place from to much to soon with the heavy rope and length of time.

Thanks again.

Hi @Garry Barker,

Thanks for sending in the video and nice set up in the yard - I like it!

Your form looks good so my question is what type of rope you are using and can you take the weight out of the handles? I would reduce the weight of this rope or use another style of rope to see if this improves the pain you are experiencing.

Thank for taking a look. At least it wasn't from bad form. Process of elimination i guess.

is this you by the way? I'm guessing it is may be because no 16 is called ''the winter'' what a trick either way!

Hi Garry,

Yes, it will be a process of elimination, let me know how you go with changing the rope. And yes that is me, I decided to name No.16 The Winter as I was trying to learn a new jump rope skill and wasn't sure of the name which is actually called "Fake EB" and for this video decided to claim it for FUN!

Winter what are the two different types of rope you use?

I've never been able to jump rope - have vague memories of being hit in the face at primary school! Maybe after foundation 4

Just ordered a new rope (Sporteq Cable Skipping Rope) , hopefully this does the trick and stops the aggravation so I can get back jumping and learning The Winter.

I read there could be GB jump rope cause on the horizon?

Hi @Garry Barker

You read right there is a GB Jump Rope course coming out that I am SUPER excited to be launching for you guys very soon! So keep checking GB social media for the release date.

And keep me posted on how you go with the new rope I have am not familiar with this brand so if you would like another recommendation then send me a message.

At last the pain has gone in my elbows after 4 months. After rest and rehab.

I haven't done anything apart from straight arm work for 1 month and want to start back on PE1 in push ups and ground rows but I feel really nervous in case it flares up again

I was just wondering if anyone could advice on how long to leave it before returning to training.

I've been pain free for 4 days and no tenderness when i touch the inner elbow.

Thank you 

Hi @Garry Barker, 

I suggest that you start doing PE1in HBP (incline pushups) using Step 1 to test how it will go. Assess it first. You are the only one who will be able to tell if they are ready or not. From experience, when I feel tenderness in my elbows and try to do the most basic stuff like HBP PE1, it really feels a lot better. Please keep us posted on how it will go.

Thanks Leo

I just didn't know if there was an certain amount of pain free time recommended before starting back on the PE1's

Will give it a few more day then give it a go.

Process for solving this golfers elbow typically goes like this. 

Phase one isometrics (1-2 weeks) : in full wrist flexion, supination, pronation & extension. I usually would prescribe 6reps of 6s isometrics in each position. Repeat 2x  (everyday 1-2 a day)

Phase 2 eccentrics(1-6weeks), thera bar works great for this, I would recommend start with their lightest, then progress accordingly (3-4 days a week)

phase 3 concentric/eccentric (1-4 weeks) : can be done with dumbells, would work flexion extension, supination, pronation, radial and ulnar deviation (use weight that you can do 2x10 with then progress upwards to 3x15 then bump up the weight)  (3-4 days a week)

* I have big time windows there as I dont know how bad it is. Sometimes it can be really stubborn, for me it took about 8 months but I was a very chronic situation (had it for over a year before I was actually put on a proper rehab program, lots of clueless physical therapist out there, or at least I saw to majority of the ones that dont really know how to treat tendonopothies)

Most important rule of thumb is, below 4/10 on the discomfort scale when preforming exercise. if you flare up big time after or the next day its a sign it was too much. Decrease load and try again. I would expect some dull aches 24-48 hours post workout but will eventually subside as the weeks go on. 

Also shoulder stability can be huge for helping prevent elbow issues later down the road. 

If you need I can provide greater detail

@Ryan Segervall this is pretty much what I give clients to do. The only thing to add is to be really strict on correct positioning of the forearm, so you can focus on the most sore part of the tendon. As you say, a bit sore during the exercise is ok. A bit less sore the next day is also ok. But really sore during/after means you need to decrease the weight, the time under load, the reps, or a combination of these.

I'm a bit all over with the rehab (I have to wait 6 weeks to get an appointment with a  physical therapist) so it's good to have a plan to work with. Will give this 100% 

Thanks for taking the time to write down advice @Ryan Segervall and @Nick Murray I know it's not the most exciting topic but probably one on the most frustrating! They flared up again after only biking 2 miles to work.

Ryan I don't suppose you know of any good Youtube videos for the Phase one isometrics (1-2 weeks) to follow?

Did you find heat and/or ice treatment effective?