Tennis elbow

[Morrisette]

I seem to have tennis elbow (have been to the doctor so pretty sure that's what it is). I have no real idea how I've got it, I don't do much heavy lifting (no kids for instance) and my job is desk-based. Using keyboard/mouse doesn't seem to affect it unless I'm working all day with the mouse (which I rarely do). Have tried (at doc's suggestion) ibuprofen gel (which did nothing), and taking ibuprofen in the morning (which helps a bit, but I'm wary of taking it for weeks at a time).

The problem is I have a bad feeling that cycling is making it worse. As this is how I get to work, it's very far from ideal. I do a train-bike commute at the moment, on a folding bike which is probably not helping (braking is painful, as is riding into a headwind or uphill, I seem to grip the bars which causes pain). The alternative is the bus, which I did for 4 days two weeks ago to try and rest the elbow - and I'm still ill (I always catch some lurg whenever I'm forced onto the bus, they are so filthy, this time it's two weeks of a hacking cough and hardly any voice with no sign of improvement - I CANNOT have months on the bus).

My question is has anyone had this and successfully healed it? I seem to keep tweaking it. I've had suggested heat pads, an elbow brace, compression band around the lower arm - are these worth a go? Would a sit-up-and-beg type bike help? I think I need to get weight off my arms, though the pain seems to be from gripping - braking feels the worst.

Essentially I need to be able to ride!!

[barakta]

I know folk who have found a compression band round the arm has helped a bit.  I thought NSAID gels had been debunked as bollocks. Ibuprofen helping a bit suggests it might help.

Could you afford a session or two of private physio? They may be able to advise you specifically on this as they tend to understand 'exercise' which cycling totes is in their eyes. I found physios more willing to accept "I cannot stop doing task X, I have to work out how to do it 'safely'" (in my case, typing). Physio may also have a view on whether a better NSAID short term is a good plan.

And sympathy! I've got various elbow (and wrist) nonsense in my one good arm and it's everything from painful to bloody annoying and debilitating. Reminds me I should try and restart some physio in case it helps.

[Palinurus]

I had it once, not sure what brought it on (first noticed it after doing some light strimming!). I didn't want to stop cycling. The doctor gave me some gel and a photocopied sheet with some excercises to do, eventually it went away and hasn't returned. I continued cycling throughout. No idea whether the excercises worked or whether it would have fixed itself anyway.

[Palinurus]

I also used a compression band, did seem to be less twinge-y with it.

[Tim Hall]

I've had it a few times, brought on initially some years ago by ice axe use.

Poor posture at my desk, combined with key board use has been the most recent suspect, so I adjusted seat height, moved keyboard etc.

For treatment, as advised by my GP, I use one of those elasticated giant tubular bandages, doubled over. Occasionally I tuck a cold pack in too. (Skinflint cold pack: tack a J cloth, moisten it, place in ziplok bag, place bag in freezer. Mould frozen J cloth/bag assembly to arm contour.  Avoid direct skin contact by tucking it between the layers of the bandage. I gobble the odd Ibuprofen too.

In your place I'd look at changing hand position on the bars and relaxing the Grip of Death.  Is it a flat bar or drop bar bike?  For the former, might bar ends work?

 

[L CC]

I've had it a couple of times and it was cured by the steroid injection in the elbow which isn't really recommended any more?

It started when I thwacked my elbow coming off a motorbike (don't ask, I was 'learning') and was exacerbated by a lot of milking- which I hadn't done for a while and then ramped up to twice a day 400 cows pretty quickly- no time to get used to it.

Second time It was triggered by carrying shopping bags. Never had trouble on the bike.

[Kim]

Learn to mouse with your other hand and/or spend some quality time learning to drive your software by keyboard.

Made a real difference to my wrist.

[Morrisette]

Thanks all. I will try the compression bandage type things, they seem to be worth a go.

The only advice I got from the doctor was to use ibuprofen gel, which as far as I can tell doesn't do anything.

[rafletcher]

Cycling doesn't usually exacerbate it - unless you honk everywhere by pulling on the bars.

Ibuprfen gel at least delivers the drug a bit more locally. Wash your hand after using of course. I used the bandage/strap thing too.   Not sure either it or the gel did too much - stopping using the rowing machine did more good, for the elbow at least.

[Paul]

Learn to mouse with your other hand and/or spend some quality time learning to drive your software by keyboard.

I had golfer's elbow 10 (or more) years ago. Golfer's elbow manifests itself on the outside of the elbow (I gather tennis elbow is felt nearer to the inside of the elbow (the elbow pit?).

I don't play golf. I was really worried - it made cycling very painful. In desperation I bought a bent. My elbow didn't hurt riding the bent because there was no pressure on it, but I never really got on with it.

Then I switched mouse hand (might even have been after reading responses to a similar post elsewhere) and the golfer's elbow stopped quickly. It took me about 2 weeks to learn to 'mouse' with my left hand. I had to be really strict with myself, and not allow me any time off, but it worked. And the pain when riding my straight* bikes disappeared too.

(*What?)

[hellymedic]

I think Paul has it the wrong way round.
Tennis elbow affects the point on the outside of the humerus where the muscles that lift the fingers and wrist attach (common extensor origin).
Golfers' elbow affects the common flexor origin on the inside of the elbow, where the muscles that bend the fingers attach.
Sometimes these afflictions come and go at random, sometimes it is helpful to take the strain off the affected muscles with a band or by strengthening others.
It is always helpful to avoid provocative actions for a while.

[Paul]

I think Paul has it the wrong way round.

Just checked: I have got it the wrong way round. But that is what I was told by a GP/physiotherapist. I know because I'd never heard of golfer's elbow before my diagnosis.

[hellymedic]

Partner had golfer's elbow, brought on I think, by injudicious weightlifting and wheelchair hoiking.

Physio with those long elastics, rest and time seem to have cured it.

[Asterix, the former Gaul.]

A friend has it and I've heard she is having acupuncture.  I will try to find out more and report back if useful.

[campagman]

I had golfers elbow brought on by overuse and then I did nothing about it for too long until it became unbearable. I avoided exercise that aggravated it the most and applied ice. It took a long time but did eventually go.

[rogerzilla]

I got it when I was doing a lot of painting and roller work on the house.  It went away after a few weeks.  More recently, I got it by hand grinding my own coffee; I started buying ready-ground beans and, again, it went away after 3 weeks.  Any reasonably forceful repetitive movement can set it off.

My father had tennis elbow from playing badminton and it was cured after a weekend's hard tiling!

[Morrisette]

This is the thing - I don't know how I have done it. I don't really honk on the bars of my tiny folder (and there's no hills in Cambridge). It really hurt at the weekend when I'd been doing....nothing much. Pulling a rolling suitcase with that arm seemed to aggravate it (I know, such a first world problem), as does lifting the bike (as in onto a train or over a step) with my right hand under the saddle. But these things REALLY aren't strenuous! Neither are they 'new' activities - same bike, same suitcase, same commute. It might be computer mousing I suppose (I have a week off next week so I'll see if it gets better with no mouse work at all). But all this sounds a bit pathetic - weren't we designed to be able to kill mammoths with our bare hands?! Throw spears and so on? So knackering a tendon pulling a suitcase along on a nice smooth tarmac surface or lifting a 10kg weight seems a little bit, I don't know, wussy.

[chrisbainbridge]

Tennis elbow is not caused by anything.  It is a micrioangiopathy of the tendon and bone insertion site.  Just like arthritis is unrelated to use so is tennis elbow.

However if you get tennis elbow then any activity which stresses the tendon will hurt.

Change the way you do all lifting and carrying.  Use an underhand grip with the palm facing upwards.   This immediately unloads the ECRL tendon.

Then buy an epicondylitis clasp off amazon or eBay and use it.  Each morning adjust the clasp to give least pain on power grip.

Stretch the arm for 1 full minute by the clock every couple of hours.  This means relaxing shoulder and arm so jam the arm over a kitchen chair and relax the arm as you stretch it with the other hand.

DO NOT  under any circumstances have a steroid injection.  They produce (probably) some immediate improvement BUT definitely make it more likely that you will have long term serious problems.  GPs did not inject tennis elbow until they started being paid for doing them!

95% of tennis elbow will settle spontaneously in 3-12 months but may recur slightly in years to come.

You could kill Mammoths with spears but died before the tennis elbow!

[Dafydd's Dad]

Might help.

https://sites.google.com/site/healgolferselbow/

[chrisbainbridge]

the problem with all such sites is that any condition with a limited duration will "respond" to treatment.  All the scientific evidence shows no benefit to exercises in terms of duration or severity of symptoms.

[Dafydd's Dad]

Helped me when the tendinitis was bad!

[Asterix, the former Gaul.]

DO NOT  under any circumstances have a steroid injection.  They produce (probably) some immediate improvement BUT definitely make it more likely that you will have long term serious problems.  GPs did not inject tennis elbow until they started being paid for doing them!

Pleased to hear that as it's almost exactly what my GP said about an ankle injury that was lingering. He prescribed exercises, a long job but effective.  He would have given the injections if i had insisted.  Glad I didn't!

No news on the acupuncture I mentioned - early days.

[Morat]

I'm suffering a bout of tennis elbow, but I've found that it is improving now that I've changed my sleeping position. I tend to sleep with the palm of my hand under my cheek which seems to stress the outside of my elbow. In changing sides and position I've noticed a slow improvement.
This is probably completely irrelevant to you, but I mention it because I couldn't figure out what was going on and it took a while to identify what part of my normal routine made my elbow hurt.

[arabella]

This ^ triggers a hazy memory of something hurting and eventually being resolved by a change of posture/rearrangement of the pillows on different beds.  So the elbow may be a symptom with some non-elbow cause.