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MemphisMechanic

Recovery from 'Shooters Elbow'

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Most of the range diaries here center around shooting. I thought it could be helpful to start one that focuses on physical therapy to get yourself in shape to shoot without pain.

Two weeks ago I ran across a link to Chad Reilly's advice on treating tendonitis in the elbow, which we refer to as shooters / golfers / tennis elbow. Hmm... a guy who finished 12th at Nationals and is a physical therapist who has fixed himself, Shannon Smith, and Rob Leatham? I think I'll give this a try.

About me:

  • Shooting IDPA and USPSA since 2007.
  • I'm a heavy equipment mechanic at my day job. Dozers, Excavators, bucket trucks...
  • (My job probably does far more damage to wrists and elbows than your range time does. They never fully heal.)
  • Currently returning from a 3 year hiatus from shooting, looking to make M in Production within a year. I dryfire 4 nights a week on average. So my shooting habit doesn't let my arms rest either.

The day after I found Chad's article, I went out and bought a set of dumbells from Academy sporting goods. The kind with the thread-on collars and an assortment of 2.5/5/10 lb weights. I intended to take Chad's advice to do these exercises every night, and I already skip the gym far too often.

So lets begin.

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Thursday, June 14 (Day Zero)

Physical condition:

This condition has slowly appeared over the past year. I'm 36. Just old enough that I notice aches and pains that didn't bother me when I took this job at age 30.

I find myself locking my left elbow in a half-bent position and pushing downward from my shoulder just to flush the toilet at work without pain.

Hanging either arm down at my side and locking the elbow joint out totally? That causes me to grit my teeth from the pain.

My left wrist has been tender for more than a year and a half. Your normal push-up position is a no-go for me. I do those on my fists at the gym, when I do them at all.

Exercise:

I find Chris's article, read it, and decide to go out and purchase a set of dumb bells for the house. I make the trip to Academy and do his four recommended exercises with 10lb weights. Starting myself out easy.

Edited by MemphisMechanic

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Friday June 15

Exercise:

Repeat exercises, as above, with 10 lb weights at all times.

----------------------------

Saturday June 16

Exercise:

Repeat exercises, as above, with 10 lb weights on first two sets and 15lb on final set. Easing into doing this with more and more weight.

Physical condition:

I can feel a difference in how much grip strength I have. It's small, but I think I feel it. Or want to.

----------------------------

Sunday June 17

Exercise:

All exercises done with 15-lb weights for all three sets.

Physical condition:

At a pool party over at a friends house, I estimate that my elbows hurt about 2/3s as much as I started at.

----------------------------

Monday, June 18

Exercise:

None. Rest day.

----------------------------

Tuesday, June 19

Exercise:

All exercises done with 15-lb weights for all three sets.

Physical condition:

Deteriorating. I'm replacing the sprockets that drive the tracks on a Cat D5H dozer. This involves torquing more than 45 bolts to 280+ ft/lbs. By hand. Curled halfway in a ball under the top edge of the tracks so that you can't straighten your spine and simply lift with your legs.

We'll see how long this job takes to recover from. I shudder to think were I'd be if I hadn't been working on my arms for the past week before starting this job.

Edited by MemphisMechanic

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Wednesday, June 20

Physical condition:

I can tell this is definitely helping. Aside from a pretty shitty physical activity at work giving me some aches and pains to look forward to for the next three days, I'm all but certain that the evening after this Saturday's match will be far less painful than I'm used to.

As I type this, my left elbow and wrist feel terrific. No pain at all unless they're really really pushed, and I'm lefthanded so this was the bad side when I started! I'd say a 50-75% improvement after just six days. My right elbow is throbbing pretty badly at the moment, but I'm pounding this out on my phone after wrenching on a breaker bar with a 36" pipe on the handle for 90 minutes straight. So I'm hardly surprised.

Exercise:

All exercises done with 15-lb weights for all three sets. (later tonight)

Edited by MemphisMechanic

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Thanks for the exposure, I hope this works out well. :)

I wouldn't sweat the pain from the pipe wrench, those things tend hurt for a few days but I don't think really set you back. I tell my patients to just keep lifting and shooting, and that it's better if they don't think of their tendinopathy and the ups and downs as a big deal.

Sounds like you are doing things about 90% like I do them so I expect it will work. Difference I usually do is, use each exercise with an easy set (kind of a warm-up) a medium set (where you are working pretty hard but technique is real clean) and a hard set (where when once you have worked up to, you can't get all 15 reps with full ROM or without a little cheating). Also I don't intend for all the exercises to be done with the same weight. Curls might be more than triceps, wrist curls should definitely be done with heavier weights than reverse wrist curls.

If you or anyone has any questions let me know. Oh, and don't let your doctor give you any shots!

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Chad, I consider myself just finishing the "warm up" phase with this. Unless I have a trainer observing, I usually do exercises with lighter weights until the proper form has been burned in.

I plan to start doing this "properly" after this weekend's match. The curls will likely be 25, 25, and 30 on the weights and then 15,15, 20 on the final two exercises. So I certainly plan to be lifting in line with your recommendations shortly!'

Thanks so much for writing that article and making these materials available for free. Again, I can't emphasize enough how much they have helped!

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You're welcome on the info, glad it's working for you.

Even if things aren't exactly like I do them, I think it should still work. I still experiment with variables to see if things work better or worse, but with everything working pretty well, it's hard to tell the difference. Most of the research on exercise and tendinopathy shows any exercise is better than none, so right now I think it's all about honing in on the right amount; resistance levels, sets, reps, exercise selection, rate of progression, etc.

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Difference I usually do is, use each exercise with an easy set (kind of a warm-up) a medium set (where you are working pretty hard but technique is real clean) and a hard set (where when once you have worked up to, you can't get all 15 reps with full ROM or without a little cheating). Also I don't intend for all the exercises to be done with the same weight. Curls might be more than triceps, wrist curls should definitely be done with heavier weights than reverse wrist curls.

That makes perfect sense, but I can vouch that even if all you own is one pair of 10lb weights (or 1 pair of 15lb weights), and even if they are in a froofy feminine color because you stole them from your wife's old aerobics gear from her 20's, you can see terrific results. I have literally zero elbow pain now. I pretty much just added the exercises to my very light 25 minute twice a week weight routine, and then I also use them for cooldown after dry-fire once or twice in between lifting.

Edited by motosapiens

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That makes perfect sense, but I can vouch that even if all you own is one pair of 10lb weights (or 1 pair of 15lb weights), and even if they are in a froofy feminine color because you stole them from your wife's old aerobics gear from her 20's, you can see terrific results. I have literally zero elbow pain now. I pretty much just added the exercises to my very light 25 minute twice a week weight routine, and then I also use them for cooldown after dry-fire once or twice in between lifting.

Yeah, I expect you are right. If you only had 3 lb or 5 lb dumbbells it might not work very well, nor would it probably work with only 50 lb, but 10-15s is probably getting in the ballpark. If I just had one fixed set of dumbbells I'd be inclined to progress by just adding reps. Maybe doing sets of 20 or 25 reps, instead of just 15 reps. I'm trying a new thing with Achilles tendinopathy where I just have people do single leg calf raises, 3 sets of as many reps as they can, and just adding reps as they get stronger. So far it seems to be working fine, and doesn't require any equipment other than a step.

I think you want to get the stress from the exercise higher (but not too high too fast) than it is during daily activities, in this case shooting, or else the tendons won't be forced to adapt positively. Too light a weights seems to be the case when most people go to physical therapy and the therapist is so worried about making things worse that they don't use enough weight to make things better, then they drop therapy, and get a cortisone shot that in the long run is worse off than no treatment.

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Well.

This certainly isn't snake oil, Chad.

Last week life got busy, and I got lazy, and skipped the exercises four days straight. The pain came right back to original intensity quite rapidly.

I've been doing the exercises the past two nights, and the pain is already fading. Weights have been 15/15/20 for the weights on the wrist curls/raises and 20/20/30 on the first two exercises.

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Last week life got busy, and I got lazy, and skipped the exercises four days straight. The pain came right back to original intensity quite rapidly.

I've been doing the exercises the past two nights, and the pain is already fading.

Yeah, that's an interesting phenomenon isn't it? I think it can take weeks to months to get the tendon to remodel and back to full strength, but the pain reduction is almost immediate. Years ago I used to do all the same exercises followed by massage and ultrasound and I thought the exercise made the muscles and tendons stronger, while the massage and ultrasound made the tendon feel better. It took me years to figure out that it was the exercise itself that makes the tendons feel better and the massage/ultrasound was doing almost nothing. Counter-intuitively the exercises didn't work unless the weights were heavy enough to really stress the tendon. Even having read all the research on the subject, I didn't get a true appreciation for how it worked until the last time I got 'shooter's elbow' myself. If I missed a few days of training my pain came back worse, but if I did the exercises daily, strength rapidly returned while pain dissipated. So it's really cool to see you are finding the same thing. I tell people to just "keep trudging," and way more often then not I tell them to "go heavier."

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I got it really bad last winter. I already lift weights but I started doing a lot of forearm grip training also this winter. I still have a little pain this year but not enough to interfere with my training. It just gets a little sore once in a while if I hit it hard. Last winter I could barely pick things up with my arm extended. Hurt like hell.

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On July 21, 2016 at 10:35 AM, badchad said:

Thanks for the exposure, I hope this works out well. :)

I wouldn't sweat the pain from the pipe wrench, those things tend hurt for a few days but I don't think really set you back. I tell my patients to just keep lifting and shooting, and that it's better if they don't think of their tendinopathy and the ups and downs as a big deal.

Sounds like you are doing things about 90% like I do them so I expect it will work. Difference I usually do is, use each exercise with an easy set (kind of a warm-up) a medium set (where you are working pretty hard but technique is real clean) and a hard set (where when once you have worked up to, you can't get all 15 reps with full ROM or without a little cheating). Also I don't intend for all the exercises to be done with the same weight. Curls might be more than triceps, wrist curls should definitely be done with heavier weights than reverse wrist curls.

If you or anyone has any questions let me know. Oh, and don't let your doctor give you any shots!

Where  can I find the article again?  Had elbow issues on and off for years from shooting.  Thanks

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Where  can I find the article again?  Had elbow issues on and off for years from shooting.  Thanks



There's a link in the first post of this thread.

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3 hours ago, fishsticks said:

 


There's a link in the first post of this thread. emoji41.png

 

Knew I missed something, to thank you 

Edited by JimmyN9
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Chad you ROCK.  Just what I was looking for Thanks for putting it out there.

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Interesting stuff! Chad, I am a PT as well. My focus is in orthopedic practice with a specialty in chronic and persistent pain. I believe you are tapping into the ideas of diminished threat with graded exercise exposure that are hallmarks of the pain science approach. Eccentric training for tendons is fantastic as well. Kind of combining the work of Bjorn Svenson with David Butler and Lorimer Moseley.

The pain reduction phenomenon is fascinating. I tell patients things like "you've got to move to improve" and "sore but safe." Finding new ways to facilitate comfort with movement is an ideal approach.

I am so impressed that this approach has been successfully applied to competitive shooting!

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Well I've had great success with chad's exercise routine over the last year or so, but somehow  managed to overcook my left (weak) elbow with a combination of hockey and dryfire. Discomfort is pretty much on the outside point of the elbow, and the main culprit seems to be stresses from handling a puck and torquing a hockey stick around left handed. I actually skipped hockey and dryfire both the last 5-6 days or so because the pain was starting to interfere with daily activities. I'm hoping I was just lazy with the exercises (only doing them 2-3 times a week usually), so i'm going to start back in with the exercises today and see how it goes, but i'm going to wait and verify i'm  really getting better for starting back in on hockey.

I don't play during the summer, so my theory is that starting back into hockey 2x a week may have been a bit much, especially since i'm actually handling the puck alot more this year instead of just skating around like a doofus beginner.

 

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Owww. Dry firing with the intention of only doing so with HARD grip. Weak left elbow is bothering. But, it's ftom the outside of the elbow and going up the upoer arm triceps.  if I press down on that tendon and flex....ouch!

These dumbbell exercises will help?

 

 

 

 

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Chad definitely knows what he's talking about!

He has helped me with "shooter's elbow" indirectly through his website and directly via email for insertional Achilles tendinopathy.

The Achilles injury was bothering me for over a year and was so bad I sometimes couldn't walk, let alone shoot a match. When I was training, I wasn't working on explosive movement for fear of reinjury, which usually happened to some extent at every match.

I am now pain free in both areas most of the time... and have totally pain free days/weeks if I remember to keep doing the exercises regularly!

Now I have no excuse not to work on movement skills.

Sent from my SM-G900P using Tapatalk

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On 1/7/2017 at 10:11 PM, johnbu said:

Owww. Dry firing with the intention of only doing so with HARD grip. Weak left elbow is bothering. But, it's ftom the outside of the elbow and going up the upoer arm triceps.  if I press down on that tendon and flex....ouch!

These dumbbell exercises will help?

We talk via text from time to time, so I know you started doing these.

 

How carefully have you been following the "every day" recommendation, and has it helped?

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I'm going to give this a try. I had to give up shooting my favorite,... Single Stack (major) because of tendinitis in both my elbows. 

As a sheet metal worker I've had carpel tunnel surgery on both hands and have been battling tendinitis in my elbows for the last fifteen years. Throw shooting fifteen to twenty thousand rounds of .45 ACP in a year and I finally had to put up the white flag. ☹️ 

 

Wish me luck.

Thanks

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On ‎7‎/‎20‎/‎2016 at 9:17 AM, MemphisMechanic said:

Most of the range diaries here center around shooting. I thought it could be helpful to start one that focuses on physical therapy to get yourself in shape to shoot without pain.

Two weeks ago I ran across a link to Chad Reilly's advice on treating tendonitis in the elbow, which we refer to as shooters / golfers / tennis elbow. Hmm... a guy who finished 12th at Nationals and is a physical therapist who has fixed himself, Shannon Smith, and Rob Leatham? I think I'll give this a try.

About me:

  • Shooting IDPA and USPSA since 2007.
  • I'm a heavy equipment mechanic at my day job. Dozers, Excavators, bucket trucks...
  • (My job probably does far more damage to wrists and elbows than your range time does. They never fully heal.)
  • Currently returning from a 3 year hiatus from shooting, looking to make M in Production within a year. I dryfire 4 nights a week on average. So my shooting habit doesn't let my arms rest either.

The day after I found Chad's article, I went out and bought a set of dumbells from Academy sporting goods. The kind with the thread-on collars and an assortment of 2.5/5/10 lb weights. I intended to take Chad's advice to do these exercises every night, and I already skip the gym far too often.

So lets begin.

there is a fella on youtube whos channel is called smashwerx...his advice, and rehab videos have saved my lifting and shooting careers...

 

 

this is just one video...but he has 100's of them..

 

the bench

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16 minutes ago, benchmstr said:

there is a fella on youtube whos channel is called smashwerx...his advice, and rehab videos have saved my lifting and shooting careers...

 

 

this is just one video...but he has 100's of them..

 

the bench

 

UGH! Trevor is KILLER!!  Your gonna be sore!! But you will get better afterwards.

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