Tennis Elbow- My trials and tribulations

[SquibRound]

I have recently experienced a severe bout of tennis elbow (shooter's elbow), which has been a somewhat recurring issue for me. This episode however was the most severe I have ever experienced and actually interfered with my shooting and work. Since I am still actively recovering from this condition, I thought I would add my experience with various treatments for the benefit of the forum.

I aggravated the condition by repeatedly drilling my presentation, which I had changed slightly in the way I acquired the initial grip on the pistol. The new method stressed the extensor muscles of my forearm and after a week or so of daily dry practice I was slightly sore. Not to be a quitter I of course kept at it, and predictably really inflamed the condition. It was at thais point that I left for a 4 day stent at Frontsight for the combat master prep course. I spent the four days doing presentations all day. By the completion of the course I literally couldn't move my strong-side arm without severe pain. A handshake became an intolerable social activity. The outside area of my elbow was swollen and warm, and the entire are of the lateral epicondyle (bony bump on the outside of the elbow) was exquisitely tender. The condition at that point was now significantly interfering with my work, and I could not shoot, so I felt I really needed to do something other than ignore the condition (my usual first line treatment).

I do have a medical background, and I do have access to several Orthopedic surgeons and Physical Therapists whom I hold in high regard. In shooters the problem is due to mico-tears and strain of the extensor tendon/muscle complex. The ligaments of the lateral elbow can be torn/strained as well in this condition, but this is usually with more stress such as with racquet-sports. After some significant R&D I began the following program which has been wildly successful:

WEEK 1-2

1. Stop doing the activity that caused the problem.... This was the worst part of the treatment, but I did lay-off for 2 weeks.

2. Stretch the extensor muscle/tendon complex every morning, every night and whenever I thought of it during the day. I did this by hyper-extending my elbow, flexing my wrist as I rotated my wrist away from my body and compressed the flexed wrist to put a bit more stretch on the tendon/muscle.

3. Ice the outside of the elbow every evening, as well as during the day if possible. I would put a thin cotton sleeve over the elbow, followed by the ice-filled plastic bag which I kept tightly applied to the elbow with an ACE wrap.

4. Anti-inflammatory meds (OTC) religiously.

5. I purchased a ACE brand tennis-elbow brace. I always thought these were placebo, but they really work, and the Orthopedists I spoke to all used them as well (all 3 surgeons suffer from the condition!?!). Evidently the compressive brace redistributes the force of the extensor tendon away from the lateral epicondyle and over a broader area.

WEEK 2

6. I got two fairly thin rubber bands and placed them around the outside of the fingers of the affected hand and began 10 rep sets or finger extensions. I did this in the car on the way to work and back. Once I started to feel better I did this during the day a few times as well. Be careful with this when you first start the exercise. If it hurts a lot, stop and rest some more, you are not ready yet. Over the course of the last 4 weeks I have slowly added resistance in the form of additional rubber bands (I'm up to 4 bands now).

7. I had an injection of the lateral epicondyle- cortisone/marcaine. Hurt like hell, but it was definitely worth it. In two days it felt like I never had the problem, which is the problem with the injections. Most knuckle-heads will then go right back to the activity that caused the problem in the first place like nothing ever happened and screw the pooch royally (don't be that guy).

8. Re-started shooting with special attention to form- and yes, I did adjust my pistol grip to avoid the stress from my ill-conceived new technique.

9. stopped the ice in the middle of week 2.

WEEK 3-4

10. Added exercise with the Theraband Flexbar. The instructions on how to use this wonderful device are on Youtube. I purchased the green level flexbar (15 lbs resistance). I highly recommend this device- it has really worked well. I started with three 10 rep sets about three times a day, and have worked up to 20 rep sets done 6-8 times a day over the course of 2 weeks.

11. Stopped the anti-inflammatories this week. Still doing the stretches, rubber-bands extensions and tennis-elbow compressive brace.

WEEK 5-6

12. Added active extension exercise to my Theraband Flexbar sessions. I do a 20 rep set of the eccentric contraction (muscle-lenghtening when the flexbar pulls on the wrist) and added concentric contraction- what you would consider "normal" muscle-contraction exercise, by twisting the Flexbar against the twist (Look at the Youtube video, it will make sense). The first week I did 5 reps concentric for every 20 reps eccentric. Week 6 I increased to 10 reps concentric for every 20 reps eccentric.

WEEK 7-8

13. I plan to increase the concentric reps over these two weeks to 15/20 and 20/20 for weeks 7&8 respectively.

14. I will wean out of the tennis-elbow brace for all activity except very stressful forearm exercise.

WEEK 9

15. Plan to start wrist extension exercise with free weights.

16. Plan to start using grip-strenght exercisers. Both of these activities I will take very slowly.

Things I learned: 1. Don't ignore tennis elbow- if it becomes truely chronic you are in for a major issue that may culminate in surgery.