tennis elbow

[samster]

I've had this progressively worsening pain in the elbow of my weapon arm. My doctor tells me it's "tennis elbow" and I got it from fencing.

He recommends anti-inflamatorys, heat/ice, and rest.

All well and good, but it hurts like the dickens. Can no longer lift much of anything with that arm.

Has anyone else had this? and what did you do about it? How long did it take to go away? etc. etc. etc.

Thanks in advance.
-Sam

[Inquartata]

Yeah, I've had various degrees of it, off and on. I am fencing with a mild case right now, in fact. Wearing a brace or strap helps some, mostly so you don't keep stressing it when fencing. ( Because that "rest" business is right out! ) Aspirin. Ice.

Nothing seems to work completely or in an acceptable amount of time. I find that eventually I weary of babying it and starting to get out of condition from not lifting weights, and I just say "Screw this" and resume a normal routine and ignore the pain. Whereupon the condition usually surrenders and heals itself. But I wouldn't recommend this for anyone else, it may be idiosyncratic to my particular muscle-bone-tendon arrangement...

[Zilverzmurfen]

I too have had it on and off. (Nothing in the last year or so, thank God.) It does hurt like hell, but it's very treatable so do not despair!

It's also been discussed many many times; if you do a search for "tennis elbow" you'll come up with a number of threads discussing different ways of treating it.

[Monash_Armourer]

Cover your bases and make sure it IS tennis elbow. Ask for a referral from your doctor and go get an x-ray, if you've not already done so.

I initially had what everybody thought was tennis elbow. Funny thing, when I did all the stretches I was instructed to do, it got much much worse. That was because it was in fact a tiny piece of bone that I'd managed to chip inside the joint somehow, which was rubbing against and inflaming one of the tendons. I now seem to have slight nerve damage that affects my pinky finger, probably because it was only correctly diagnosed and operated on 8 months later.

It probably is tendonitis, but better safe than sorry.

[Greg]

I had it last fall and it got really painful after too much fencing in a short period of time. Just like you describe, it was very difficult to lift anything let along a foil or epee. It took about 6-8 weeks to recover fully after being diagnosed by my doctor. I did PT involving light weights every day and used a strap that put pressure on the affected ligament (see WebMD). Rest and ice were also used. It will clear up, but just takes time. Don't ignore it though. My doctor told me gets a lot of manual laborers - carpenters, contractors, etc. - who work through it (because they have to) and don't seek treatment until a year or even longer after it started. By then, the elbow is permanently damaged.

[Downtown]

I noticed mine got better during Thanksgiving. You should use the holidays as a time to rest if you can.

[OROD]

For the last couple of years I had Golfers Elbow (like Tennis Elbow, but on the other side of the elbow). Due to extreme laziness I havent gone to the doctor, but I somehow got it to mostly go away. I did that by taking 2 Advil each time before going to fencing practice, and sometimes by icing it afterwards. Oh, also by not flicking anymore, since it's the lateral movements that really hurt.

.

[edew]

Do some weight training, such as bicep curls and other curls with free weights. Take a 5 lb weight and hold the arm out and twist the arm 180-deg (or slightly more), slowly for ten reps or so. Hold the weight palm down and curl the weight upwards (flexing your wrist backwards like you're doing a heil hitler salute with a closed fist around a weight).

Do it at least twice a week for 3 sets of 10 or so.

As for the flicking part, get a blade that isn't too stiff for flicking. I once had a very stiff blade that when I tried flicking, I would get tennis elbow that lasted months even after I stopped using the blade. I no longer have that blade as I permanently bent it out of shape so I don't get to use it again. (It's too stiff for me to break.) It was like trying to flick a baseball bat. And even hitting with thrusts didn't help. All actions with that blade (and I had 4 of them!) were painful.

[pinkelephant]

Be careful about carrying on. I did just that, and over-extended the shoulder in compensation for not being able to extend the arm at the elbow properly. Now the shoulder needs sorting out.

The first time I had it it took about 6 months to heal. I measured my progress by the fullness of the bottle of wine I was able to lift with a straight arm!

[samster]

Many thanks for the comments/suggestions/warnings everyone. Not to wish unwell on anyone, but it helps to know that I'm not the only one with the issue.

[Ordway]

Don't ignore it, don't fence through the pain. Rest alone won't do it. Anti-inflammatories alone won't do it. See a physical therapist, strengthen your arm muscles, and get the rehab you need.

I had "fencer's elbow" in the spring and tried to fence through the pain. Bad idea, bad idea, bad idea. After an agonizing wipeout in the Tucson NAC I ended up having to take 8 weeks off without even picking up a blade. I'm back to normal strength now - no pain while fencing - but that was because I got serious about rehab. PT once a week, weight exercises every day, stretching, ice, rest.

The longer you wait to get therapy, the more scar tissue builds up. Scar tissue = pain. Some pain is good pain, some pain is bad pain. Tendinitis pain is bad pain.

[TBean]

Tennis Elbow rarely goes away if you continue to fence, you simply manage the condition.

I have been coping with it for the better part of ten years - lots of experience here. First, have you gone to an orthopod? You need x-rays and/or an MRI to determine what is really happening in your elbow. Try and find someone in sports medicine and not a surgeon. Second, rest. Really rest - this is not a couple days off, when my elbow inflamed this past summer I took over 12 weeks off. I suggest, to stay in shape, fencing with your off-hand. It keeps you in the salle, in shape and thinking about fencing. You will be suprised when you switch back. Third, push for some PT. They really can help get you over the severe inflamation much, much faster. The ultrasounds and stim. can help. Fourth, when you do get back to fencing, watch your form. You must be hyper careful about making sure your elbow is not swinging wide. If you work with a coach, have him work with you on basics to be sure you are doing them correctly with the elbow in. Finally, make other adjustments in your life to be sure you are protecting the elbow from further injury. If you do not already, switch to mousing with your non-dominant hand, do as many things as possible with your non-dominant hand. And when you do things with your dominant hand, make sure you are protecting the elbow.

Braces can and do help. Remember, however, they are not curing the problem. They are simply transferring the muscle load to another group. There is the classic brace for the forearm, but you might also think about something that immobilizes the wrist - the two are often tied togehter. (she sings .... the wrist bone is connected to the elbow bone.) This past time for me, the wrist brace has helped a lot.

Don't try and fence through the pain. The last time I did that I was out of fencing for the better part of nine months. Give this the rest it needs to really feel better and them build back slowly.

Good luck.

[parrythis]

Treatment: ice and anti-inflammatories. My favorite is naproxin sodium, but different ones work better or worse with different people.

Prevention: What grip are you using? Have you considered trying a different one. Undue stress in the fingers can have an effect on your elbow. Try having a coach or other experienced person look at your form. I have incurred many fencing-related aches and pains over the years and most, if not all, could be traced to something that I was doing incorrectly. Figuring out if this is the case all by yourself can be difficult.

[DonnaP]

Samster,

This is a topic that drives me to drink!! This is what I do for a living and so here are my two cents..

1. You don't get your medical advice from an on-line chat board.
2. "Lateral Epicondylosis" (commonly known as tennis elbow) if that is in fact what you have, is NOT an inflammatory diagnosis unless you have had it for only a few weeks or so - for the majority of people with this, it is a chronic condition. Therefore, inflammatories and ice are going to be of little help - except for some people they may offer interim relief.
3. It's not really an elbow problem - it's a wrist problem that everyone thinks is an elbow problem - the elbow is just where the muscle attaches to the bone. (don't worry - I'll explain in a minute)
4. Current quality medical research has identified that the diagnosis is more of an angiofibroblastic issue - in common terms, a bunch of biological scar like gunk, that develops on the extensor carpi radialis longus (if you put your arm out in front of you with your palm towards the floor and lift your wrist up toward the cieling - the muscle that bulges up near your elbow is that one - it attaches to the elbow but the other end attaches to the wrist - what does it do?..... it bends the wrist up) So - anything you do that requires you to use your wrist will cause pain at the elbow - such as pour milk or coffee, lift groceries from the cart or car trunk, pull wet laundry from the washing machine, hold a fencing weapon - especially an epee!
5. What do you do?? There are so many treatment options out there and all of them have helped someone at one time or another - bottom line - no hard core research proves any of it works better than any other - everything is antidotal. So here are some facts....
6. The single one thing that seems to work is time. (sorry - not the answer anyone wants) - check the research - it's the only true answer. Change how you do activities. Only lift using your elbow and keeping your palm facing the ceiling at all times - for about 2 - 3 months. If that doesn't work for you here are some other options:
- If you want to use ice, use it around the elbow region itself, follow the crease of the elbow out to the bony prominence where the pain is and ice the tendon there.
- If yo want to use heat - best to use it over the muscle belly - so go about 2-3 finger widths down fromt the elbow crease and put the heat there over the bulky part of the muscle.
- If you want to use anti-inflammatories - fine, but using them here and there won't really do much for the swelling as you need to maintain a blood serum level for 7 - 10 days at least to make much difference.
- The "forearm bands" can help, but most people don't wear them correctly anyway so they are useless. IMO the only ones that really work are the ones with the pillow in them - but it must be kept over the muscle/tendon junction (about 2-3 finger widths from the elbow crease).
- Steroid injections can make a huge difference, however, there are docs who know how and where to put the shot, and those who don't. I would only let a specialized surgeon inject me - sorry, but I don't think the primary care docs really know how to do it right. The type of steroid they use also makes a difference - there are many different kinds, each with different properties.
- Wrist splints can help, like the ones in the stores, they keep your wrist immobile and therefore stop you from abusing the wrist extensor muscles so much, which decreases the pain.
- Some others; yoga, electrical stimulation with steroid medication, passive stretching (which I believe makes some people worse and can aggrivate the radial nerve which lives right next to the wrist muscle), massage, vitamins, skin rubs such as Biofreeze or Sombra, the list just goes on and on.
- Personally, I believe that strengthening is just about the worst thing you can do while you are symptomatic (in pain). Try this test - take a gripper or tennis ball, put it in your hand, put your elbow at 90 degrees next to your body and your palm facing sideways (your pinky should be facing the floor) and squeeze it as hard as you can. If you don't have much pain - great - now put your arm out straight in front of you - elbow completely straight - palm facing the floor and squeeze the ball as hard as you can - does it bring on the pain in the elbow?? If so, don't start any weight training until you can do this without the pain. Then once you do start strength training, go slow and easy - it can take several months to get back to even 5 pounds of wrist motion with strengthening.

Just make sure you have epicondylosis and not radial tunnel syndrome or any other possible diagnosis that may have overlapping symptoms.

Good Luck

[piste off]

It might be traced to how you fence. Also, which weapon do you fence?

Are you constantly getting caught on your opponent's blade (e.g. in six)? Do you fence with the lightest weapon possible?

Rick

[samster]

Originally Posted by DonnaP

Samster,

1. You don't get your medical advice from an on-line chat board.
...
Good Luck

Duly noted. Despite your advice (and its merits), I sincerely appreciate everyone's comments. I've already called a physical therapist for an appointment.

Thanks again.
-Sam

[hello?]

I started having 'fencing elbow' a couple of months ago. One night it was bad enough for me to ask my coach to stop a lesson. I went to a chiropractor (at least two times a week for the last month) and it has actually helped a lot. She doesn't really do the 'cracking' I usually associate with a chiropractor. She stretches my arm and does something that I think is called "grafton technique." Basically, with a tool that resembles a butter knife, she rubs (more like "grates") around the elbow. Anyway, for what it's worth, it's helped a lot. (I also try to ice after practice.) I was able to fence (if you can call what I did this weekend 'fencing') three epee events in Richmond without the elbow being a problem. The pain is definitely not gone but it is greatly reduced...

[Beloit Fencer of Old]

Originally Posted by DonnaP

Samster,

This is a topic that drives me to drink!! This is what I do for a living and so here are my two cents.. [snip]

5. What do you do?? There are so many treatment options out there and all of them have helped someone at one time or another - bottom line - no hard core research proves any of it works better than any other - everything is antidotal. So here are some facts.... [snip]

Good Luck

Antidotal or anecdotal? Totally different meanings.

[keith]

Originally Posted by Beloit Fencer of Old

Antidotal or anecdotal? Totally different meanings.

.... but in context it works either way - either everything does work or it is all hearsay. Both readings are supported by the text.

[bunbury]

Originally Posted by keith

.... but in context it works either way - either everything does work or it is all hearsay. Both readings are supported by the text.

Considering how he's talking about how everything works, I'd go with him meaning antidotal.