North's Tendinitis update

[North]

Well, I had surgery for tennis elbow back on May 9th. I have been doing my physical therapy by the letter. I have taken it easy, no shooting for 3 months.

Unfortunately it appears that I also have something (Tendinitis) wrong in my triceps as well, so when I squeeze my fist or grip anything when my arm is at or near full extension I have some pretty intense pain back part of my elbow. Forget any strong hand only shooting.

So they are changing up my physical therapy, ordered an MRI, and follow up in 4 weeks. They said this type of Tendinitis usually heals its self if you take it easy, but I have been for the past three months. (I was in a cast for three weeks) I have been fighting this for a year now.

Looks like I need to focus on an 09 comeback.

[SLM]

Unfortunately it appears that I also have something (Tendinitis) wrong in my triceps as well, so when I squeeze my fist or grip anything when my arm is at or near full extension I have some pretty intense pain back part of my elbow. Forget any strong hand only shooting.

That sounds like whatever I have going on. Sometimes if I just grip a glass of water wrong... AArgh!!!! Lots of OUCH!!!

Take care of yourself and get it healed up. I know how bad that can hurt.

[DonT]

I feel bad for you. When we talked last, I was also going through a severe bout of tennis elbow and was interested in your surgery and how your rehab was going. It took about 3 months for mine to get better after re-injuring it again.

Do whatever you have to do to let it heal. I don't think I will ever have the strength in that arm that I had before. But you learn to compensate by lifting, moving, etc., differently than you did before. You learn to baby that elbow and always wear a brace when shooting or working. When you do something you shouldn't, it lets you know immediately and that scares the crap out of me that I might have to go through another 3 month healing process.

I've also noticed that I often have pain in my bicep (not tricep) when arm is extended or stretched but I am attributing that to overworking those muscles from babying the elbow.

I wish you the best and hope you heal soon. But let it heal. The last thing you want is to push the mag release button or draw and feel the micro tears ripping from the bone.

Edited July 22, 2008 by DonT

[JThompson]

Sorry to hear of your continued issues.... I live with some pretty good pain in my wrist and I feel for you. Here's hoping they/you get it figured out.

JT

[badchad]

I have wrote what I think is a pretty good article on tendinitis. It’s been my experience that most doctors and therapists don’t know about this stuff yet.

Here's the article:

http://absolutept.com/tendinitispage.htm

Edited July 22, 2008 by badchad

[kimel]

Very nice article Chad! But without my background in anatomy I wouldn't have gotten much out of it. Care to post an abstract for the lay folk?

Glad to read the stuff about compression bands. I tried them and found them to be almost as annoying as the problem itself.

[Paul Burtchell]

http://www.activerelease.com/

Worked wonders for me.

[badchad]

Very nice article Chad! But without my background in anatomy I wouldn't have gotten much out of it. Care to post an abstract for the lay folk?

Glad to read the stuff about compression bands. I tried them and found them to be almost as annoying as the problem itself.

Thanks. The quick and dirty take home message is that concentric exercise is when you lift a weight. Eccentric is when you lower the weight (under control). So to do eccentric exercise with the painful muscle you want to figure out how to lift the weight with your good arm (in this case) and lower it with your painful arm. With lateral epicondylitis (tennis/shooters elbow) that generally means to do reverse wrist curls, griping the weight with your bad arm, but using your good arm to grab your bad hand and lift the weight, then let go with the good arm, and lower the weight with your bad arm. It’s a lot easier to do than to describe. I just got a video camera, and plan on taking another web design class so perhaps I can add demo’s of common exercises in the future.

3 sets of 10-15 reps is usually enough, and you want to use enough weight to cause mild pain by the end of the 3rd set. Do the workout 1-2 times per day 3-7 days per week. In my experience most guys end up working towards 30 plus pound dumbbells before the pain goes away. Research says it cures ~80% of people in 12 weeks, and my experience is along those lines.

For triceps tendonitis I would probably rig up a triceps pushdown machine, pushing down the weight with the good arm, changing hands and than raising the handle (lowering the weight stack) with the bad arm. This assumes that it is in fact triceps tendonitis, which I certainly don’t know is the case. I typed this in a hurry so let me know if I can be more specific.

Edited July 22, 2008 by badchad

[kimel]

Thanks Chad. I started on the eccentric exercises this morning after I read your article. I have it on both arms so have to get creative to not exacerbate one problem while trying to take care of another one.

[badchad]

Thanks Chad. I started on the eccentric exercises this morning after I read your article. I have it on both arms so have to get creative to not exacerbate one problem while trying to take care of another one.

It’s hard to be descriptive without using anatomical terms. However if it is lateral epicondylitis that you have (hurt on the outside of your elbow) and you have it in both arms you can usually keep from hurting the “helping” side by keeping your palm up while lifting the weight. You have probably figured out that doing the concentric lifting with the palms down is painful.

Also I usually start guys off with 5lb and work up from there. If doing home exercise and adjustable dumbbell with some extra small plates works well to keep from having to make too big of jumps from one weight to the next. I have also duct taped large 3 oz washers to dumbbells to raise the weight in small/reasonable amounts (2-3lb). As you work to greater weights, the washers/smaller jumps shouldn’t be necessary and you should be able to tolerate 5 lb jumps.

It sometimes does take some creativity, and it doesn’t always improve in a smooth and linear fashion so sometimes you have to keep the faith for a while, so to speak.

[North]

Ok, I saw the Physical Therapist (A Major in the USAF) today.

I carefully explained I can't extend my arm and grip without considerable pain. That the pain in my forearm was pretty much gone, but about 1 inch up from my funny bone it hurts like hell when I grip with any strength at all when my elbow is past about 160 degrees extended. That when I perform the triceps pull down (10lb) my elbow pops (and hurts) at least once per 10 set rep. That when I walk at any length my elbow gets really stiff and I must grab my collar to stretch out the arm to gain relief.

I also brought my MRI that no one but me has looked at for more than 5 minutes. (it looks like Picasso to me) He said that he can't figure those (MRI's) out without a radiologist report.

So he put me though a range of motion test, and I can move my wrist and elbow to an acceptable extent. But without even gripping anything when I fully extend my arm i have pain at the back of my elbow.

He concludes the surgery was a success and I am pretty much good to go. But because I'm having pain I will still come to therapy twice a week, and they will put me into building back my upper body strength. with regular push-ups and other normal exercises. He also had me perform several different stretches and then would ask me to extend my arm. When I finally said that the pain might have decreased, he said that to perform that stretch for ten reps five time a day.

I see the surgeon again on 28 august for my follow up. I will try to get in to my normal Dr. for a referral to a non-DOD physical therapist in in the mean time. Heck maybe I can get him to look at my MRI.

My arm got stiff just sitting here and typing this. And I'm drinking beer.

Edited August 2, 2008 by North

[John Dunn]

Having a PT or Primary Care doc look at your MRI is like having an orthopedic surgeon look at your EKG...it's not something they usually do with any regularity. For a good review of your MRI, I'd go over it with your orthopod, they have the advantage of correlating hundreds or thousands of MRIs with surgical findings. Good luck with your recovery.

[North]

I drove 90 miles to see my surgeon today. He had ask to me to bring a copy of my MRI with me. Well I did, But the US military security soft ware would not allow him to open it on a government computer. So he poked and prodded my arm. Could not really figure it out. He ordered a CT Scan and ask me to get a copy of the Radiologist report on the MRI He also gave a my Third injection on my elbow, but the first post surgery.

I get home in time swing by the place that gave me the MRI to get the copy of the report. (attached) To summarize it says I have a "partial thickness tear of the common extensor tendon, representing a probably a complete tear of the extensor carpi radialis brevis tendon."

When they did the surgery there was no mention of this, just the debridement of frayed tendons.

So it appears I have been walking around for a year with a torn tendon. I will try to contact the surgeon tomorrow.

Edited August 29, 2008 by North

[Michael Carlin]

North,

A US Army Major did a arthroscopic debridement of my right ulnar tendon fascia in 1998. It was probably several years before i considered it healed. Good luck.

Michael

Editing this to add that I am fully satisfied with the surgery, and had experienced increasing pain in my right elbow to constancy for fourteen years prior to my surgery.

Edited August 29, 2008 by Michael Carlin

[North]

North,

A US Army Major did a arthroscopic debridement of my right ulnar tendon fascia in 1998. It was probably several years before i considered it healed. Good luck.

Michael

Editing this to add that I am fully satisfied with the surgery, and had experienced increasing pain in my right elbow to constancy for fourteen years prior to my surgery.

What a coincidence, A US Army Major did my surgery as well. Don't get me wrong, he did a great job. Only he didn't get to he root of my problem. I think the torn tendons caused the tennis elbow (over use) in the other ones.

[Unleashed]

I have run the full spectrum of overuse injuries to include tennis elbow, carpal tunnel syndrome, shoulder separation, etc. and have found no better tool for any "finger to shoulder" injury than a Gyro Ball. Originally developed for tennis elbow injuries, the Gyro Ball quickly caught on in the rock climbing industry to increase grip strength. That was my original intent when I bought mine. I went from climbing 2" ropes to climbing 9mm rappel ropes in 6 weeks by using the Gyro Ball and increasing my grip strength. I found out what the thing was actually designed for and recommended it to my dad for his arthritis in his wrist. He noticed improvement in just a few weeks. I have had always had a problem with carpal tunnel syndrome and any time I have a flare up I just use the Gyro Ball for a week and it goes away. I have also experienced what seems to be tendinitis in my tricep just behind my elbow as you have described and have had great results using this thing. The best place to find them is REI but I am pretty sure there are other outdoor/mountaineering companies that sell them

I just thought I would throw my $.02 in there. If nothing else, your grip strength will improve!

[North]

I have run the full spectrum of overuse injuries to include tennis elbow, carpal tunnel syndrome, shoulder separation, etc. and have found no better tool for any "finger to shoulder" injury than a Gyro Ball. Originally developed for tennis elbow injuries, the Gyro Ball quickly caught on in the rock climbing industry to increase grip strength. That was my original intent when I bought mine. I went from climbing 2" ropes to climbing 9mm rappel ropes in 6 weeks by using the Gyro Ball and increasing my grip strength. I found out what the thing was actually designed for and recommended it to my dad for his arthritis in his wrist. He noticed improvement in just a few weeks. I have had always had a problem with carpal tunnel syndrome and any time I have a flare up I just use the Gyro Ball for a week and it goes away. I have also experienced what seems to be tendinitis in my tricep just behind my elbow as you have described and have had great results using this thing. The best place to find them is REI but I am pretty sure there are other outdoor/mountaineering companies that sell them

I just thought I would throw my $.02 in there. If nothing else, your grip strength will improve!

Yes indeed; I bought one when this first reared its ugly head. But the Ball can not mend completely torn tendons. But I do like them.

see the following link.

http://www.brianenos.com/forums/index.php?...mp;hl=gyro+ball

[North]

Update: Back in October see the Dr. and he assures me that they caught the torn tendon. He orders me back to therapy and to follow up with him in 2 months.

OK, so I have 6 weeks of 1 hour of hell 3 times a week (plus home work) under my belt with no improvement.

Drive the 90 miles (one way) to the Dr today. Get there the 15 minutes early like you’re supposed to. They call be back, and I only wait for the Dr about 3 minutes. I'm thinking this is my day.

The Dr asks how I'm doing. I tell him not so good, and then explain what and where it hurts, and what make it worse. I was really psyched because I was sure that me paying attention and being able to relay the information to the Dr. would do some good.

Then he tells me he is not sure what to do next. He needs to research it, maybe I'm just screwed (my word) or maybe another operation. Come back in January. So 180 miles round trip and I get let me think about it and see you in a month.

You would think that after referring me to therapy, he would have considered the three possibilities. 1. It worked. Great. 2. It helped. Great keep doing it. 3. No Improvement. bueler? bueler? WTF.

At least the day wasn't a total bust; I stopped by the Toys R Us and picked up my Boy some of the Wall-E action figures.

Edited December 9, 2008 by North

[GentlemanJim]

That just sucks

Mine comes and goes and I dont think a Doc will do me any good ...so I just cope with it.

I feel for you.

Jim

[JThompson]

That's why I just deal with the pain in my shoulders and wrist...

I wish you the best of luck

[North]

Yea, unfortunately dealing with it isn't an option. I'm limited in what I can do at work, and forget anything but the occasional plinking session. I maybe could get away with shooting the local monthly match, but nothing resembling regular practice.

[JThompson]

Yea, unfortunately dealing with it isn't an option. I'm limited in what I can do at work, and forget anything but the occasional plinking session. I maybe could get away with shooting the local monthly match, but nothing resembling regular practice.

I hear you... that's the only way I would allow it. Was it that bad before they started cutting on it?

[North]

Yea, unfortunately dealing with it isn't an option. I'm limited in what I can do at work, and forget anything but the occasional plinking session. I maybe could get away with shooting the local monthly match, but nothing resembling regular practice.

I hear you... that's the only way I would allow it. Was it that bad before they started cutting on it?

Actually it was worse. Before the surgery I could not pick up a 20 oz soda with my right hand. The pain in my right arm was just insane. Now it is still there and hurts quite abit, but I can do it.

For therapy they have me doing three sets of 10 each wrist curl, reverse wrist curl, then rotating the wrist one way, then the other way with a 3 pound dumbbell at full extension. After each rotation of the four exercises, my arm is pretty much locked up and I have to massage the hell out it to get to bend and then it don't like to extend back out. I sure do look forward to the Ice after that.

[JThompson]

Yea, unfortunately dealing with it isn't an option. I'm limited in what I can do at work, and forget anything but the occasional plinking session. I maybe could get away with shooting the local monthly match, but nothing resembling regular practice.

I hear you... that's the only way I would allow it. Was it that bad before they started cutting on it?

Actually it was worse. Before the surgery I could not pick up a 20 oz soda with my right hand. The pain in my right arm was just insane. Now it is still there and hurts quite abit, but I can do it.

For therapy they have me doing three sets of 10 each wrist curl, reverse wrist curl, then rotating the wrist one way, then the other way with a 3 pound dumbbell at full extension. After each rotation of the four exercises, my arm is pretty much locked up and I have to massage the hell out it to get to bend and then it don't like to extend back out. I sure do look forward to the Ice after that.

Man that would blow... my wrist gets so bad I can't do anything with it, but i comes back if I give it a rest. From the sound of how bad your is I'm going to quit my bitching and deal with the pain.

I do hope you get someone who can do it right.

[North]

thanks