Shooting and tennis elbow

[whipkiller]

Have you tried Cortisone shots?

I got very good results for my tennis elbow a few years ago.

Two (I think, maybe three) Cortisone shots and it's no longer an issue. I can still tell it's there, but not really painful, and I can do stuff just like I used to.

Racquetball, (that's how I injured it) shooting, hand tools, opening jars for my wife, all pretty much normal now.

While cortisone can give better short term relief than alternative treatment your chances of the symptoms returning within a few months is high and at 1 year post injury you may be no better off, or worse, than similar folks that did not have injections.

This is one of my specialty areas of treatment and I frequently perform literature reviews. I am happy to send any reference articles if you'd like to read up on the topic.

You sound very knowledgeable on the subject, and while I'm certainly not an expert on anything more than my personal experience with this, it has been years since I had the injections and my symptoms have not returned, and I am absoljutely better off than I was.

[AregularGuy]

You sound very knowledgeable on the subject, and while I'm certainly not an expert on anything more than my personal experience with this, it has been years since I had the injections and my symptoms have not returned, and I am absoljutely better off than I was.

I don't discount at all that the injections helped. I have seen many people that have had at least partial resolution of their symptoms after an injection. I have also seen many that have had no relief, as someone mentioned above. However, generally speaking, I don't think the docs doing these injections do a great job informing patients of the risks. If a patient has the luxury of time to "wait it out" then in the long run they may get to the same point or be better off without the risks. Those risks last a lifetime. What's a person to do? Not many of us have the luxury of resting our arms from the rigors of work and life activities unfortunately.

It's interesting that you mention that you can still tell it's there but does not limit your activities. This is actually quite typical after recovery from this type of injury, whether a patient has injections or not. That is what I meant when I wrote that 1 year post injury those who received injections were no better off than those who did not receive them. As an interesting aside, there are other central processing (brain) changes that happen after a bout of severe lateral elbow pain. This can be demonstrated by tenderness found on the uninjured elbow. Go ahead and poke around in the same area of the uninjured elbow and see if you can find a tender area that has no business being there. Changes in the ability to discriminate between hot/cold sensation have also been demonstrated, on both elbows, after injury to one elbow. That tells us that there is also some rewiring taking place in response to the chronic nature of the injury.

I'm glad to hear your elbow is holding up as this can be a real bear to tackle. Take good care.

[whipkiller]

However, generally speaking, I don't think the docs doing these injections do a great job informing patients of the risks.

I do recall the Doc saying if the two rounds of Cortisone I did were not successful that he wouldn't recommend doing more. Something about the Cortisone making the tendons get "brittle" or dried out? I don't remember exactly, maybe you could expand on that?

Not many of us have the luxury of resting our arms from the rigors of work and life activities unfortunately.

So true, unfortunately.

It's interesting that you mention that you can still tell it's there but does not limit your activities.

Yeah, I'm actually kind of glad that there's a little reminder there. It makes me cognizant of whether or not I'm doing something that might put undue stresses on the area. So far, so good.

As an interesting aside, there are other central processing (brain) changes that happen after a bout of severe lateral elbow pain. This can be demonstrated by tenderness found on the uninjured elbow. Go ahead and poke around in the same area of the uninjured elbow and see if you can find a tender area that has no business being there. Changes in the ability to discriminate between hot/cold sensation have also been demonstrated, on both elbows, after injury to one elbow. That tells us that there is also some rewiring taking place in response to the chronic nature of the injury.

So I've been sitting here at my desk poking around in my other elbow, and don't find anything that feels weird except that little funny button in the Humerus.

Haven't noticed any change in hot/cold sensation either, I'll do more testing on that later.

It's not surprising that my results are somewhat anomalous, ask most people who know me and they'll tell you that my brain ain't quite right.

I'm glad to hear your elbow is holding up as this can be a real bear to tackle. Take good care.

Thanks for sharing your expertise with us, what exactly do you do?

[beardog308]

I had the bursa removed after 25 years of down hill mountain biking crashes, 10 days ago. I developed a blood clot a day later and was put on anti coagulation that Blue Shield Gold wouldn't cover. I paid $700 out of pocket. Next, two days later a severe gout attack manifested itself in the hand of the same arm. I've never experienced that kind of pain. I would rather suffer from a third degree burn as that is mild compared to this. I can't take anything for the pain because of the blood thinners so I'm just working through it. I heal quick and should be good to go in a week. Now it's off to the doc to get the blood that's pooled in my elbow drained. This would all be very difficult without the support of my wife.

[imbryanxxx]

kt tape helps me a bit with tennis elbow

[Chapped Hide]

24 years of mountain biking and 35 years of golfing has taken it's toll on my elbows. I used to get cortisone shots in my right elbow about every 6 months up until about a year ago. The last one hit my ulnar nerve and just about sent me through the ceiling, that was it. Now I take ibuprofen every morning and that seems to control it pretty well.

[RobertMW]

I was starting to get tennis elbow from shooting. Took a break from anything for about a month, started to do weight lifting, good stretching, and tennis elbow specific exercises, completely gone within a few months. Now I've shot about 1500 rounds of 40 in the last 3 weeks at practices and competitions while the wife is away for work.

[AregularGuy]

Thanks for sharing your expertise with us, what exactly do you do?

Physical therapist.

[Leadingall]

I absolutely would not recommend this approach to treating a soft tissue injury. Even one shot of cortisone may begin to change the integrity of the tissue. Two or three and your potential for a tear increases dramatically, particularly in high load tendons. While cortisone can give better short term relief than alternative treatment your chances of the symptoms returning within a few months is high and at 1 year post injury you may be no better off, or worse, than similar folks that did not have injections.
Typically, if you have had symptoms for more than a few weeks, there is no more "-itis" or inflammation in the tendon. This necessitates a different approach to treatment, i. e. , ice for pain control, gentle stretching and exercise for the forearm, or more aggressive exercise if tolerated - Concentric or eccentric (negative portions) don't matter as much as simply exercising, addressing any muscle strength or flexibility imbalances in the upper extremity/upper quarter, elbow and cervicothoracic (lower neck) manipulation and mobilization with movement. It may take 6-8 months for this to resolve fully and you may end up with prolonged tenderness to touch (palpation) at the elbow, or even tenderness of the other elbow, even if your grasp and function is pain-free.

This is one of my specialty areas of treatment and I frequently perform literature reviews. I am happy to send any reference articles if you'd like to read up on the topic.

...this, MWM's, stretching and strengthening. Good research supports use of a forearm band

[96chevjumps]

I have noticed most individuals that get tennis elbow have a major muscle imbalance in the forearm/biceps triceps region. Taking a small can of soup or similar weighted object and with the arm relaxed to your side while standing articulate your wrist away from your anterior and only go in the range that has zero pain. Minimize your repetition until you feel some pain relief and rinse and repeat a few times a day. Muscular imbalance is a s.o.b.

[protohyp]

I have noticed most individuals that get tennis elbow have a major muscle imbalance in the forearm/biceps triceps region. Taking a small can of soup or similar weighted object and with the arm relaxed to your side while standing articulate your wrist away from your anterior and only go in the range that has zero pain. Minimize your repetition until you feel some pain relief and rinse and repeat a few times a day. Muscular imbalance is a s.o.b.

So you're saying I should use my left hand more often?!


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[deerdeerdeer]

24 years of mountain biking and 35 years of golfing has taken it's toll on my elbows. I used to get cortisone shots in my right elbow about every 6 months up until about a year ago. The last one hit my ulnar nerve and just about sent me through the ceiling, that was it. Now I take ibuprofen every morning and that seems to control it pretty well.

I use glucosamine and it helps out a lot on the joints. Sometimes I will mix it up with ibuprofen, and that's one a day I am surfing for 5-6 hours, because I know it's going to hurt.

[caliboy]

Good info on here, I was diagnosed with tennis elbow/tendonitis early Dec from using cable cutters wrong at work. Lifting weights prior to being diagnosed did not help. Been on PT for the past month and a half but still have pain when i lift or move a certain way. I've noticed also your sleep position helps in regards to inflammation. I tend to sleep on my right side with arm extended out. My elbow feels very stiff and sore in the morning when I sleep this way as opposed to sleeping on my back or left side with my right arm over another pillow. I need to be better at icing it too. Hurts a little when I dry fire a pistol with my arm extended out.