My qualifications: physician, tennis player (USTA 4.0 - low B grade), and
fencer with tennis elbow caused by fencing. My orthopaedic surgeon is the
onsite doc at major tennis tournaments, so he is somewhat of an expert in
tennis elbow. He knew a bit about fencing - his roommate in college was a
fencer.
Different grips can help, although some say get larger, some say get
smaller, at least for tennis. Probably, there is some biomechanical problem
that is causing the symptom, and changing grip changes the biomechanics
enough to get rid of the problem.
For fencing:
REST - Stop fencing. Yeah, yeah. If it is bad, the patient may have to
stop fencing for 6 months or a year. I stopped for 4 months (I had knee
surgery at 2 months), and by the end of my first bout, it was hurting again.
More on that later.
STRETCH - perhaps even ten times per day. With the elbow straight, flex the
wrist (bend it towards the palm) and hold for 30 seconds. Repeat twice. As
you get used to it, rotate the hand into more pronation (palm down, or even
further so that the palm goes all the way to facing out) and bend the
fingers into a fist. Initially, you tend to feel the stretch at the back of
the hand, then the wrist, then the forearm and finally near the elbow.
You should probably also stretch the flexor muscles of the forearm, which
attach to the medial epicondyle. Again, elbow straight. With fingers
straight, and hand in supination (rotate palm up), extend the wrist
passively by pressing up against a wall, or you can just use the other hand
to grab the fingers and bend the wrist back.
EXERCISE - With a dumbbell in the hand, rest the arm across a bench or table
with the hand over the edge, palm down. Bend the wrist up and down lifting
the weight. Do 10-15 repetitions, rest a bit (do the other arm then), and
then another two sets. Do this once or perhaps twice a day. Start with a
low weight, and when you can do 15 reps without pain, increase the weight by
1 pound.
Do the same thing with the palm up, to exercise the forearm flexor muscles.
I am not sure of the clinical justification for this, but the PT and ortho
folks seem to recommend it. There is a version of tennis elbow that is
medial epicondylitis that I have read about by never seen. Perhaps this is
preventive since the patient has already exhibited a tendency to that type
of injury.
And now for the more later. When I went back to fencing and got immediate
symptoms, the symptoms were a bit different, with pain distal to the elbow
in the forearm rather than right at the lateral epicondyle. With Gray's
Anatomy and some poking around, I figured out that it was the muscle
extensor indicus which extends (straightens) the index finger, and perhaps
to some extent the larger muscle that extends all the fingers. A couple of
old fencers knew about this, and suggested a finger extension exercise where
you wrap a rubber band (or two as you get stronger) around the ends of the
fingers and thumb, and work at extending the fingers. If, like me, you have
an index finger problem, isolate that finger and extend just it.
COMPRESSION - Wear the tennis elbow wrap. Some people think this is voodoo,
but the one time I did not wear mine, I hurt for two days afterwards. It
probably does no harm, and it may help.
ICE - Ice it down after exercise, especially after fencing. I have a cooler
in the car with a few blue ice packs and a drink. On the way home, the ice
goes on the arm and the knee, and the drink is good too.
MEDS - Anti-inflammatory drugs are good. Things like ibuprofen (Motrin,
Advil) or naproxen (Aleve). I like naproxen because you only need to take
it twice a day. There are others for which you need a prescription. Do NOT
use them like pain killers. Take them regularly for a while, until the
inflammation has settled. If you get indigestion/heartburn from them, stop
taking them and see a doc.
DOCTOR - sounds like the patient already has one. The doc can prescribe
stronger anti-inflammatories, or pull out (stick in) the big gun of a
steroid injection. Note that some people get a "steroid flare" that makes
it hurt like hell for a couple of days.
FENCING - start slow. Wave the blade around. Easy stuff frequently to
start. The problem is caused by contraction of the muscles that you use for
parry 6, counter 6, or resistance to pressure in that direction. I think
mine started because my parry 4 was too big, and I had to haul the blade
back into line. Instead of parry 6, use a circle 4 parry.
Good luck!
Peter Harrison
"Reptile" <a9600006@unet.univie.ac.at> wrote in message
news:67c6a51.0305130700.144bf5b4@posting.google.co m...
> >
> > Any suggestions?
> >
> > Thanks!
> >
> > Steve Behrends
> > Des Moines Fencing Club
>
> a clubmate of mine got rid of it by using a softer, larger allstar grip
(saber).
> this was a tip from his physician and it helped 
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